Employers bracing for rising cancer claims

April 27, 2022

Suzie Kim

For the past two years, discussions around employee health have focused on mental wellness and post-pandemic resilience. But employers are also facing what some are calling a shadow pandemic of serious acute and chronic illnesses, including cancer.

Cancer is the leading cause of death for people in Canada, and the pandemic has created delays in testing, diagnosis and treatment that could reverberate for months or years. In fact, 68% of large employers expect to see more late stage cancer diagnoses among plan members. This article looks at the consequences of the pandemic on cancer and how plan sponsors and managers can respond.

Cancer in the shadows

Each year, more than 220,000 people in Canada are diagnosed with cancer. About 40% of the population will develop some form of cancer in their lifetimes and 25% will die from the disease. As our population ages, new diagnoses are expected to grow by about 40% by 2030.

As frightening as these statistics are, it’s worth noting that Canada is a world leader in cancer research and has among the highest survival rates in the developed world. For example, death rates for both breast and prostate cancer have been declining for decades, thanks to early diagnosis and advances in treatments.

Pandemic fallout

Plan sponsors aren’t the only ones worried about a spike in late-stage cancers; physicians are reporting that patients are showing up with more advanced disease, while 48% of plan members admit they avoided seeking treatment for various complaints during the pandemic. Delays in seeking treatment were particularly common among caregivers, with 64% saying they had waited, and among those experiencing stress (63%) and people in poor health (58%).

It’s not yet clear what the implications of cancelled or delayed mammograms, pap tests and colonoscopies will be; however, where patients did seek care, there were significant delays in diagnosis. Nearly a quarter of Canadian cancer patients say they experienced a delay in their diagnosis because of the pandemic and almost one in five reported a delay between diagnosis and treatment. Among those being treated, almost half had appointments cancelled or postponed.

According to the Canadian Cancer Society a treatment delay of four weeks increases the risk of death by 10%.For those who survive, the majority will experience significant physical and emotional challenges that will require support following their treatment.

For plan sponsors, the impact of delayed diagnosis and treatment may be spread out as bottlenecks persist. Ontario, for example, has a backlog of more than 16-million surgeries, diagnostic exams, screenings and other procedures, including 700,000 missed or delayed MRIs and CT scans. Forty-three percent of plan sponsors say they’re worried about claims for serious diseases and chronic conditions that may have worsened during the pandemic.

New ways to access care

As healthcare providers work to clear backlogs amid resurgences of COVID-19 infections, plan sponsors have an opportunity to support patients with innovative benefits. For many employers, virtual care has proven to be a successful addition to their offering. Unsurprisingly, with 76% of plan sponsors increasing their virtual care benefits during the pandemic, patient use has exploded. Forty-three percent of plan members report using virtual care in the past two years, and this rate was higher among those in poor health (57%) and those living with a chronic condition (51%).

Virtual care can be a powerful tool for supporting patients and caregivers on a cancer journey. Virtual consultations with physicians or therapists by phone, text or video offer a convenient way for patients to ask questions about treatment options, symptoms and mental wellness at a time and place that is best for them. Some virtual care services can also assist with referrals to medical or paramedical specialists.

Plan members are happy with the quality of the virtual care they have received in the past year, with 88% who received virtual care through their employer reporting their treatment was excellent or very good. Looking ahead, two-thirds of plan members will consider using it when the pandemic is over. Employers and carriers should be assessing existing virtual care benefits to understand if they will accommodate both the volume and complex support needs of plan members who may be facing a cancer diagnosis in coming months.

For patients who prefer to use in-person visits, offering access to clinics where patients who are without a family physician or who need an appointment quickly can find care, while taking some pressure off the public healthcare system.

For cancer patients, managing medication can be a key challenge, with 43% taking at least three medications as part of their treatment. Another health benefits innovation that can help is virtual pharmacy services. In addition to the convenience of ordering and managing medications online, virtual pharmacies offer adherence packaging and the personal touch of on-demand access to a pharmacist.

Through personal consultations with pharmacists, patients and caregivers can discuss side-effects, medication management and adherence and lifestyle changes, such as smoking cessation. Half of plan members aged 18 to 34 say they intend to keep using virtual pharmacy services after the pandemic.

Virtual healthcare, whether for physical, mental or pharmaceutical needs is a valuable tool for helping plan members access care when family physicians, specialists or urgent care providers are unable to help right away.

Holistic support

Every cancer journey is unique, and a modern employee assistance program (EAP) can offer support for the physical, emotional and financial impacts of the disease. Once an underused benefit, plan sponsors with EAPs reported a 40% increase in their use during the pandemic.

For optimal support, ensure your EAP provides personal care advocates who can take the time to understand each family’s needs so they can book appointments with specialists, therapists or financial advisors. Top EAPs also offer employee resources to support cancer prevention through healthy choices and education.

The road ahead

April is Cancer Awareness Month so it’s a great opportunity to assess how you can support plan members who are facing a cancer journey.

Remind employees about the importance of healthy lifestyles and regular screenings
Include accessible, virtual and in-person clinical care from experienced physicians and specialists
Explore digital mental wellness tools including digital cognitive behavioural therapy
Add virtual pharmacy services for additional support and medication adherence
Review your employee assistance program to ensure it addresses long-term health and financial impacts of a cancer diagnosis
Work with your insurer on a detailed claims review to understand current and future plan member needs