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Insights

Dana-Farber & Lockton team up to fight Cancer's Costs & Complexities

7/24/2023

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On June 20th, Dana-Farber hosted Lockton as well as invited guests to learn about how we are partnering to better manage complex cancer cases.
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Dana-Farber & lockton video  - Part 1
dana-farber & lockton video - Part 2
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Watch Part 1 and Part 2 of our videos to learn... 
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What's Really Driving Employer Health Plan Costs?
  • The reinsurance / stop-loss market is reactive and fractured. 0.6% of employees drive 35% of costs (1% = 1/3) “Purple Zebra Unicorns” show up as complex cases consistently across geographies, industries and employer sizes. 
  • Life saving therapies and medications are remarkable. The insurance market is not set up for or can account for these longitudinal cases which can last decades and cost millions.  Reinsurance is grounded in covering unknown rather than known risks.
How to improve the cost and quality in complex cancer cases?
  • Dana-Farber & Lockton want to help through the clinical journey and do more for “people swirling in the system” – 17% of referrals to Dana-Farber are misdiagnosed primarily due to incorrect reading of the pathology. Rereading of the pathology by Dana-Farber specialists closes this gap. 
  • Population Health & Disease Management aren’t enough – we need a person level strategy to manage these claims / costs. Amazing new technologies for early detection and intervention (tests from companies such Galleri or Grail) are part of Dana-Farber’s early detection program. This program wants to disrupt the treatment model to prevent death and improve quality of life. “Future state is a proactive model”.
What makes Lockton's approach unique?
  • Traditional monitoring of high cost claims like using a “50% report” (waiting for claims to reach 50% of a specific stop-loss level) are reactive and outdated. Through use of data, predictive analytics and outreach from clients, health plans and navigators, Lockton developed 5,900+ clinical and financial triggers and have performed more than 20,000 clinical reviews referring thousands of patients to high quality providers. The resulting savings for our employer clients is $342M to date and climbing. 
Other topics we discussed include;
  • Cancer remains the costliest condition since 2010
  • The number of cancer claimants increased 39% from 2018 to 2021
  • Due to delayed/missed screenings, we may see up to a 44% increase in new cancer diagnoses this year, including more late-stage cancers
  • The top two categories (Malignant Neoplasm and Leukemia, Lymphoma, Multiple Myeloma) are responsible for 29% of total stop loss reimbursement in the past four years
  • Dana-Farber is only hospital in the Top 4 for Adult and Pediatric cancer treatment
  • More than 50% of all oncology drugs have a contribution from a Dana-Farber researcher
  • At any time, over 1,100 clinical trials are being run now including innovative cancer screens like Color, Grail and Galleri 
  • Direct Connect is a FREE program from Dana-Farber and will work no matter your zip code (nationwide plus 130 countries)
  • Across written second opinions performed by Dana-Farber, only 3% fully agree with care plans from local oncologists – 97% have some level of discordance with these local physicians
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Dana-Farber Presentation

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Lockton Presentation

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    Mike Smith - trying to put my history degree to good use through research and writing .  Mom would be proud but she still wanted me to study business.

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  • Home
  • BenefitSmith Global
    • 2023 Global Risks & Rewards
    • Elevate Capacity & Well-Being
    • The Future of Talent
  • Insights
  • Self Insured Solutions
  • Pharmacy Management
  • Data & Analytics
  • People Solutions
  • Stream with Smith
  • NEEBC & Lockton
  • Private Equity and M&A Support
  • About
  • Resources
    • MA Benefit & Leave Mandates
    • Uncommon Perspectives
    • Lockton Benefit Blog
    • Lockton Employee Benefits
    • Lockton Global Benefits - Compliance News
    • Lockton Insights & Publications
    • Lockton Private Risk Solutions
    • Kaiser Health News
    • New England Employee Benefits Council
  • Contact
  • Individual & Small Business Services from Mylo
  • Benchmarking, Trends & Updates
  • Where Employers Focus & How Lockton Helps