NEW YORK, NY--(Marketwired - Nov 2, 2016) - Employers can take several immediate actions to increase the value of cancer care benefits they provide to employees and their families, says a new report from Northeast Business Group on Health (NEBGH). The report, "High Value Cancer Care: Guidance for Employers," says steering employees to high value sites of care, ensuring the availability of second opinions and educating employees about the benefits of palliative care early in the treatment process can all increase the value of clinical cancer care. When it comes to support services, making sure that employees and families have access to behavioral health services and assistance in dealing with the financial complexity associated with cancer treatments are especially high value, says the report.
"Employer benefits professionals are not meant to be experts in healthcare, but they are nonetheless faced with making difficult decisions about buying care and support services that affect the health and wellbeing of their employees, as well as their organizations' bottom lines," said Laurel Pickering, President and CEO of NEBGH. "These decisions are especially critical when it comes to cancer given the seriousness of this illness, the impact on employees and families emotionally, financially and career-wise, and the dollars at stake for an employer. As a result, employers are seeking guidance in doing what they can to amplify the value of the cancer care benefits and services they offer."
NEBGH's report is based on interviews with cancer experts and employer benefits professionals, and a May 2016 workshop attended by 48 stakeholders -- employer benefits professionals, oncology experts, care providers and health plan executives. It notes that healthcare in general in the U.S. is moving from a primarily volume-based, fee-for-service system to one in which value is central, and as a result, the cancer care landscape is also undergoing significant changes ranging from new options for better navigation and coordination of care, and more personalized and precision-based treatments, to new payment models like bundles and total cost of care.
"Gauging the relative value of cancer treatments is challenging given the complex and rapidly changing landscape, so as the marketplace continues to shift, we've identified several aspects of clinical care that can have a significant impact on the value equation for employers as well as employees and their families," said Jeremy Nobel, MPH, MD, and Executive Director of NEBGH's Solutions Center, which conducted this work. "Understanding what high-value services to look for when evaluating sites of care; making sure patients have access and coverage for seeking expert second opinions whether via health plan-recommended specialists, a Center of Excellence (COE) or third-party second opinion services; and encouraging employees to educate themselves about the benefits of palliative care and to request it early in the treatment process are all important steps employers can take right now.
"Employers also need to help employees address the emotional issues, workplace concerns, financial worries and other problems that accompany a cancer diagnosis. We've concluded that the availability of behavioral health services preferably integrated with clinical care and offering some type of assistance in navigating bills and paperwork are two critical components of high-value support services employers can offer," said Dr. Nobel.
NEBGH's report provides information on various value-based approaches to payment for cancer treatment and oncology drug pricing, and encourages employers to signal interest in these to health plans and PBMs. Employers are also encouraged to act as a catalyst for connecting the cost of cancer care more directly to the value of treatments, including requesting reports from health plans that place greater focus on patient-reported outcomes.
NEBGH is an employer-led coalition of healthcare leaders and other stakeholders with the mission of empowering members to drive excellence in health and achieve the highest value in healthcare delivery and the consumer experience. The Solutions Center is NEBGH's research and discovery platform for identifying the most promising, innovative opportunities for improving health outcomes, focused on employers as the catalyst for change.
Merck and Genentech provided funding to NEBGH's Solutions Center for its work on high-value cancer care.
Access the guide here.
For more information, contact Laurel Pickering at firstname.lastname@example.org or 212-252-7440, ext. 224.