With the November 2013 release of An Employer’s Guide to Cancer Treatment and Prevention, the nonprofit National Business Group on Health (NBGH) and National Comprehensive Cancer Network (NCCN) culminated a three-year initiative to help employers battle cancer in the workplace.
The Employer’s Guide provides technical assistance to organizations as they design, implement and monitor the performance of their cancer-related strategies.
For employers and insurers, the costs associated with cancer are significant. Cancer expenses are one of the top three medical expense categories and represent an average of 12 percent of total medical costs, said NBGH President Helen Darling, speaking at a Washington, D.C., media briefing on Nov. 20.
“Cancer casts a wide net, affecting not only those diagnosed with the disease but also family members, friends, managers and co-workers,” said Darling. “With significant gains in cancer survival rates, and most cancer survivors staying at work during their treatment or returning to work after their treatment, employers need a comprehensive benefits plan to ensure that their current strategies to address cancer in the workplace complement the needs of their employees.”
She noted that:
- Approximately 12 million Americans have cancer, and 3 million of them are actively employed.
- Cancer is the leading cause of long-term disability among employees, representing about 17 percent of claims. Treatment for the disease represents a sizable share of short-term disability claims.
- More than 25 percent of workers act as caregivers for family members who have an illness, including cancer.
- There are many controllable lifestyle factors that contribute to cancer, including tobacco use (the most important), excess weight and obesity, and lack of exercise.
In addition, the two groups developed communication resources including Resource Guides for Different Employee Populations and related fact sheets, which companies can use to educate employees and their families about key decisions they need to make, and an Employer’s Companion Guide for educating workers regarding cancer prevention and treatment.
Delta Air Lines’ Commitment
Also at the media briefing, Lynn Zonakis, managing director of health strategy at Delta Air Lines, highlighted Delta’s initiatives that support cancer patients. These include full coverage for recommended cancer screenings, a Centers of Excellence program, ongoing communication on cancer topics, and Delta Health Direct—a confidential concierge health program that includes a nurse line, treatment-decision support, wellness coaching (including tobacco cessation) and disease-management services.
“Employers can play a major role in keeping workers healthy and also supporting cancer patients during treatment and return to work,” said Zonakis. “Employers are in a unique position to educate employees; design and provide benefits, so people can take advantage of them to stay healthy; and identify cancers early on, when they’re most treatable.”
Health-benefit design plays a critical role. For instance, Delta’s self-funded health plans allow patients to obtain cancer drugs either through the medical benefit (including infusions in hospitals) or through the prescription pharmacy benefit, Zonakis pointed out. For prescriptions, there are reasonable out-of-pocket thresholds in place: The maximum cost of an individual prescription is $75, with an annual out-of-pocket maximum of $1,200, after which all prescriptions are 100 percent paid. “We think it’s essential” to help employees stick with their drug regimens, she said.
Hospice and Palliative Benefits
Delta also offers up to 12 months of hospice coverage, Zonakis noted, adding that companies should remove any disincentive to using hospice benefits, which provide a holistic approach to end-of-life care. “Essentially, nobody is going to abuse a hospice benefit,” she noted. “You should have it in place to support people when they need it.”
Another component of Delta's program is palliative (pain-management) care. “The best practice is to bring palliative care to the forefront early in the cancer diagnosis so you can provide that support for the patient,” she said.
“We are always communicating,” Zonakis emphasized. “We have quarterly newsletters, monthly health fliers, e-mails, health fairs—having the right information available to people at the right time.”