The Highmark Cancer Collaborative
Better cancer care that costs less.
Did you know that cancer costs employers $7.5 billion1 in lost productivity each year?
And the price of treatment in the U.S. is expected to reach over $200 billion a year by 2020.2 Many of these costs will be passed on to employers.
But you want to keep your employees healthy and make sure they’re getting the best possible cancer care.
That’s why we formed the Highmark Cancer Collaborative. We’ve brought together a health insurer, health providers, and researchers to transform cancer care for you and your employees by:
- Taking a patient-centered approach.
- Working to deliver safer, more efficient treatment with better outcomes through evidence-based pathways and protocols.
- Cutting costs by 35% by eliminating unnecessary care variation3 and helping to ensure members get the most appropriate care (not too little and not too much).
The Highmark Cancer Collaborative benefits you and your employees financially and delivers a better patient experience — including higher-quality and safer care and more healthy outcomes. There’s value in that.
Find out how to pay less for better outcomes
Fighting cancer on all fronts through the Highmark Cancer Collaborative
We bring together a health insurer, local providers, and national medical researchers to collaborate on new best practices and to share data. Each group contributes its strengths:
Health insurer – national best-practice data, operational and financial experience
Local providers – advanced clinical know-how in communities where people live
National medical researchers – expertise in treating rare and complex cancers
By sharing resources and establishing best practices, participants are improving cancer care while cutting costs.
Improved care comes with the best national safety standards and treatment outcomes for you and your employees.
This means more value for your health care dollar in terms of employee well-being and long-term cost reduction.
Safer, more effective treatment
Through the Highmark Cancer Collaborative your employees get the optimum course of treatment because doctors follow established clinical pathways. Clinical pathways are evidence-based treatment guidelines developed by leading national cancer experts, cancer centers, and disease-based societies.
Teams of specialists follow clinical pathways to provide personalized coordination of care for your employees. They work together to analyze best-practice data and decide on the safest, most effective course of treatment. This ensures the right amount of treatment at the right time and prevents complications from over exposure to radiation or chemotherapy drugs.
Having set treatment standards helps prevent fragmented and unwarranted variations in care that also contribute to the skyrocketing cost of cancer treatment. Which can put treatment beyond the financial reach of many individuals.
Access to premier local cancer care + world-class medical research institutions
Through the Highmark Cancer Collaborative your employees have access to premier cancer care expertise locally and a world-class medical research institution, plus access to the highest national care standards.
Johns Hopkins Medicine is a Preferred Referral Partner for Highmark health insurance members with rare and complex adult and pediatric cancers. This means:
- No matter where they live, Highmark members have in-network access to Johns Hopkins for the treatment of rare and complex adult and pediatric cancers. Plus lung and pediatric bone marrow transplants.
- Highmark offers a “concierge” program committed to enhancing member access to Johns Hopkins when necessary.
- Members have continued access to new technology and cutting-edge treatments available only at a handful of facilities nationwide.
Lowering cancer care costs for your employees and you
Cancer costs are rising at an unsustainable rate. In fact, 1 in 5 cancer patients stop taking medications because they can’t afford them.4
The Highmark Cancer Collaborative works to lower costs for you and your employees by rewarding doctors for the quality of care they provide patients rather than the quantity. Traditionally, doctors have been reimbursed according to the number of procedures they perform.
An alarming 30-50% of health care costs is due to unnecessary care and duplicate tests.5 Because physicians are no longer reimbursed for ordering multiple tests, they can evaluate patients more efficiently. And put member health, safety, and financial well-being at the center of care.
Better patient experience and convenience
The Highmark Cancer Collaborative helps ensure the best possible experience for patients by focusing on convenience. Because health care and coverage are connected through the Collaborative, it can remove administrative hurdles.
If your employees need radiation or chemotherapy, they do not need prior authorization before treatment. By clearing away the red tape, physicians are empowered to provide a more seamless patient experience.
And Highmark members are covered for routine cancer treatments at community-based facilities, at after-hours clinics, and through home-based services often eliminating the need for members to travel to big-city hospitals. In addition to reducing stress for patients, it reduces costs.
- Partnership to Fight Chronic Disease: Facilitating Full Employment Opportunity for Employees with Cancer: A Call to Action
- National Institutes of Health: Cancer costs projected to reach at least $158 billion in 2020
- Oncology Times: First Published Cost-Effectiveness Study of Evidence-Based Clinical Pathways Documents 35% Lower Costs with No Differences in Survival
- The Oncologist: The Financial Toxicity of Cancer Treatment
- HealthAffairs: Reducing Waste in Health Care