Los Angeles, CA—Worksite health centers can improve the quality and effectiveness of cancer treatment for employees while reducing costs for their employers.
Although they do not have specific cancer expertise, onsite health centers can support primary and specialty physicians in multiple ways, including navigation through an often fragmented treatment process, coordination of procedures, and monitoring, said Larry S. Boress, President and Chief Executive Health Officer, Midwest Business Group on Health, and Executive Director, National Association of Worksite Health Centers, at the Fourth Annual Conference of the Association for Value-Based Cancer Care.
Economic Burden on Employers
The impact of cancer on employers in monetary terms is conservatively estimated at $93 billion annually in direct costs and $18.8 billion from lost productivity. Because cancer is one of the most costly medical conditions, employers are looking for ways to improve traditional treatment methods, Mr Boress said.
Cancer treatment can translate into increased employer cost in the form of employee absenteeism, loss of productivity, and loss of health, and affects caregivers as well, said Mr Boress. Productivity decreases as much as 25% among employees who are acting as caregivers for family members with cancer.
Onsite Cancer Care Services
Mr Boress enumerated the benefits of onsite centers and, more specifically, how employers are utilizing them in an effort to help manage cancer care. Some employers are utilizing onsite health centers to support employees with cancer.
“We find that about 30% of companies of all different sizes have some form of onsite health services,” Mr Boress noted. These may be onsite, near-site, or mobile health programs. Some centers are large enough to serve several thousand employees, although many are much smaller.
The services employers provide vary greatly, ranging from only pharmacy services to full healthcare facilities with primary care physicians, nurse practitioners, imaging and infusion services, physical therapy, and more (Table).
The objectives of onsite health centers include improving employee health, increasing productivity and reducing absenteeism, offering occupational health and safety services, and increasing the effectiveness of health promotion efforts. Improving integration of health management efforts and reducing overall medical costs are other primary aims.
The ability to coordinate and collaborate care management, consolidate data, and improve visibility and access to services makes it possible for worksite health centers to achieve these goals. Onsite centers are capable of integrating worksite programs, providing easy access to services, and improving support for patient self-management.
Companies from highly diverse industries are developing worksite health centers. “They’re doing it, clearly, to improve the health of the population,” Mr Boress said. “What many of these employers have done is a reaction to the local health system not meeting their needs in access, quality, cost, and effectiveness. Also, they want to reduce their cost.”
Reducing productivity losses is an effective way to reduce costs. When an employee leaves work for a medical service or to visit the pharmacy, the employee is typically gone for 3 to 4 hours. “If you offer these services onsite, the employee can often be back in 30 minutes. It makes a huge difference in productivity and many employers are focusing on that,” said Mr Boress.
Addressing Fragmented Care
A lack of cost and outcomes transparency for cancer treatments and providers makes choosing appropriate options confusing for patients. According to a 2007 Commonwealth Fund study, many cancer therapies that can increase the chance of survival are not received by patients because of a lack of communication between doctors and patients. “Lack of communication, lack of interaction, lack of record-keeping and sharing, lack of a team approach have caused all kinds of problems,” said Mr Boress.
Adding to the confusion is the fragmentation of care that occurs with cancer treatment. After diagnosis, patients are usually sent to oncologists, undergo various tests, then treatments, return to their doctors for evaluation, and perhaps attend support groups. This care is often not coordinated. “The whole maze of uncoordinated care and providers causes lost time and productivity and confusion in general,” said Mr Boress.
Worksite health centers have the capabilities to address these cancer-related issues. These centers can offer cancer screening and prevention programs. They can provide support and assist in managing and coordinating care once an employee is diagnosed. “They can be the navigator to help them understand what lies ahead,” Mr Boress explained.
Worksite health centers can help to streamline the fragmented treatment process, support adherence to therapy, and assist with nutritional counseling, fitness, and coping strategies. Following treatment, centers can assist employees returning to function.
The ability of worksite health centers to implement these strategies can make cancer therapy more tolerable for employees and more economical for employers.