CAPP and Employers Share Best Practices in Cancer Care at SIIA Meeting

Almost half of Americans will face a cancer diagnosis in their lifetime. For patients who are still working, this impacts their employers too. Employers are concerned about cancer’s impact on their employees’ health, medical  expenses, and employee productivity. 

The good news in cancer care is that more people are surviving their initial diagnosis and treatment. For some, cancer becomes a chronic condition that requires treatment for life. The not-as-good news is that the treatment experience for patients is more often than not fragmented and frustrating, with lack of coordinated care increasing the chance of medical errors as well as wasted time and resources. For those who are aware of the fragmentation in our existing fee-for-service health care system, it will not come as a surprise that the U.S. ranks last among industrialized nationals for coordinated care.

Providers and Employers: Allies Against a Common Foe

CAPP Chair Stephen Parodi, MD, joined a panel at the Self-Insured Institute of America’s national conference to share how coordinated cancer care can make a difference for patients. CAPP groups have made numerous innovations to improve health care for cancer patients, such as:

  • Leveraging the electronic health record (EHR) to track and proactively reach out to patients to receive preventive screenings for early detection and treatment.
  • Using care coordinators to streamline the process for patients. Coordinators schedule appointments in one day to avoid unnecessary trips, help getting test results acted upon quickly, and navigate the complicated journey so that patients and their families can focus on getting well.
  • Deploying telemedicine to link specialists for immediate consultations, virtual consultations in remote areas, and fast interpretation and action on test results. 

CAPP groups are also addressing the social determinants of health and lifestyle factors that can increase the likelihood of cancer. On the other side of the patient journey, they are developing palliative care programs and end-of-life planning, as well as support programs for survivors. 

Michael Thompson, president and CEO of The National Alliance of Healthcare Purchasers, shared the employer’s perspective and his Alliance’s in-depth report on oncology, with a focus on the patient journey. He noted that employers’ challenges with cancer care include:

  • Getting access to appropriate care in a timely manner with limited obstacles and barriers
  • The unwelcome level of financial burden on the employee for a course of treatment
  • Balancing quality and improved cancer care outcomes with a prudent eye on costs 

For employers, cancer accounts for more than half of health care costs, and more than half of employee diagnoses. For example, breast cancer represents 13% of total cancer claims, but the cost is nearly three times that of the next most costly cancer condition. 

New challenges faced by employers and providers include:

  •  a growing number of cancer cases are being diagnosed due to people’s  lifespans and lifestyle factors.
  • emerging treatment options like gene therapy and injectable drugs that can be very expensive and whose value may be difficult to measure.

Bringing Providers and Employers Together

Dr. Parodi recommended areas for employers to focus on to help ensure their employers are receiving responsible care, including:

  • Determine data needs that can measure outcomes and quality care in meaningful ways.
  • Understand and look for aspects of good coordinated care: meaningful provider connectivity and communication channels, the team approach, patient navigation and research-based treatment decisions.
  • Use plan designs that cover innovations to improve outcomes: telemedicine, relevant genetic testing, and patient navigation. 
  • Ensure psychosocial support for patients and families.
  • Offer solutions to the high costs that patients may incur, for example by guiding patients to quality in-network providers or asking questions about patient expectations. Ask to see evidence of improvement before funding high copays for specific drugs or therapies.
  • Provide access to preventive screenings and vaccines at an affordable price so that patients are not deterred due to cost. 

Seeing is believing, especially when looking at how coordinated care makes a difference in the patient experience and outcomes for cancer. That’s why CAPP created the video above to illustrate that difference. At CAPP groups around the country, patients experience how care coordination avoids a potentially dangerous surgery, how proactive prevention tied to the electronic health record detects a life-threatening cancer, and how care coordinators bring peace of mind and outstanding treatment to long-term cancer survivors. The video shares a few of their stories from CAPP groups Geisinger, HealthPartners, and the Southern California Permanente Medical Group 

For more information about cancer care, check out the CAPP paper, “The State of Cancer Care in America,” published with the American Cancer Society.

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