It’s a staggering and sad reality: cancer patients today are more worried about the cost of their cancer care than dying from the disease.
They needn’t be, not as long as their employer health plan has an oncology center of excellence in place.
More employers, in fact, are doing just that.
Half of employers surveyed say they will have added a center of excellence option for cancer in their health plans in 2023, while another 26% are considering doing so by 2025.
That oncology spending has been on the rise should not be news to any of us.
Costs for cancer-related medical services and drugs are expected to reach nearly $250 billion in the U.S. by 2030 — a 34% increase since 2015, according to a study by the American Association for Cancer Research.
And while oncology accounts for only 1% of claims volumes, it makes up 15% of the overall employer health care spend.
Adding a center for excellence to your group health plan is, we know, a better way to manage that cost. Adding a COE feature to your company health plan means no longer having to deal with huge cost discrepancies or inconsistent outcomes for the same procedures.
(This option, we should note, is available to self-funded plans, not traditional plans.)
With a COE in place, your employees receive care from world-class physicians focused on delivering comprehensive, evidence-based specialized treatment options, meaning patients benefit from the latest research on cancer care.
Moreover, cancer COEs offer patients a multidisciplinary approach, so that more than one doctor is involved in a patient’s care. In that way, the doctors can share information and collectively make the best decision regarding care.
COEs also include needed ancillary resources including nutrition counseling, physical therapy and financial counseling; it is a more holistic approach to patient care.
As part of that approach, COEs have staff who try to make the logistics of obtaining care easier. Sometimes called “navigators,” these good people guide patients through the health care system and help them understand their options, overcome barriers, and make informed decisions about their treatment.
A navigator also will coordinate with the multidisciplinary team to help schedule appointments, assist through the surgical and rehab process, and answer questions along the way.
Patients who receive care using a COE also never receive unexpected medical bills, if any at all, and will often have their cost-share waived.
In other words, the employee receiving care through a cancer COE can focus on getting better, not how much doing so might cost them.
The Mahoney Group, based in Mesa, Ariz., is one of the largest independent insurance and employee benefits brokerages in the U.S. An employee-owned organization, we’ve been providing our clients with the confidence to face whatever lies ahead for more than 100 years. For more information, contact us online or call 877-440-3304.
This article is not intended to be exhaustive, nor should any discussion or opinions be construed as legal advice. Readers should contact legal counsel or an insurance professional for appropriate advice.