More doctors are telling working-age people the words no one wants to hear: “You have cancer.”
Around 40% of people will receive a cancer diagnosis at some point during their lifetime. Today, more young people are getting cancer than ever before—for reasons unclear to researchers.
The U.S. spends over $200 billion annually to treat cancer, and it’s now the top cost driver for employer health spending. While breakthrough cancer treatments offer hope, prices for new cancer drugs continue to outpace inflation.
Beyond the exploding costs for both employers and patients, navigating the cancer journey, from diagnosis to treatment to survivorship, is complex. For instance, there are at least 30 touchpoints for a woman with breast cancer from diagnosis through first treatment. Employees with cancer must traverse uncharted waters with minimal support.
HR leaders want to guide employees to the right resources and ensure they receive meaningful support at work, home and from their care team, but they face tremendous pressure.
The challenge for HR leaders involves:
- Understanding the latest cancer care resources available to workers
- Connecting employees with high-quality oncologists and care navigators
- Handling sensitive conversations with empathy and compassion
“We were inspired to add the cancer care program because we saw an increasing incidence of cancer in our population, right? Just like probably every other employer out there. And so we felt like we had to do something.
One, for our colleagues who were facing what can be a devastating diagnosis and wanting to make sure that they were getting the care they need. But two, because we also saw our costs going up because of all the cancer diagnoses in our population.”
Traditional Cancer Care Benefits Often Fall Short
Cancer care remains one of the most challenging and costly areas in healthcare benefits, yet most employers rely on fragmented solutions that fail to meaningfully address the problem. Here’s why traditional approaches prove insufficient.
Fragmented Point Solutions and Experiences Create Headaches
To help employees manage cancer care and reduce health plan costs, many employers stitch together point solutions, such as second opinion services, care navigation vendors and Centers of Excellence.
For the health benefits administrator, this creates a headache of vendors to manage and the loss of bundled pricing. For the employee, it creates a confusing, fragmented care journey.
What’s Missing from Longitudinal Bundles and Navigation-Only Solutions
When it comes to cancer bundles, navigation services or advisory models, none offer a complete solution. Traditional longitudinal cancer bundles routinely exclude the most complex cases and don’t ensure clinical appropriateness.
Navigation-only services help employees find doctors and schedule appointments, but lack the clinical depth to evaluate treatment quality or the financial leverage to actually reduce costs.
Advisory Models Don’t Offer Full Employee Support
While users receive second opinions and treatment recommendations, advisory models are too light-touch, leaving employees to figure out how to act on recommendations within their existing benefits structure.
What a Cancer Solution Should Offer
To be truly effective, a cancer care benefit should address member experience, cost and quality of care. When evaluating vendor solutions, look for the following:
- Complete, Inclusive Cancer Support: For all cancer types and stages for patients of any age.
- Personalized Expert Care Teams: Oncology nurse-led care teams and licensed clinical social workers to offer care navigation, support and treatment plan reviews.
- Expertise Everywhere: Your members live with ongoing review from oncologists to high-quality, local care at NCI-designated comprehensive cancer centers.
- AI-enabled technology: For efficiencies across predictive outreach, guideline tracking and clinical team workflows.
- Episodic bundles: To manage predictable costs, including radiation bundles and infusions.
The Right Cancer Care Navigation Lowers Spend and Improves Outcomes
“For a community oncologist who has to treat every single type of cancer every single day, it’s basically impossible to keep up with all the evidence-based guidance.
Subspecialists only treat one type of cancer, but they know everything about it. So it’s sort of narrowing down that knowledge base and reducing the variability and lack of adherence to guidelines in care.”
A strong cancer care navigation program takes a comprehensive approach to cancer care, focusing on cost, quality, and member experience. Here’s how effective navigation lowers spend while improving outcomes.
Reducing Infusion and Drug Costs
Up to 50% of cancer spend is driven by drug costs, which continue to increase as more therapy and treatment options are introduced, such as gene and cell therapies and immunotherapies.
Costs are often marked up 300% for those receiving infusion therapy in a hospital above what the same treatment would cost in a different setting. Infusion therapy is a top treatment option for cancer.
Significant savings can be achieved by steering infusion patients out of the hospital and into ambulatory infusion clinics or home care. Increased clinical trial utilization also helps lower spend, as trial sponsors often cover the costs of any experimental pharmaceuticals used.
Optimizing for Site of Care Savings and Better Experience
Site of care optimization refers to the deliberate selection of the locations where patients receive cancer treatment. The goal is to deliver the highest-quality care, minimize costs, reduce complications and side effects and improve patient outcomes. Depending on the complexities of the cancer, a patient may receive treatment in a hospital, outpatient clinic, specialized cancer center or even at home.
For many patients, receiving treatment close to home at a community oncology center is the better option. It means less travel, less disruption to daily life and the ability to stay connected to their local support system during an already difficult time. Cost savings are a meaningful added benefit, with community-based care running approximately 2x less than treatment at NCI-designated centers.
But receiving care in the community doesn’t mean sacrificing access to the best expertise in the field. Patients treated locally can still benefit from ongoing treatment plan review by subspecialists at NCI-designated comprehensive cancer centers.
The time it takes to receive a cancer diagnosis and begin treatment makes a big difference. One study found that people whose treatment for cancer is delayed by just one month have a 5% to 13% higher risk of mortality. Lantern members can access faster appointments at local and national cancer centers, with an average wait time of less than 10 days.
Craig, a Lantern member and cancer survivor says Lantern helped him sort through the hurdles and frustrations of understanding his insurance and scheduling appointments with specialists.
“Because Emily, my Oncology Nurse, was able to get me into several specialists within two weeks instead of waiting months and months, I was quickly enrolled into a treatment plan that had me on a path to recovery,” Craig said.
Preventing Avoidable Acute Care and Unnecessary Treatments for Employees
Up to 40% of cancer care is improper and not consistent with guidelines, leading to avoidable acute care and costly complications. Expert review of a diagnosis or treatment plan, whether by an oncology nurse or subspecialist, helps ensure care follows the latest published guidelines set by the National Comprehensive Cancer Network (NCCN). This has been shown to lower the total cost of care and improve outcomes by increasing treatment plan adherence and minimizing costly emergency room visits.
Navigation to Clinical Trial Opportunities
One study found 84% of people who received a cancer diagnosis never sought a second opinion on their course of treatment. It’s often because patients feel uncomfortable “questioning” their oncologist by seeking a second opinion.
A second opinion can surface several benefits, such as introducing alternative therapies or clinical trials that are more beneficial or have fewer side effects. There’s currently a 4% trial participation rate in community settings compared to over 20% participation rates at NCI-designated comprehensive cancer centers.
”What we also know is that if you can align care with that standard of care quickly, you might see a short-term bump in the cost of care. But what happens after that is a longer term reduction in the total cost of care,” says Zafar. “And that’s because of all of the evidence out there that uniformly points to this idea that if you align care to the evidence, if you make sure the patient is getting the best care according to the evidence, so the standard of care, their costs are lower over time, and that’s because their cancer is not growing as much.”
Zarfar says patients and oncologists are not aware of trial options. “There are numerous barriers to getting patients on trial, both clinical and socioeconomic barriers,” he says.
Zafar recalls a recent second opinion performed through AccessHope.
“We performed a second opinion on a patient who was living in a rural county and had an advanced complex cancer,” Zafar says. “When our reviewer at an NCI-designated comprehensive cancer center reviewed these patient’s records, they realized the patient’s care was not aligned with the standard of care by any means.”
After receiving the review, AccessHope shared it with the community oncologist, who said the timing was perfect, as they had reached the end of what they expected to be the standard of care.
“We also provided a clinical trial option for this patient, and that oncologist said, ‘This trial is something that I think my patient would be interested in. I’m going to investigate it. So in this case, we were able to pick out that sort of needle in a haystack, that patient who’s getting care with an incredibly intelligent and well-meaning oncologist who needed help. I was really proud that we were able to help the patient and oncologist using our technological capabilities and our expertise,” Zafar says.
Supporting Mental Health and Reducing Related Costs
Cancer takes an immense toll on both the patient and their support team. According to the American Cancer Society, up to 60% of people with cancer experience major financial hardship. It’s also an incredibly emotional and stressful disease. The CDC shows 75% of people living with cancer experience significant distress.
Offering employees a support team helps take some of the complexity out of understanding a diagnosis and treatment options. For example, Lantern Oncology Nurses can take away some of the time burden by scheduling appointments and navigating insurance.
“We’ve heard a lot of anecdotal stories from our colleagues that have just raved about the care that they’ve gotten from the Oncology nurses,” says Beaudin of Hyatt Hotels. “And knowing that there’s someone there that they can call with any questions they have, or knowing that they have someone that’s going to reach out to them proactively to make sure they’re okay, to make sure they understand what’s going on, what their treatment plan entails, knowing what to do if they have side effects. They’ve really appreciated that care that they’re being given.”
Identifying the Right Members at the Right Time
Even the most comprehensive cancer navigation program can only deliver value if the right members are enrolled at the right moment in their care journey. Early identification and timely engagement are foundational. An employee who is connected to navigation support at diagnosis has far more options available to them than one who is reached weeks or months later, when treatment decisions may already be locked in.
Effective identification means looking beyond simple claims data to surface members who are newly diagnosed, at risk of a delayed diagnosis or facing a complex treatment decision where expert guidance could make a meaningful difference. From there, proactive outreach and thoughtful engagement are critical.
“I’ve told our team and partners, every time we hear the word cancer, you should immediately think Lantern and give them the number or tell them to visit the app. Cancer equals Lantern. That’s where we want to navigate our people to for care.”
How Lantern’s Modern Cancer Care Program Ensures Employee Support and Savings
Lantern offers a one-of-its-kind comprehensive and fully integrated cancer care solution with a mission to ensure personalized, whole-person and best-in-class care for every member affected.
Key program features include:
- Equitable Access: Lantern covers any cancer type or stage for members of all ages. This includes pediatric care, which is left off of many point solutions.
- Personalized Support: Members receive emotional, clinical and logistical guidance through Lantern’s care support team, which includes Care Advocates, Oncology Nurse Navigators and a Licensed Clinical Social Worker.
- Ongoing Expert Review: An oncologist at an NCI-designated comprehensive cancer center reviews treatment plans not just at diagnosis, but at multiple points throughout a treatment journey.
- Local Care: We align member needs to the best-fit provider and site of care close to home, while offering ongoing treatment plan review by NCI-level subspecialist oncologists.
- Cost Management: Through direct contracts, site-of-care optimization and our Infusions solution, Lantern guarantees a 1.5x return on investment. (More on this in the next section)
- Technology Enablement: AI-powered medical record summarization, risk prediction and workflow automation enhance clinical decision-making while preserving the essential human connection members need during cancer care.
Download the Modern Guide to Cancer Care Benefits
Pieced-together solutions don’t lead to the cost and quality savings you need. It’s time for a comprehensive approach.
Cancer Support for Employees at Every Step
Ongoing expert review is offered through Lantern’s partnership with cancer care benefit AccessHope.
“80% of care that happens in the US is happening at community oncology practices,” says Zafar of AccessHope. “One way we’re helping the patient and community oncologist is by having an oncologist at an NCI-designated comprehensive cancer center review your care. We’ll bring the review back to you to limit delays, travel expenses and difficulty in decision-making.”
Because NCI-designated comprehensive cancer centers employ subspecialists, this ongoing review often helps identify and correct care that may be unnecessary, ineffective or outdated. It also increases access to clinical trials.
“Patients and oncologists are not aware of trial options. There are numerous barriers to getting patients on trial, both clinical and socioeconomic barriers,” Zafar says. “We can match patients using their clinical data to any trial in the country, but really focus geographically down to where the patient is. And we then can navigate that patient through those educational barriers to then help them get enrolled in the trial, if it’s considered appropriate by their treating oncologist.”
“What’s really differentiating about the program, for both the patient and caregiver, is having a nurse by your side for the entirety of that journey. They know you. They build a really deep relationship. They’re quarterbacking for you, because they’ve seen everything and done this many times before.”
Member Cancer Care Journey: What Employees Experience
Pre-Diagnosis
Early cancer detection
We offer proactive, evidence-based screenings and predictive analysis that identify members at elevated risk, enabling earlier intervention and better outcomes.
Care navigation
Lantern’s oncologist matching connects members to top in-network providers, via local or NCI-designated cancer care centers.
Diagnosis and Care Planning
Diagnosis review
Automated expert review is triggered by claims or initiated by the member.
Confirmed diagnosis
Our multi-disciplinary clinical team reviews the case, provides recommendations and consults with the treating oncologist.
Treatment plan optimization
We ensure NCCN-aligned treatment plans and evaluate clinical trials for advanced options.
Treatment
Treatment adherence support
We help members stay on track with their treatment plan by managing barriers, addressing side effects and providing emotional support.
Care coordination
Members connect to Lantern’s Network of Excellence for high-quality, affordable infusion care.
Continuous review
We ensure ongoing optimization as the treatment path evolves, with NCI-level review at each milestone.
Survivorship
Seamless transition to long-term wellness
We facilitate care continuity from active treatment to survivorship, including scheduling routine scans, escalating signs of recurrence, coordinating survivorship care plans with primary care providers and establishing long-term monitoring protocols.
End-of-Life Care
Compassionate expert guidance
We ensure members and families receive expert guidance and emotional support, including evidence-aligned treatment plans, proactive management of symptom burden and side effects and connection to palliative care as early as possible.
A Live-Saving Experience
A Lantern member felt lost when he received a diagnosis for a rare blood cancer, Polycythemia Vera. He learned about Lantern through his employer’s benefits materials and reached out. His Care Advocate helped him understand his diagnosis and treatment options and guided him through insurance and treatment navigation.
“Lantern was invaluable,” the member says. “It gave me purpose and peace of mind during the hardest time of my life.”
Why Hyatt Chose Lantern for Cancer Care Support
Hyatt saw cancer cases climbing among its population, a trend playing out at employers nationwide. Dawn needed a partner that could support employees through the emotional weight of a diagnosis while also getting a handle on rising costs.
“We were looking for a solution that could help us on both ends of that equation. Lantern’s program did just that,” Beaudin said. “It provided us with oncology nurse navigators that were able to provide our colleagues with the care they needed, getting their questions answered, holding their hand through the diagnosis and treatment, making them feel like their employer cared about their health and their wellbeing.”
Lantern’s partnership with AccessHope also connects Hyatt members with NCI-level oncology specialists who work alongside local oncologists, helping confirm the right diagnosis and treatment plan while keeping costs in check. Beaudin said the feedback from employees has stood out.
“We’ve heard a lot of anecdotal stories from our colleagues that have just raved about the care that they’ve gotten from the Care Advocates,” she said. “A heartfelt thank you to all of our Care Advocates that help our Hyatt colleagues every day. We believe in the purpose of care so that people can be their best.”
