While cancer deaths have been declining since the early 1990s, costs have continued to increase, with more than $ 147 billion spent for cancer care in the United States in 2017.
Despite these rising costs, employers and health plans have been reticent to manage oncology care, and are also faced with keeping pace with technology and treatment advances.
To help purchasers drive better value and outcomes and reduce waste in cancer care, the nonprofit National Alliance of Healthcare Purchaser Coalitions released an assessment of how health plans are currently managing cancer for their employees and families.
The report identifies gaps in treatment and related benefits administration based on the National Alliance’s annual eValue8 survey of health plans.
The results reveal that health plan performance with respect to cancer care and support varies across plans, much as it does in other areas, like behavioral health and heart disease.
More importantly, the study found that even though health plans as an industry identified cancer treatment as a critical issue, there remains an essential need for plans to review and enhance the cancer patient’s journey so purchasers and patients have access to affordable and quality care.
The National Alliance dispensed a number of recommendations, including developing and communicating a patient-centered approach for cancer care benefits that provides comprehensive support to impacted employees and families.
Since many cancers can now be treated as a chronic disease, it’s also recommended to ensure care with an eye toward the entire patient’s journey, including psychosocial support, benefits coordination, successful recovery, ongoing management and an effective and accommodating return to the workforce.
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Another suggestion: Review current benefits coverage to assess against coverage needs for standards of personalized, evidence-based cancer treatment; and assess how new treatments can be included with an eye to reasonable costs for care.
The National Alliance also recommended changing how care is paid for to accelerate the adoption of best practices, and also to look to bundled payment options to address quality and cost.
It also suggested reviewing data sources and rooting out waste associated with high costs and poor outcomes linked to inappropriate or low-value care, poor adherence, and high cost variation by site of care.
The high cost of cancer care is no secret. In September, researchers from the University of North Carolina Lineberger Comprehensive Cancer Center estimated that screening and treatment for prostate cancer alone cost Medicare more than $ 1.2 billion annually over a three-year period from 2004 to 2007.
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