What to Know About Cancer Benefits

Cancer is a sad, painful reality for many people and their families—and while employers want to be able to support their employees through their cancer diagnosis and treatment, there’s no denying that cancer benefits are complex and can get quite expensive for both employers and their employees.

In a recent report based on a survey of large employers, 86% of respondents named cancer as the top condition driving healthcare spend. Knowing this, it’s that much more critical for companies to stay up-to-date on matters of cancer care and how best to support employees in navigating it.

In our recent webinar, The State of Oncology Benefits in 2024, with PwC US’s Director of Healthcare Strategy Kristin Craig, MD Anderson’s Chief Quality and Value Officer Dr. Kerin Adelson, and Carrum’s Market Vice President for Oncology Deirdre (De) Saulet, we discussed the current state of cancer benefits.

Here are a few takeaways from the webinar:

1. Employers need to learn more about what their employees want and need—specifically around cancer benefits

While cancer is a common and widespread concern, every individual, family, and employee population has unique needs when facing a cancer diagnosis.

“When you ask employees what they really want, it might be a little bit different than the problems the employer thought they were solving for,” says Kristin.

One large employer, for example, learned from surveying their employees that, “beyond the actual cancer diagnosis, [employees’] biggest pain point was the admin piece”—eligibility forms, programs to sign up for, appointments to make, and so forth.

The more employers can maintain open lines of communication with their teams—whether through individual conversations, anonymous surveys, Q&A sessions at all-staff meetings, or something else in a similar vein—the better equipped they’ll be to offer cancer benefits and resources that will serve their people in a meaningful and cost-effective way.

In these conversations and information-gathering sessions or surveys, make sure to go beyond matters of testing and treatment and also address things like mental health and caregiver support.

2. Don’t ignore end-of-life care

In a poll we conducted during the webinar, not one of the 61 attendees named “end-of-life care” as their biggest focus area when it comes to cancer benefits.

“Early-stage cancer makes us think of cures and is inherently sexy,” Dr. Adelson says. But “it’s end-of-life care where we, as a society, are getting the least for our money.”

For example, the Medicare costs for end-of-life care are approximately three times higher than what they are for an earlier stage of care—and even with its high price tag, end-of-life care is the least beneficial because patients, unfortunately, don’t live long enough to reap the benefits.

According to Dr. Adelson, studies show that cancer patients who have proactive, honest conversations with their providers about prognoses and end-of-life care experience far better outcomes than those who don’t.

“When patients continue to receive cancer-directed therapy that’s no longer working, they’re much more likely to die in the intensive care unit, to have repeated hospitalizations, to spend those last months of life in medical facilities instead of at home peacefully with their families,” Dr. Adelson explains.

When employers search for the best cancer benefits, they should make sure they understand the support that’s included for end-of-life care (if any). “We talk about quality of life all the time,” De adds. “We need to normalize and have conversations about quality of death in this country.”

3. Employers want to find a “one-stop shop” for cancer benefits

Based on findings from the report, the panelists see a real call for streamlining services when it comes to cancer benefits.

 

“Part of what we heard was frustration and overwhelm around point solution fatigue,” Kristin explains. Employers would love to have “one place that they could go to instead of having to cobble it all together for themselves and their employees.”

4. Optimize cancer benefits offerings to yield the best health outcomes 

Streamlining cancer care (as much as possible) is better for the employees, too. Employers can serve their populations best when their benefits packages offer access to care providers and systems with robust facilities, skills, and resources.

There are “cancer care delivery providers with whom we know the patient will get their cancer treated with the optimal, most evidence-based way, that they will get the care coordination and support they need, and the mental healthcare, the survivorship care—and they will receive it all with an eye toward cost containment,” says Dr. Adelson.

Providing patients with access to high-quality care that’s convenient, efficient, centralized, and affordable can set them up for better outcomes and a more positive journey through a challenging experience.

5. We’re getting closer to bundled cancer care—but not everything can be in a bundle

Traditionally—and like many other healthcare services—cancer care has been delivered via the fee-for-service healthcare model, in which a price is assigned to each and every individual procedure, visit, or service.

“There is no question,” says Dr. Adelson, “that in our fee-for-service system, cancer care delivery costs are out of control, and sometimes with elements that don’t actually benefit the patient.”

Slowly but surely, the industry is moving toward a more bundled approach for cancer patients, and everyone has high hopes for what bundled payments could mean for people diagnosed with cancer.

However, as Dr. Adelson notes, “when we talk about one-stop-shopping for payment, I think we need to be a little bit realistic. Not everything in cancer care at this point today is amenable for a bundle.”

“I think we’re going to get closer over the next five to 10 years being able to build more and more aspects of care delivery into bundles,” Dr. Adelson continues. “But I think the key is to focus on getting your patients into centers that are at least dipping their feet into the space.”

We all dream of a day when conversations about cancer and cancer benefits become moot. In the meantime, information like what we’ve gathered in our recent report can help shape standards for cancer benefits to help employers support an employee who has cancer.

To learn more about the state of cancer benefits—and where they’re going—watch the webinar.

The information contained on this page is for informational purposes only. No material is intended to be a substitute for professional medical advice, diagnosis, or treatment.