Trends in the Rising Costs of Care Among Self-Insured Employers

In this interview, Frederick M. Schnell, MD, FACP, National Cancer Treatment Alliance and Community Oncology Alliance, discusses the rising costs of cancer care for self-insured employers and how they can partner with cancer centers to continue to provide high-value care despite the cost increases. His presentation was part of the panel titled “The Hunt for Value in Value-Based Cancer Care: How to Meet Stakeholders' Evolving Demands” at the 2023 Clinical Pathways Congress + Cancer Care Business Exchange.

Frederick Schnell, MD: My name is Dr. Frederick Schnell. I’m a medical oncologist, hematologist. I have worked recently over the last six or eight years with the Community Oncology Alliance (COA) and a new organization called the National Cancer Treatment Alliance, both of which are governed under the awning of COA. I've served as the Chief Medical Officer of both of those organizations, and we are very actively putting together a product, which we hope will serve as a vehicle to drive cancer care in the self-insured employer community (called NCTA for short).

What factors have led to the rising costs of care for employers?

Dr Schnell: So employers, self-insured employers, we believe are the most important and underserved group in terms of what's going on for the insured sector in the United States. We have been working to educate self-insured employers about the advantages of modern cancer care, particularly focused on comprehensive genomic testing. We've been in that space for the last two or three years in a very direct way. We're also promoting the value of community oncology in terms of cost and quality. And we're building at the moment of what is going to be a very large network of predominantly community oncologists across a broad specter of the United States.

Do you see the cost going down in the future? If not, why?

Dr Schnell: Well, we hope costs could be driven down, and we think much of that is going to come under the umbrella of payment reform. So we're very aggressively, in the two organizations I just described, trying to get the ear of the federal government and also make self-insured employers aware that they need to come together to force appropriate pressures in the payment models that will allow very good care to be delivered at hopefully much more reasonable prices. So that's what we're hoping. We believe that we can provide much better care that is currently available at a lower cost point. And that's again, the purpose of us coming together as an organization.

How can employers maintain a high value of care while managing cost increases?

Dr Schnell: Well, that's the challenge. And I think the challenge will be met if the communities of self-insured employers come together with groups like ours that want to work collaboratively to deliver care. We believe it can be delivered more efficiently and with less expense in freestanding cancer centers, staffed and stocked by community oncologists. And [we] hope to do this in a broad way across the country.