How OneOncology is Reducing Employers’ Cancer Care Spend, Now the Largest Driver of Cost
Cancer care is now the largest driver of large employers’ health care costs according to Business Group on Health latest survey of 135 large employers covering 18 million people across the United States. This is driven partially by an increase in later stage cancers due to delayed screening during the pandemic, with 13 percent of employers saying they are seeing more late-stage cancers and 44 percent expecting late-stage cancers to increase in the future. Other factors include increases in drug prices and approval of novel therapies, which have been critical in improving outcomes, albeit at a hefty price tag.
However, perhaps the largest factor, and one that rarely makes headlines, is the increasing shift in site of service for cancer care to costly hospital-based settings. Multiple studies have shown that hospitals markup oncology drugs by over 250% and the price difference for other services such as radiation oncology can be much greater.
In 2020, the Community Oncology Alliance published that over the prior 12 years over 720 independent practices have been acquired by hospitals. Other studies have highlighted a 37% decline in the market share of chemotherapy being delivered in physician offices. These trends have only accelerated due to the challenges facing community-based practices during the pandemic and are expected to worsen with rising inflation and reimbursement pressures.
Previously, the largest driver of employers’ health care costs was musculoskeletal conditions. Numerous innovative services were then developed to combat this from companies including Hinge Health and Sword Health, both of which have seen rapid adoption by employers. However, employers have historically been hesitant to adopt similar solutions for cancer care. While digital solutions may not be as feasible in cancer care, a readily available solution is navigation of patients to high-quality, low-cost sites of care – namely leading community oncology practices. Employers are finally recognizing this, and new solutions are being launched through companies such as Employer Direct Healthcare, Carrum Health, Transcarent, and Cancer Study Group. Other companies, including Thyme Care, are also now offering similar services to insurance companies. These groups work to provide high value care through care navigation, ongoing member support, benefit redesign, member education, and alternative payment models.
At OneOncology, our goal is to provide the capital and support to enable leading community oncology practices to remain independent. Recognition of community oncology as the highest value cancer care is a critical component to that mission. That is why we have formed partnerships with leading national companies, such as Employer Direct Healthcare, as well as local employers and benefits consultants. In partnership with these companies, we are developing programs to not only lower employers’ costs, but also offer improved member experience, same-day or next-day appointments, access to innovative clinical trials, including cell therapy, and expansion of alternative payment models. While there is not one easy fix for the high cost of cancer care, by expanding our existing partnerships and creating new ones, OneOncology is committed to advancing solutions to lower employers’ costs, while also strengthening independent oncology practices across the country.