It is estimated that 4.8 million Americans of working age have cancer, and according to a recent study in the journal Cancer, one-third of patients with incurable cancer will continue to work. These facts are difficult for both individuals and employers, but an active partnership ensuring patients have access to the highest quality medical care and a supportive work environment is beneficial to both. There are many options for employers to expand or enhance support for employees with cancer, but the best options begin with benefit design focused on educating and empowering patients to achieve high-quality, effective care while minimizing unnecessary costs for the employee, employer and the health plan.
Anyone facing cancer wants to retain a normal life – whether that includes continuing to work, seeing friends and family, or maintaining a routine during treatment. Convenient and fast access to treatment supports that goal by leading to quicker treatment initiation, less scheduling challenges that interfere with work, family and friend commitments, and the confidence to continuing working rather than going on short-term disability. While the extent and impact of the disease will primarily dictate how achievable this goal is, so too does the cost of care. For many patients, the cost can be as devastating as the disease. One in three cancer patients with insurance experience significant debt or bankruptcy, and one in four do not refill a prescription or take less than recommended doses of prescription medication to save money. Employers can provide critical and trusted education to employees about how to improve care and mitigate costs related to cancer treatment so they can continue with their normal life and be a productive part of the workforce.
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We’ve found that providing financial aids tied to good care decisions is critical for both quality of care and reducing costs. The most effective way to provide employee-based financial incentives is to ensure employees have the resources and education needed to understand how each decision impacts outcomes and the expense of treatment.
Even when good family support is present, the average patient will find it challenging to manage the series of decisions needing to be made with complex care. Employers can build programs into benefit design to educate patients about choosing a doctor, what questions to ask, supportive care, ways to mitigate side effects and manage pain, how to avoid unnecessary emergency room visits and hospitalizations, and advanced care planning. A clear benefit to the patient is how quickly treatment can be initiated and in turn, a return to routine and re-engagement with supportive friends and family.
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Two common decisions patients face are where and when to seek care. When a patient wants to continue working while pursuing treatment or palliative care, the location of care can play a determining role in active employment. Often, it’s unrealistic for a patient to continue working when the site of care is hours away from home. Importantly, effective, high quality care can many times be proximal to where the patient lives and works. Community oncology practices, aside from their convenience locally, provide high-quality care that is also cost-effective. Studies show that compared with patients managed in community office settings, the average cost per chemotherapy episode is 27% to 50% higher in hospital outpatient clinics.
The symptoms and side effects of cancer present patients with ongoing decisions about when to call a doctor or go to the emergency room. Studies show that reduced hospitalization and emergency room visits can decrease the cost of cancer care by 10%. The best way to achieve this is to facilitate active participation of the patient in monitoring and reporting symptoms and side effects to their primary oncologist before an acute crisis arises. Employers can empower their employees with cancer to be active participants in understanding and managing their care plan, and when problems arise patients can be educated on when to seek emergency care or when to manage side effects at home.
Facing a cancer diagnosis and making decisions about treatment is not easy, and employers also find cancer to be a complex and foreboding challenge. However, employers can manage cancer-related healthcare costs by proactively creating supportive programs for their employees and providing resources that make those initial dark hours and the ensuing treatments easier to navigate. While we have found that financial incentives help reinforce best-practice decisions, employees must first understand what best practice looks like and what it will mean for them.
One key to successful implementation of a cancer management program is broad employee awareness. Incidents of cancer may be low for the average employer. Ongoing, internal announcements reiterating a commitment to empowering and educating employees diagnosed with cancer are imperative for enrollment and usage. An encouraging environment can help employees feel more comfortable discussing a cancer diagnosis with their supervisor, and a well-trained management and human resources team can, in turn, provide the employee with education and resources for their care.
AmerisourceBergen has put its deep knowledge of the oncology space and of the patient journey into practice with CareFront, a newly developed benefit program designed to support employees and empower them to maximize their care. The program is available to AmerisourceBergen’s own employees and is offered to other companies as well. The two pillars of CareFront are based on the two areas that health plans can influence in cancer care: treatment site selection best matched to the employee’s needs and avoiding unnecessary services through proactive, engaged care.
Patients, who are properly educated and understand when to seek care from their oncologists, can help optimize their own care and its cost. We’ve found that implementing this program into our benefits structure is good for our employees, good for their families and good for the company.ZW\?rO�U
