Question 1

What should employers look for in a cancer benefit solution?

Accepted Answer

Key evaluation criteria for cancer benefit vendors: centers of excellence (COE) network quality and outcomes data, second opinion services (access to NCI-designated cancer centers), care navigation (dedicated oncology nurse navigators), financial support (copay assistance, travel benefits), clinical trial access, and outcomes measurement. Request vendor-specific data on time-to-treatment, COE utilization rates, and member satisfaction scores.

Question 2

What is an oncology center of excellence and why does it matter?

Accepted Answer

An oncology center of excellence (COE) is a high-volume cancer center — typically an NCI-designated cancer center or academic medical center — that has demonstrated superior outcomes for cancer treatment. Studies show that high-volume cancer centers have 20–40% lower mortality rates for complex cancers compared to community hospitals. Cancer benefit vendors direct members to COE facilities, often with waived cost-sharing and travel benefits, to improve outcomes and reduce total cost of care.

Question 3

How much do employer cancer benefit programs cost?

Accepted Answer

Cancer benefit programs typically cost $2–$8 per employee per month (PEPM), depending on the scope of services (COE network only vs. full navigation and financial support). ROI studies show cancer programs return $2–$5 for every $1 invested through reduced unnecessary treatment, fewer complications, and lower total episode costs. Cancer is the second-largest cost driver for most employer health plans, making dedicated cancer benefit management one of the highest-ROI investments.

Question 4

What is a second opinion service for cancer and how does it work?

Accepted Answer

A second opinion service connects employees diagnosed with cancer to expert oncologists at leading cancer centers (Mayo Clinic, MD Anderson, Memorial Sloan Kettering) for an independent review of their diagnosis and treatment plan. Studies show that second opinions change the diagnosis or treatment plan in 20–40% of cases. Most cancer benefit vendors include second opinion services as a core feature, with turnaround times of 5–10 business days and no cost to the member.

Question 5

How do I evaluate cancer benefit vendors for my self-funded plan?

Accepted Answer

Evaluate cancer benefit vendors on: COE network breadth and quality (number of NCI-designated centers, outcomes data), second opinion access and turnaround time, care navigation model (dedicated navigators vs. call center), financial support programs, clinical trial access, data and reporting capabilities, and integration with your TPA and health plan. Request case studies and outcomes data from current employer clients of similar size and industry.

Cancer Benefit Solution Profiles

AccessHope

Cancer Expert Now

Carrum Health

Color Health

Jasper

Lantern

MSK Direct

OncoHealth / Iris

Thyme Care

Transcarent Cancer Care