Do you know anyone who has been touched by cancer? Chances are that you do. Cancer strikes thousands of people each year, and when it touches someone you care about, you want to know how you can help.
Employers are asking that same question. The National Business Group on Health (www.businessgrouphealth.org) wants to help them respond. They have begun a long-term project aimed at giving employers tools they can use in the fight against cancer. The NBGH partnered with the National Comprehensive Cancer Network (NCCN) to develop a series of comprehensive resource tools for large employers, which will include an Employer’s Guide to Cancer Treatment and Prevention. The information they develop will be released to the public domain, in order to benefit the most people possible, says project leader Ron Finch of the NBGH.
The 3-year project began in December 2010. “Our goal,” says Finch, “is to create an integrated, standardized approach to the delivery of cancer services. Employers need a full approach to cancer for their employees who have cancer, their employees who have a family member who has cancer, and their retirees who have cancer.” By joining with the NCCN, an organization focusing on research, they plan to translate the research into benefits language – which is the NBGH’s strong suit.
Not Just a Health Plan Issue
The obvious starting point is addressing cancer through the health plans. But the project extends to other benefits, because some may have a significant role to play. “We started thinking about, not only what are the evidence-based benefits we have in the health care plan, but others as well. What about disability management, for example?” Finch says. “Now that many cancers are treated more as a chronic illness than as a death sentence, how do we effectively manage disability? There are some critical questions that come into play.
“For example, once an employee has been diagnosed with cancer, has been out on disability, then comes back to work, what are the work limitations they may have? How do those get accommodated? What about having to be away from the workplace for infusions (such as chemotherapy)? How is that time managed? What about family medical leave—what do we need to know there, about family members who are taking time away from work to care for somebody?”
These and many other questions will guide the project and direct its ultimate format. But if you’d like to tackle some of the cancer-related issues in your own workplace, 3 years is a long time to wait. Finch says there are several things you can do right now.
Make sure that cancer screenings are available – and emphasized. Finch says that many employees don’t realize that preventive services are available to them, and he suggests a robust communications plan featuring their importance. “Make sure employees get those screenings, that mammograms are done, prostate exams are done, colonoscopies are done. Just think about cervical cancer; we now have a vaccination that keeps cancer from forming! Make sure that employees get those preventive services so that cancer can be detected and treated early.”
“I believe that screening should be done, not only through the health plan, but also through the disability plan,” Finch continues. “For example, if an employee has been on disability because of some respiratory problem, has that person been screened for tobacco use? With the disability plan, we generally think about getting the person back to work as quickly as possible, but what about the long term? Making sure those preventive services are offered is valuable.”
Review your health promotion/wellness program for cancer prevention ideas. “We now know that about 60% of cancers are caused by lifestyle issues,” says Finch, “in terms of smoking, or how we eat. And we’ve seen the relationship between cancer and obesity.” Encouraging smoking cessation, weight loss, healthy eating and exercise are great lifestyle choices that may prevent cancer.
Find out how your EAP treats cancer issues. Finch says that not all employee assistance programs (EAPs) are effective at dealing with issues around cancer. “I would make sure that the EAP counselors have the kind of skill sets that are needed for assisting employees and their families with concerns about cancer,” he says. “Make sure they are knowledgeable about hospice care and palliative care, so they can assist employees and family members facing end-of-life issues.”
Learn how your pharmacy benefit manager treats out-of-pocket costs. With the continuing rise in the cost of health care, carriers and employers have had to take a close look at exactly what to include in out-of-pocket maximums, Finch says. “Some employers are taking a look at the out-of-pocket expense,” he says. “Historically, employers have included all the expenses in the out-of-pocket maximum, but more recently, just in the last few years, some have been excluding pharmaceuticals from the out-of-pocket maximum because of the high cost of biologics. Now that they have done away with including the pharmacy benefits in out-of-pocket maximums, some employers are rethinking the whole issue. Some have made the decision to go back and include pharmaceuticals in the out-of-pocket maximum, because they do not want their employees just giving up on treatment because they can’t afford the expense.”
Consider the whole person
Finch urges employers to consider the whole person when developing a strategy to combat cancer. “When we think about cancer benefits, we need to think about three areas: the general medical benefits, the pharmacy benefits, and the mental health benefits. The emotional component is important because we know that making the immune system fully effective in the fight with cancer requires that the patient manage their stress so they can manage their immune system.”
Part of the stress a cancer patient feels is likely to be financial. HealthReform.gov reports that even among those individual with health insurance, 22% report using up most or all of their savings fighting their cancer. According to the American Cancer Society, only about 1/3 of the actual costs of cancer are direct medical costs. The rest of the cost is indirect, covering things like time off to get treatments and to recover, for the patient and other family members. Offering a voluntary cancer insurance policy could help offset some of those costs.
Whether you decide to wait for the employer toolkit, or begin the fight on your own, you can do a lot to prevent and to ease the impact of cancer on your employees. Start now.