Transcript How Employers can Help - National Business Coalition on Health

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CANCER IN THE WORKPLACE:
HOW EMPLOYERS CAN HELP
National Business Coalition on Health Webinar
September 9, 2015
Balancing Work and Cancer:
How Employers Can Help
Kate Sweeney
Executive Director
Cancer and Careers
CANCER AND CAREERS
Cancer and Careers empowers and educates people
with cancer to thrive in their work environment by
providing expert advice, interactive tools and
educational events.
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CancerAndCareers.org
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Publications in English and Spanish •
Job Search Tools & Resume Review •
Accredited Programs for Healthcare •
Professionals
CancerAndCareers.org/es
Balancing Work & Cancer Webinars
Community Events
National and Regional Conferences
RESEARCH: WORK & CANCER
• 41% of cancer survivors are diagnosed at “working age”
(Mariotto AB, Yabroff KR, Shao Y, Feuer EJ, Brown ML. Projections of the cost of cancer care in the
United States: 2010-2020. J Natl Cancer Inst. 2011 Jan 19;103(2): 117-28. Epub 2011 Jan 12)
• Cancer survivors are more likely to be unemployed
(JAMA 2009; 301(7):753-762)
• 20% of cancer survivors still report work limitations affected
by cancer-related problems 1-5 years after diagnosis
(Work & Cancer Survivors)
RESEARCH: BREAST CANCER IN THE
WORKPLACE
A Story Half Told Initiative: Pfizer/Cancer and Careers/Harris Survey
Objectives
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Understand attitudes and
beliefs of working women
with breast cancer
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Understand barriers women
with both early and
metastatic breast cancer
face at work, or as they
return to work
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Gain broad understanding
from 3 perspectives:
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Patient
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Physician
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Employer
Raise awareness of the
needs of women with
breast cancer in the
workforce
Partners
Multi-Disciplinary Steering
Committee:
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Cancer and Careers
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National Business Group
on Health
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Triage Center
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Johns Hopkins
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Avon Foundation
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Cancer Care
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Sharsharet
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Young Survivors Coalition
Initiative
Commissioned Harris Poll to
conduct the Supporting
Workplace Conversations
survey with:
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1,002 women with breast
cancer who have worked
or looked for work since
diagnosis; of these, 189 had
metastatic disease
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200 healthcare providers
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102 employers, represented
by human resources
personnel
KEY FINDINGS
Majority of women with breast cancer (70%)
who work want to do so even while
undergoing treatment; Greater support and
communication from employers and
healthcare professionals may help women
with breast cancer thrive in the workplace
The majority of breast cancer patients (77%),
including 7 in 10 metastatic patients (70%),
have felt that working aids their recovery, a
view endorsed by virtually all oncologists
(96%) and many employers (90%)
Many patients (48%) reported that breast
cancer and its treatments have negatively
impacted their work life
While most employers (91%) reported that
their organization is supportive of employees
with serious health conditions such as breast
cancer, there is a disparity between the
supportive measures and benefits employers
report they provide and what women with
breast cancer report are available
Taken together, these findings suggest a need for improved alignment and
communications between patients, employers and HCPs
WHAT SHOULD I KNOW?
• Information on company policy
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Medical leave policy
Short-term and long-term disability
Health Insurance
Flexible work policy
PTO, leave banks (if applicable)
• Applicable laws
– Federal (ADA, FMLA, HIPPA)
– State
• How situations like this have been
handled in the past
WHAT SHOULD I SAY TO MY
EMPLOYEE?
• "I am sorry this is happening to you.“
• "I don't know what to say or how to say it, but I do
want you to know I am here for you."
• "Don't worry about work.“
• "I am thinking of you.“
• "How are you feeling today?“
• "May I email you?“
• "Wasn’t that a productive meeting?"
WHAT SHOULDN’T I SAY
TO MY EMPLOYEE?
• "I know how you feel.“
• "My brother had this kind of cancer and he was in
the hospital for months.“
• "I know this will turn out OK.“
• "The same thing happened to my neighbor, and it
worked out fine.“
• "Did you drink?“ or "Do you smoke?"
• Remember: Don't let talk about the cancer
dominate every conversation.
WHAT INFORMATION CAN I PROVIDE
TO HELP MY EMPLOYEE?
• Information on company policy
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Medical leave policy
Short-term and long-term disability
Health Insurance
Flexible work policy
PTO, leave banks (if applicable)
• Introductions to EAP/Insurance providers
• Cancerandcareers.org
WHAT ARE SOME GOOD
COMMUNICATION STRATEGIES?
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Point person
Creating a written plan
Regular email wrap-ups or phone calls
Online document sharing programs
Keep employee visible
WHAT ARE SOME FLEXIBLE
WORK OPTIONS?
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Flex time
• Telecommuting
• Part Time
• Equipment
WHAT CAN I SUGGEST WHEN MY
EMPLOYEE IS STRUGGLING
TO STAY FOCUSED?
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Do one thing at a time
Clear away clutter
Make a list and prioritize it
Turn off phone and email
Take a walk around the block
WHAT ARE SOME COMMON SIDE
EFFECTS MY EMPLOYEE MIGHT BE
STRUGGLING WITH?
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Pain
Hair Loss
“Chemo Brain”
Fatigue
Weight Changes
Skin Changes
HOW CAN I MAKE SURE MY
EMPLOYEE IS COMFORTABLE?
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Manipulate Work Space
- Phone, fax, files within easy reach
- Switching offices
- Special furniture requests
WORKPLACE TRANSITIONS FOR
PEOPLE TOUCHED BY CANCER
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Free eToolkit for Employers
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Program developed by Cancer and Careers, The US
Business Leadership Network, Pfizer, Anthem and SEDL (a
non-profit research firm)
Piloted by Ernst & Young, Merck, North American Mission
Board, Northrop Grumman, Verizon and Anthem
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93% of managers reported finding this resource helpful,
especially in helping them provide employees emotional
support
86% of managers reported finding this resource easy to
access and use
Available via www.workplacetransitions.org
WorkplaceTransitions.org
CANCER IN THE WORKPLACE:
HOW EMPLOYERS CAN HELP
Lynn Zonakis
Principal, The Zonakis Group LLC
September 9, 2015
Agenda
Employer specific strategies for
managing cancer in the workplace
highlighting Delta Air Lines’ approach
Why a focus on cancer is important
Employer Toolkit on Cancer Treatment
and Prevention
Importance of employee communications
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Why a Focus on Cancer is Important:
The experience at Delta
Always in top three for trend and highest
cost conditions
25% of high cost claimant expense and 16%
of overall health plans cost attributable to
cancer
Cancer pharmacy spend is over 15% of total
pharmacy spend
Breast cancer is number one cancer cost
and prevalence
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Cancer in the Workplace:
An Employer’s Toolkit on Cancer Treatment and Prevention
The Toolkit – Overview
Tool 1 – Quick Reference Guide: A brief summary of benefit and
program recommendations across the benefit continuum.
Tool 2 – Employer Benefit Design and Assessment: Provides
practice recommendations and suggestions for comprehensive
benefits, along with a methodology employers can use to assess their
current benefits.
 Tools include recommendations related to medical and
pharmacy benefits, short-term disability, family medical leave
and employee assistance programs and health improvement.
Tool 3 – RFP and Proposal Scoring Tools: Resources to support
implementation of recommendations from Tool 2.
Tool 4 – SPD Guidance: Offers guidance to help employers translate
the recommended benefit or practice into summary plan description
language for beneficiaries.
Tool 5 – Vendor Contracting and Administration
Tool 6 – Vendor and Program Evaluation
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Sample of Benefit Recommendations
 Reasonable out-of-pocket thresholds should be established so
that cost is not a significant barrier for patients to obtain their
medications. (Max of $100 per script and aggregate $200 per
month)
Delta Air Lines’ approach
 Benefit plan should establish parity of patient cost-sharing
between the medical and pharmacy benefits.
Delta Air Lines’ approach
 Benefit plan should include hospice coverage for individuals
with an estimated life expectancy of 12 months or less to live if
their disease runs its usual course.
Delta Air Lines’ approach
 Benefit plan should have appropriate time off and leave
provisions that support the employee with cancer
Delta Air Lines’ approach
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To Access the Tools:
www.businessgrouphealth.org/cancer
Click on “All Cancer Resources” at
top of the page.
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Delta Air Lines’
Initiatives to Support
Cancer Patients:
Programs & Communications
Prevention
Managing cancer starts with
prevention and early detection
Preventive care is important
in order to maintain a
healthy workforce – strongly
supported by our leadership
team
Delta provides 100 percent
coverage for recommended
cancer screenings
Has been in place for many
years, well before the
requirement by the ACA
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Support – Delta Health Direct
A confidential, concierge total
population management
healthcare program. Services
include NurseLine, treatment
decision support, wellness
coaching, complex case/disease
management and more.
The Cancer Resource
Services/Support program is part
of Delta Health Direct. There are
two dedicated cancer nurses
available to work one-on-one
with employees and/or their
eligible family members.
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Cancer Resource Services / Support
Telephonic case management
program delivery model.
 On-going case management
delivered by experienced cancer nurse
with 10-15 years of oncology
experience, throughout treatment,
survivorship, or through end of life
 Treatment plan created from initial
assessment; each call has specific
goals around right care, right provider,
right lifestyle, right medication
 For patients in active cancer
treatment
 Common and complex cancers
 Adult and pediatric patients
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Value Throughout the Care Continuum
Diagnosis
Treatment
Adjuvant therapy
Recurrent metastatic
End of Life
Laboratory
Pathology
Radiology
Surgery
Radiation
Transplant
Chemotherapy
Medication
Radiation
Chemotherapy
Medication
Radiation
Chemotherapy
Pain management
Palliative care
Advanced illness care
• Help patients confirm
diagnosis at COE or
through other vendors
• Guide patients to
appropriate providers
• Confirm goals of
treatment (curative)
• Confirm goals of
treatment (palliative)
• Decision support around
end of life
• Confirm treatment plan
• Confirm treatment plan
• Confirm treatment plan
• Option for second
opinion at COE or other
• Option for specialized
physician review
• Help patient understand
diagnosis and potential
treatment options
• Option for second
opinion at COE or other
• Educate patient on
importance of adhering
to treatment plan
• Educate patient on
importance of adhering
to treatment plan
• Manage high cost
medications
• Manage high-cost
medications
• Confirm member has
symptom control meds
• Confirm member has
symptom control meds
on-going pain mgmt
• Member understands
when to use ER
• Manage systems and
side-effects to prevent
unnecessary
hospitalizations
• Access to support
(behavioral, social
worker, other)
Cancer Support Program
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• Member understands
when to use ER
• Manage systems and
side-effects to prevent
unnecessary
hospitalizations
• Access support
(behavioral, social
worker, other)
– Discuss patient goals
and desires
– Help patient communicate to family and
caregivers
• Care in the most
appropriate setting
• Pain management
• Manage symptoms and
side-effects to prevent
unnecessary
hospitalizations
• Behavioral support
• Social worker support
Cancer Centers of Excellence Program
Approximately 30 facilities nationwide specializing in
various types of cancer
Dedicated cancer nurse through the Cancer Resource
Services / Support program can assist in arranging care
at a COE
Travel & Lodging Benefit
$10,000 for employee and one family member
Enhanced coinsurance benefit
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Communication
Quarterly newsletters –
home mailing and online
Monthly Healthflyers –
online
Intranet information
E-mails
Health fairs
Referrals from HR and
Leaders
Referrals from Delta Health
Direct and other service
providers including
UnitedHealthCare, disability
vendor, etc.
Employee Testimonials
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