Cancer Insights & Action: Key Headlines from the Start of 2024

From screening adherence to oncology drug pricing and every micro-detail in between, the complexity of cancer care is top of mind for anyone who offers employer-sponsored healthcare. Here's what you need to know—and why:

• The nature of cancer in the U.S. is changing dramatically. Mortality rates are down, but incidence rates—particularly among those under the age of 55–are on the rise.?
• Some providers are creating barriers to basic cancer screenings–which are fully covered by the ACA—by introducing additional financial obligations for patients undergoing preventive testing such as colonoscopies.?
• In a recent clinical trial, direct-mail self-sampling increased cervical cancer screening by more than 14% in individuals who were due or overdue for screening.?
• New research from national Blue Cross Blue Shield claims shows oncology drug price markups vary wildly based on the site of treatment, dramatically impacting financial obligation for individuals undergoing treatment.
• According to CMS, nothing in cancer care is going to get cheaper any time soon, which further highlights the need for new models for early identification and cancer care management.

Key news and research deep dive

Key headline: The American Cancer Society releases Cancer Facts and Figures 2024.

Key takeaways from the report:

• For the first year ever, the American Cancer Society predicts there will be over 2 million new cancer diagnoses in the US.?
• The incidence rates of four screenable cancers–colorectal, breast, cervical, and prostate—are rising, especially among younger populations.
• Thanks to better care, mortality rates have declined.?
• Colorectal cancer is now the #1 cause of cancer-related death in men under 50 and the #2 cause of cancer-related death in women under 50.?

Impact: More cancer cases, especially among young people, mean more claims for employers and the need for new care strategies. Screening is particularly critical, as younger individuals are less likely to have a primary care provider or see them routinely.?

Key headline: Patients are billed extraneous charges from ACA-covered cancer screenings—including $600 for a surgical tray.

Key takeaways from NPR:

• The Affordable Care Act requires that insurers cover preventive care services—including recommended cancer screens such as colonoscopies, mammograms, and lung cancer screens—at no cost to patients.?
• But, medical providers have freedom to determine how they bill for care around the screening, which could mean charging patients for additional goods or services.?
• In Chicago, each member of a self-insured couple was charged $600 for “surgical supplies”, which, in this case, was surgical tray usage, after undergoing a preventive colonoscopy. While the entirety of the $2,034 screening was covered through insurance discounts or reductions, only $350 of the $600 supply fee was covered by insurance, leaving the couple with an unexpected bill of $500.?
• Patients can contest these charges, but the process can be time-consuming and unclear and discourage them from seeking preventive care more broadly.

Impact: Whether due to fear of results, lack of access, or uncertainty around testing needed, many individuals are already behind on their recommended screenings. Poor provider billing practices not only discourage compliance but also drive up overall health plan costs.?

New research: Strategies to increase cervical cancer screening with mailed human Papillomavirus self-sampling kits

Key findings from JAMA:?

• In a randomized clinical trial of over 30,000 individuals within Kaiser Permanente, direct-mail HPV screening kits doubled adherence among non-compliant patients versus education-only campaigns.?
• Health care systems should prioritize direct-mail options for individuals who are either due for or behind on HPV screening.?

Impact: Screening outside the walls of a doctor’s office through self-collected testing options, where possible, can help remove logistical barriers that accompany traditional, in-person care, resulting in increased screening adherence. Through more accessible screening methods and high immunization rates, cervical cancer can effectively be ended as we know it.

New research: Hospital prices for physician-administered drugs for patients with private insurance

Key findings from NEJM:

• Based on 2020–2021 Blue Cross Blue Shield claims data, price markups at some hospitals were nearly 7x higher than those at independent physician practices.?
• Hospitals that imposed these high price markups retained a large portion of insurer spending on physician-administered drugs for patients with private insurance.?

Impact: Though “site of care” is a much-discussed lever in cost management for oncology treatment, this study demonstrates just how significant the delta can be on oncology drugs and highlights the potential for cost savings through navigated support that prioritizes high-quality and cost-effective treatment.

New data: National Health Expenditure (NHE) analysis from 2022, published in December

Key data from CMS:

• Specifically, out of pocket spending grew 6.6%, private health insurance spending grew 5.9%, and prescription drug spending increased by 8.4%.
• The projected NHE growth of 5.4% between 2022 and 2031 will likely outpace GDP growth, at 4.6%.

Impact: Across the board, healthcare costs are on the rise and are projected to continue rising through 2031. In order to get ahead of growing cancer-related expenditures for individuals and organizations, detecting cancer earlier and providing more cost-effective care is essential.?

Resources and upcoming events

Get more information, data, and resources from Color.

Read:?

• The Employer Insights Report: The State of Cancer | The Harris Poll & Color
• Confronting Cancer’s New Landscape: Key Insights from the 2024 ACS Facts & Figures Report | Alicia Zhou, Chief Science Officer, Color
• How to Get Ahead of the Priciest Health-Care Expense—Cancer Care | Othman Laraki, CEO of Color & Brian Marcotte, Former CEO of Business Group on Health

Attend:?

• National Labor and Management Conference | February 15–20 | Hollywood, FL
• Transform | March 11–13 | Las Vegas, NV
• Conference Board Annual Health Care Conference | March 19–20 | San Diego, CA

Learn more about taking control of cancer at color.com.