Supporting the Employee Journey Through Cancer: Carrum Health and AccessHope's Partnership

In the first video for Cancer Care Business Breakthroughs, Erich Mounce, MHA, Oncology Care Partners, speaks with Deirdre Saulet, PhD, Carrum Health, and Harlan Levine, MD, AccessHope, to discuss the recently announced partnership between Carrum Health and AccessHope. This partnership aims to help self-insured employers support their employees throughout the cancer journey, ensuring each patient has access to the right care at the right time.

This video kicks off the Cancer Care Business Breakthroughs series and the first topic area, "The Sleeping Giant: Cost of Cancer Rousing Self-Insured Employers." Future videos will include an explainer on self-insured employers, discussions on innovative solutions in the market, and a breakdown of what this all means for cancer care providers. If you have topics you'd like Cancer Care Business Breakthroughs to cover, let us know by using the Submit Feedback option below.

Read the full transcript:

Erich Mounce: Hello, I'm Erich Mounce, and over the past decade I've had the privilege of serving as a senior executive with some of the most dynamic delivery systems in oncology, such as West Cancer Center, OneOncology, and now the CEO of a new start up, Oncology Care Partners.            
            
During my tenure with these amazing institutions, I've had the opportunity to work with some of the most influential leaders within oncology delivery. As such, today I'm privileged to help launch the Cancer Business Exchange, in collaboration with HMP.            
            
To kick this off, we're launching a series of focused videos on the self-insured employer space. Why they care about oncology so much right now, and the solutions we're seeing that are beginning to develop in the market to address their needs.         
            
One recent headline that caught the Exchange's eye is a partnership between Carrum Health and AccessHope. We are lucky enough today to have brought two people from those organizations together. So, welcome to the Cancer Business Exchange. Let's dive in.
 
First, we'll start with our panelists introducing themselves. Deirdre Saulet, if you would start.      
 
Dr Deirdre Saulet: Hello, everyone. I'm Deirdre Saulet, please feel free to call me De, and I am Market VP of Oncology at Carrum Health. 
            
Mounce: Thank you. And Harlan Levine.       
            
Dr Harlan Levine: Hi, Erich and hi everybody. I'm Harlan Levine; I'm the President of Health Innovation and Policy at City of Hope. But I'm also the Chairman of the Board of AccessHope.         
            
Mounce: Thank you so much for both of you joining us today. First off, can you give us some context as to what you're seeing and hearing in the employer space when it comes to cancer care? We'll start with you first, Deirdre. 
            
Dr Saulet: Sure. So it's been really interesting to see, because cancer's quickly become one of employers' top concerns. For many years, it wasn't necessarily a top priority, not because they don't care about cancer, but because it's so complex, and it's so personal.  
            
But we've seen that change really dramatically for a few reasons. First off, we'll start with the obvious, and that was costs. There was a study in August of 2022 from the Business Group on Health, and that showed that for the first time ever cancer was the top condition driving large employers' health care spend. And employers are anxiously awaiting how the pandemic and the drop off in preventive care and screening is going to impact those costs moving forward.         
            
Additionally, I'll say, too, there's been a lot more awareness about the variation we see in patient outcomes and quality of care, adherence to evidence-based care, and just overall patient experience.   
            
Included in that is the patient's financial experience. A lot of employers are starting to zero in on financial toxicity. It's something we've been talking about in the oncology space for years now, and they are seeing the very real and very lasting impact that the cost of cancer has on their employees' overall well-being.

          
Mounce: Thank you. And Harlan, can you answer the same pot?    
            
Dr Levine: Yeah, I agree with De, and I would just drill down a little bit in some of that variability that she's referring to. It's driven a lot by disparities in health care, and inequity, and I think the employers are really picking up on this, and they know they need to take action.   
 
And in addition to being more costly, I think it is the complexity that De was mentioning. The employers are realizing it is so complex to take care of the cancer patient, and that the solutions that have been out there in the past aren't really meeting the needs.
 
And this is supported by data. When you look at the death rate of African American men being twice the death rate of their white counterparts for prostate cancer. And, you know, with black women the same for breast cancer, 40% more.   
            
Employers just know they have to do something as part of their imperative as an employer. So I think they're expecting more, and they quite frankly demanding more from the health care system.         
            
Mounce: Well, thank you. And Harlan, I know City Hope has been an amazing provider as it grows across the nation. And, you know, it's totally focused on providing, you know, innovative, adding care. But AccessHope is something different, and tell us exactly what AccessHope is doing to address these employer concerns.    
            
Dr Levine: So AccessHope started in the back room at City of Hope, and it started with the notion that we've just been talking about, that cancer is changing so fast with so many different subtypes, it's really impossible for every oncologist to keep up. So, unlike other conditions, there's really a gap in what the network can provide in terms of some of these more complex cancer issues.
 
So, we created a product that actually leveraged existing health operations, which is what's unique about this. We're working within health operations, and that design, in addition to the algorithms that we've used to identify the high-risk, highly complex patients, allow us to proactively reach out to those high-risk patients.     
            
And the product we started with was a very simple notion, which is, we are going to support the local treating oncologists. So, when appropriate, the patient can get the optimal care in their local community, closing the gap.
 
So, it started with City of Hope, and its NCI multidisciplinary expertise providing the support to the community. But it's grown much bigger than that. In the last couple of years, we've got Northwestern    join us, Emory, Dana Farber Cancer Institute, and most recently the Fred Hutchinson Cancer Center up in Seattle. So, we now have a wide and deep bench of NCI-level expertise supporting care to stay in the community.           
            
In addition to that, employers have demanded—well, they've actually said to us, "That's great for the highly complex care. But what can you do for the rest of our population?" So, we also have an opt-in program for the less complex that some employers have picked up on where anyone with cancer can reach out and ask for that support.
 
And that support really is, I think, a private tumor board for the treating oncologists. So, in our two products where we're supporting the oncologist, we've created a unique experience where the oncologist can feel comfortable that they have access to the most leading-edge information, and, quite frankly, they can have access or knowledge of some of the leading-edge clinical trials that are happening.       
            
And then, lastly, employers said, "Well, not everyone wants a second opinion, but they need support." So we created a cancer support line, which is made up of oncology-trained nurses that are there really just to help educate and help support people through the journey. Because it's a really complex journey, and people have questions, and they don't always think to ask their doctor. Quite frankly, they're sometimes more comfortable asking someone who they don't know the questions that they wish they asked their doctor.           
            
Mounce: Thank you, and especially, with the addition of those newer groups to your AccessHope network, it really creates a national sort of presence, as well as all of those other opportunities to deliver back locally. So that's pretty cool. Thank you. Deirdre, what exactly is Carrum focusing on?  
            
Dr Saulet: Yeah, Erich, so we're a center of excellence platform for commercial lives. And really the basis, the foundation of Carrum Health is that we are committed to driving high-quality value-based care. 
            
So, we do this through partnering with providers—those are centers of excellence—to set up bundles for specific procedures or conditions, and that includes joint replacement, spine, and bariatrics.          
            
We also have an oncology program, and that is really meant to help employers ensure that their members are receiving high-value, high-quality care, and are having an exceptional patient experience.      
            
So, for cancer care, for instance, we have solutions and programs in place that really cover the continuum from early detection and diagnosis to treatment planning to actual treatment bundles that include the cost of surgery, chemotherapy, and radiation therapy.           
            
Mounce: Cool. So that brings to sort of mind like, for Harlan. Why did you guys partner with Carrum? What is the vision for this partnership? 
            
Dr Levine: So, I think you just heard the reason why we combined. And you said, "Cool." It really is a cool concept, which is the industry is so used to offering one-size-fits-all products to the members, or to employers. And, you know, cancer is so many different diseases now, and each one really defined by its DNA, and patients just quite simply have different needs. Some need surgery, some need standard care, some need access to leading-edge information. Others need to have special procedures or a multidisciplinary approach that you might not be able to get in a community, and others need to be on a clinical trial.
 
So, the driver here was cancer care is different, and there's a greater need for personalization in cancer than there is in other conditions. So, this partnership puts the patient or the member in the middle, it identifies what the need is, and if someone needs to go to a specialized COE for a procedure or a treatment, they have that. But if they either don't have that need or can't travel for some reason, they can get virtual support from AccessHope and, by way of AccessHope, all the NCI experts that I mentioned before.          
            
Mounce: Great. And so with that, Deirdre, where do you see Carrum? I'm sure that they're looking at this vision similarly. But what, from an employer perspective, how do they look at this partnership?        
            
Dr Saulet: Yeah, Erich. That's spot on, right. So, as you could sort of piece apart from Harlan's points, you know, when we think about this from the employer perspective, one of the things we consistently hear from them is that they are concerned about integrating the different benefit solutions that they have access to, and making that really seamless for their employees to get to the right solution at the right time.  
            
So really, we want to help simplify and address that as much as we can. So, this partnership allows employers who are on our platform to turn on AccessHope through Carrum. This means on our end that we can provide a much more seamless experience for employees and their family members when they're facing a cancer diagnosis, so they can come to Carrum, and then we can help them get where they need to go. For instance, some patients might be eligible for a treatment bundle where they can get their surgery, chemo, radiation at a specific center of excellence, while anyone facing a diagnosis of cancer will be able to benefit from AccessHope. Right there they can go and get that expert review of their diagnosis and their treatment plan and have ongoing support across their journey.         
            
So, to sum it up, our overarching vision is that this is going to help simplify the experience for employers and for their employees and dependents. When we talk to employers about what they're looking for in a cancer solution specifically, their top priority is member experience. You know, they ask us, how can we help make a diagnosis of cancer as easy to deal with as humanly possible for their families, right, for their employees, and that really is what this partnership is going to help us accomplish.           
            
Mounce: Amazing. Really, Harlan, you and Deirdre both have talked about the patient experience, and how complex oncology care can be. So, Harlan, what do you see the future as it comes to self-insured employers and their cancer care benefits? I mean, it is so complex. How do you see that playing out for these employers in the future? And are you going to be able to broaden this program and offer even more specifics into oncology care?           
            
Dr Levine: It's a really good question, and it's always hard to predict. I think I know the endpoint. It's hard to predict how long it'll take to get there. I'll start by saying this: I don't think employers want to be directly involved in care delivery, but I also think the disparities and the gaps in care, the accelerating cost, the accelerating complexity, which is just different, it'll drive more involvement over time.
 
And as De said at the beginning, oncology really has moved from like a third rail topic, because of how personal and sensitive it was, to what is now a first imperative. And you're beginning to see employers move in that direction. They're offering multi-cancer early detection blood screening, which is a long way of saying the Grail test. But I also see employers are going to diverge from the path of health plans and payers that focus only on cost and don't place value on access to expertise.
 
So what I see is employers over time getting actually more proactive and supporting members to receive the right care the first time as opposed to step therapy and waiting to the end. So, I think you're going to see partnerships like the one we just talked about between Carrum and AccessHope, where you're facilitating access to best-in-class care and clinical trials and procedures and bundles in a cost-effective, affordable way. I think you're going to see employers driving the future of how cancer care should be delivered. So, I think there'll be the leaders in ensuring that genomic testing is done in all appropriate cases of tumor—of cancer care before treatment is started.
 
You know, I go back long enough in medicine that surgeons had to use their judgment of whether to operate on a person with gallbladder disease. I mean today, you can't imagine doing a gallbladder removal without an ultrasound. I think it's going to be very true of cancer care. You can't imagine starting treatment without getting full genomic testing. So, I think employers are going to make sure that their members are getting the right test before, because they want what's best for the patient, and they want to avoid waste from patients getting treatments that they really otherwise wouldn't get if they had their appropriate genomic testing.
 
And again, the data is there. You can look at a study from just a few years ago that 72% of people were not getting the right diagnostic genomic test for lung cancer, even though the evidence was clear. And there's a more recent publication that says still about, you know, only two-thirds get the right test, so I think employers are going to step up. They won't be providing the specialty care like they are getting more involved in primary care, but they're going to demand more use of leading-edge science and access to top health experts in order to achieve better outcomes.       
            
Mounce: Well, I certainly agree with you 100%, it's hard. It's so complex; it's hard to keep everything front and center. Even one of the health plans our new company is working with has shared data from claims data that more than 12% of their patients get started on the wrong care plans, or through the wrong diagnosis. So, I think there's a huge opportunity there. I love the thought about Galleri and Grail. That's going to be another video series.
 
But I guess I'd like to know, Deirdre, what do you see as the future?           
            
Dr Saulet: Yeah, I want to underscore what Harlan said. Where I think we're just gonna keep seeing employers take more of a front seat. I think that they really are sort of embracing and stepping into their role and having a stronger voice in cancer care, and sort of driving change. 
 
And I think another place that we're going to see them willing to get creative and start to think more seriously about is really just support across the entire continuum for their employees. And so I think that is going to be really looking at these different parts of the journey, so that could be on the early detection side, as Harlan mentioned, taking advantage of new innovations, or through diagnosis and treatment planning, and through active treatment, you know, making sure that patients are getting support for the many social, financial, psychological impacts of a diagnosis as well as the physical, of course, as well. 
            
One of the really big opportunities across the continuum that I think employers are going to be prioritizing in the near future is survivorship. We know cancer survivors are a growing population, and that they can be at high risk for all sorts of other conditions, like heart disease and anxiety and depression, and I think figuring out how to really improve care for survivors is, of course, a priority across the nation and for providers.   
            
But I think specifically, when we think about employers who are really worried about, and they're really invested in the long-term health and well-being of their employees. I think, I hope, we're going to start having some really interesting conversations about what survivorship solutions can and should look like from the employer perspective. 
            
Mounce: And I also just think cancer is becoming so much more of a chronic disease. It'll affect employers while employees are with them for years and years to come. So, I think it's really important to really focus on some of those things. 
            
Dr Levine: I think what De and you just said is really important for this audience, because right now there's a, you know, an under attention, if you will, to survivorship, and quite frankly supportive care.        
 
And I think anyone that's had a close family member, close friend, or a personal experience, you feel the lack of support during the journey, and then, even when you're done you're caught between your oncologist and your internist. There's a huge opportunity here to really advocate for supportive care and survivorship services. They just aren't out there today.           
            
Mounce: A hundred percent agree. And I think that's something that we'll continue to add on.   
            
Well, I want to thank you both. Great insights, Deirdre, Dr. Levine, I thank you so much for your time, and also participating in our launch of this video series. We look forward to building on this conversation in the upcoming forum videos. And we'll be covering other topics about the self-insured employer space, including industry explainers and other recent partnerships. So, thanks for watching, and I look forward to having you all again.