Cancer is one of the most expensive conditions to treat, driving about 20 percent of a company's healthcare spend, said Hugh Ma, co-founder and Chief Executive Officer of Robin Care, which guides workers through cancer illnesses.
Rather than focus on the big picture of cutting costs, some companies are designing benefits that specifically target certain conditions.
Often the first step is for a company to contract a third-party patient advocate like Robin Care or Edison Health that specializes in cancer cases. This is because human resources departments cannot delve into the particulars of an employee's health issues, due to privacy rules.
The benefit of these subcontractors is that they can really be there and hold your hand, said Dave Chase, co-founder of Health Rosetta, which promotes healthcare reform.
"All they deal with is cancer. Having somebody available on your side is good," Chase said.
Tom Emerick, CEO of Edison Healthcare, works with about 5,000 client companies and gets personally involved in cancer cases.
Emerick's first priority is to make sure that the cancer gets diagnosed properly. About 30 percent of the cases he handles are misdiagnosed originally, he says. Many workers are sent for surgery they do not need or expensive treatments that will not help them, he added.
Edison works to get patients to the right place for treatment based on the type of cancer they have.
A top echelon of cancer treatment hospitals are designated as Centers of Excellence, and companies can contract for services with them directly or through their insurance provider. Centers of Excellence also help workers with organ transplants.
Currently, 40 percent of large companies use Centers of Excellence for cancer care, up 10 percent over the past two years, according to the National Business Group on Health (NGBH), a nonpartisan research group for large employers.
About 24 percent more large employers have said they plan to start offering this benefit by 2021.
In addition to helping with specialized care, companies are easing the cancer burden in other ways.
Some companies, like Delta Air Lines, will also cover travel costs up to $10,000 for the patient and accompanying family to go to a special facility.
"That goes a long way," said Vickie Strickland, director of health strategy and resources for Delta, which is based in Atlanta, Georgia.
Only a few of the few thousand employees dealing with cancer hit the $10,000 limit each year, from a workforce of 150,000.
"It’s a nice message to send to the employee: They care enough about you to send you to the Mayo Clinic to make sure you get the best treatment. With the misdiagnosis rate, it easily pays for itself," said Health Rosetta's Chase.
Top cancer centers can do advanced genetic testing on patients to identify those mostly likely to benefit from particular treatments, avoiding extremely costly new regimens for those unlikely to be helped by them.
"I can't imagine what our costs would be if we weren't doing all of this," said Delta's Strickland.
Nearly 30 percent of large companies are also offering incentives for employees with cancer to use the case management companies or an on-call nurse to help manage their condition, which can involve dealing with treatment side effects and future care choices.
Employers deposit money into the health savings account or offer some other type of monetary reward, according to NGBH.
Sometimes getting to the right place is just the start. At Robin Care, Hugh Ma helped an employee deal with her elderly mother's stomach cancer diagnosis. All the experts concluded that the woman needed her stomach removed, and fast, but she balked.
Ma assessed the situation. He found another elderly Vietnamese woman who had had the same surgery to reassure the patient that the treatment was safe.
"We were visiting her in the recovery room four days later," Ma said. His conclusion: "When you take the approach to support the human being, you’ll have better outcome and lower costs."
(Editing by Lauren Young and Bill Berkrot) ((firstname.lastname@example.org; 1 646 223 7289; Reuters Messaging: email@example.com)(Twitter: @bethpinsker))
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