EVERNORTH GUIDED CANCER CARE
Guiding and supporting members through every step of the cancer journey, while improving savings and experiences.
Cancer care is a fragmented experience for members and extremely costly for all.
Complex challenges remain for health plans, employers and members despite today’s advancements in treatment.
Cancer treatments are one of the top drivers of medical expense.1
As cost and complexity continue to be barriers to quality and effective cancer care, offering solutions that mitigate spend and lead to improved outcomes are vital.
1. Ca Cancer J Clin 2019: 69:363-385; American Cancer Society; American Society of Clinical Oncology.
Care services are becoming more expensive, and engagement needs to improve.
Reported incurring medical debt from cancer care2
2. Survivor Views: Cancer & Medical Debt. American Cancer Society Cancer Action Network. March 2022.
Felt unprepared for the costs of cancer care3
3. Survivor Views: Cancer & Medical Debt. American Cancer Society Cancer Action Network. March 2022.
Of ovarian cancer patients do not receive recommended testing to inform treatment4
4. Kurian AW, Ward KC, Abrahamse P, et al. Time trends in receipt of germline genetic testing and results for women diagnosed with breast cancer or ovarian cancer, 2012-2019. J Clin Oncol. 2021;39(15):1631-1640. doi:10.1200/JCO.20.02785.
Evernorth Guided Cancer Care
We ensure members get the right care early enough in their journey to have a positive impact on both health outcomes and costs. Members (and their caregivers) are often overwhelmed and stressed after diagnosis and need help navigating the life-changing situation and finding valuable support.
Our comprehensive approach combines two unique solutions:
Our approach is designed to quickly identify where we can add the most value for each individual. We provide a single point of contact—a care advocate—who first identifies which needs are most pressing for the member, and then works to address those needs.
Helping them navigate the care delivery system and their health plan benefits
Building care plans for each member (and their caregivers) based on their specific needs
Identifying resources to help with financial or other support available within the community, such as childcare, transportation, and meal delivery
Care coordination to better understand treatment plans and coordinate care across various resources
Distress screening and behavioral health access and support—this resource is critical and often improves outcomes for cancer patients at lower costs
We deliver additional value by helping to ensure that members with the most complex cancer cases receive an accurate diagnosis and optimal treatment plan without delay.
Focuses on cases most likely to benefit from the review:
Our data analytics helps concentrate resources for the most value
Helps reduce burden on members:
Typical second opinion services rely on members to initiate and facilitate reviews—our approach handles everything, so members can stay focused on their cancer care without traveling to meet with subspecialists
Designed to efficiently use resources:
Cases that have a likely accurate diagnosis or are already being treated at a leading center aren’t eligible for this service
Lowering the Cost of Care
Average medical oncology savings per completed consult with a change in diagnosis and/or treatment plan with Cancer Consult Service5
5. Evernorth internal analysis of consult service for large commercial health plan population, 2023. Some cases have higher fees, and this is just an average. Results may vary.
Savings per engaged member with Concierge Cancer Support6
6. Evernorth internal analysis of oncology case management program for large commercial health plan population, 2023. Medical cost savings accrue in the year after treatment. Results may vary.
Potential per member per month savings with the combined Guided Cancer Care program solutions7
7. Evernorth internal projected savings analysis, 2023. Results may vary.