From costly prescriptions to catastrophic claims, employer healthcare costs are projected to increase 10% in 2026.
Specialty care impacts a small percentage of your workforce, yet it accounts for 50% of healthcare spend.
Most employers don’t have a strategy to control these costs. As CFO, you’re accountable to the board for every dollar spent. This is an area where you can make an immediate impact.
Top 3 Drivers of Specialty Care Costs
- Cancer: Cancer is the top cost driver for 88% of employers, increasing 8% over the previous year. Costs are attributed to expensive specialty drugs, complex treatment protocols and extended hospital stays.
- Surgery: Surgical cases make up 20% of healthcare spending. A lot of cost variability and waste exists within this massive line item.
- Infusions: Infusion treatments make up about 10% of employer healthcare spending, accounting for more than $110 billion annually.
How Lantern Delivers Savings and ROI for Specialty Care
Lantern employs the following strategic levers for cost containment:
Site-of-Care Shifts
Site-of-care shifts significantly lower costs. Surgeries performed in ambulatory surgical centers can cost 5x less than in hospitals. For in-hospital infusion therapies, costs are often marked up 300%.
Lantern also optimizes care sites for oncology patients, shifting from large hospitals to community oncology centers, when appropriate.
Bundled Pricing and Direct Contracting
Employers and private health plans pay, on average, 254% of Medicare prices. Specialty care solutions can negotiate better rates for in-network providers.
Lantern contracts directly with high-performing surgeons. By cutting out intermediaries and negotiating directly, we achieve rates significantly lower than traditional carriers, saving employers 50% to 60% on high-cost procedures.
We really like the fact that the billing and bundled payment model from Lantern allows us to know our costs for surgeries, as opposed to the process for carriers where you’ve got a million different charges.
Early Intervention and Care Navigation
Wait times for oncology appointments in the traditional healthcare system often take weeks or months.
Through Lantern’s accelerated access to the best National Cancer Institute-designated centers (NCIs) and community oncologists, our members can typically be seen within 10 days for their first appointment.
Avoiding Unnecessary Treatments
Unnecessary procedures, misdiagnoses and preventable complications are significant drivers of wasteful spending and poor outcomes.
Lantern drives surgical avoidance by rigorously vetting providers and ensuring members receive the most appropriate, least-invasive care plan. This approach is key to securing better patient outcomes and lower costs.
Lantern’s Success Metrics
Surgery
- 30% surgical avoidance rate
- Less than 1% complication rate
- 55% lower rates than the average health plan
Cancer
- Access to treatment in less than 10 days
- 1:1 support from Oncology Nurse Navigators
- 100% of members eligible (every diagnosis, age and stage)
Infusions
- Up to 40% savings
- 1:1 support
- Optimized care at ambulatory center or home
Lantern Delivers Real-World Savings for Employers
Here are a few examples of employers who have significantly reduced their costs through Lantern. See more case studies.
Hyatt Hotels
By the numbers:
- $16.1 million cumulative savings
- Lifetime average savings of $29.90 PEPM
In 2021, Hyatt found significant spending attributed to surgical care. Due to the success Hyatt saw with the surgical program, they decided to implement Lantern’s cancer and infusions programs as well.
We liked the fact that Lantern was steering procedures to ambulatory surgical centers, which was ultimately reducing that unit cost because we were using a lower-cost facility and removing some of those high-cost hospital fees.
The Wonderful Company
By the numbers:
- $1.7M+ in lifetime savings
- 2.86X ROI
The Wonderful Company’s workforce faced specialty-care challenges, from difficulty finding quality providers to language barriers and rising cancer and surgical costs.
After just two completed procedures via Lantern’s surgical Center of Excellence, The Wonderful Company saved $30K. To build on that success, the company decided to implement Lantern’s cancer program.
Greystar
By the numbers:
- Nearly $8 million in total savings since launching the surgical program in 2019
- An almost 4.5X ROI
Multifamily housing company Greystar sought a solution to lower their specialty care spend. The company implemented Lantern’s surgical Center of Excellence in 2019, followed by the cancer care program.
Looking at our data, cancer is our most expensive diagnostic category. Within the first week of being live, four people connected with Lantern via the program.
You can bend healthcare trend at your organization
Healthcare costs increases aren’t slowing down. A solution like Lantern:
- Drives down costs as soon as employees start using the program, as opposed to lifestyle programs that have a longer ROI
- Reduces unnecessary care thanks to higher-quality providers
- Improves affordability for employees when you waive cost-share, ensuring employees don’t have to delay care they need
Ready to learn more about how Lantern can help your organization reduce costs? Get in touch with us.
