C-Change Making the Business Case Questions & Answers

C-Change Making the Business Case Questions & Answers How To Use This Document Following are a set of questions and answers about C-Change s multi-year Making the Business Case for cancer prevention and early detection effort. The questions and answers are posed so that the C- Change leadership and designated spokespeople will be able to speak consistently about C-Change s Making the Business Case efforts if questioned by current members, potential members, the media, donors, potential donors and/or by critics. This document is for internal use only by C-Change and its Making the Business Case partners. This document is not intended for wide distribution. A comprehensive C-Change question and answer document was developed in 2004 and can provide further guidance on C-Change membership, resource acquisition and governance questions. Items addressed in this document are: Page 2 Making the Business Case Questions Page 4 C-Change Background Questions C-Change Background C-Change s multi-year Making the Business Case effort is designed to encourage the nation s employers to provide coverage for and ensure maximum utilization of recommended early detection services (breast, colorectal and cervical cancer screening) and evidence-based tobacco cessation programs. For more information Contact Kellie Hotz at 312-240-2701 (Kellie.Hotz@Edelman.com) ***************************************************** 1

Q&A - For internal use only About Making the Business Case Q1. What is C-Change s Making the Business Case effort? A1. C-Change is kicking-off a multi-year campaign to encourage employers to save lives while saving money through their health benefits plans. Data show that it is far more costly to treat cancer than to prevent it. Investing in cancer prevention is a long-term strategy employers should use to reduce costs and ensure a healthier workforce. Q2. Why is C-Change targeting employers for the business case effort? A2. The nation s employers are the second-largest provider of health insurance coverage in the country, second only to the federal Medicare program. Collectively, employers in the United States influence the health and wellness of more than 160 million Americans through their health benefit plans. 1 As such, employers have the ability to significantly decrease the number of cancer cases and deaths by ensuring proper prevention and early detection among their workforce. Q3. What is C-Change asking employers to do? A3. Specifically, C-Change is calling on every U.S. employer to do three things: 1. Provide coverage for four, proven cost-effective cancer prevention services - tobacco cessation programs and breast, colorectal and cervical cancer screening while waiving co-pays and deductibles. 2. Encourage all eligible employees to use these services through combined actions of education and individual financial incentives. 3. Implement tobacco-free policies For those employers already offering the C-Change health benefits plan, consider becoming a CEO Cancer Gold Standard-Accredited company. Join companies such as Johnson & Johnson, SAS Institute, and GlaxoSmithKline, who have joined the war on cancer by implementing initiatives that reduce the risk of cancer, enable early diagnosis, facilitate better access to bestavailable treatments, and hasten the discovery of novel diagnostic tools and anti-cancer therapies. For more information, please visit the CEO Roundtable s Web site (www.ceoroundtableoncancer.org). Q4. What evidence/data support the business case for cancer prevention? A4. It is far more costly to pay for cancer treatments and support than it is to provide early detection and tobacco cessation services. Direct medical expenses (health insurance premiums) and indirect costs (lost productivity) related to treating employees with cancer cost employers thousands of dollars every year. Cancer is the leading cause of death for those aged 45 to 65, the largest segment of corporate employees. And while people with cancer represent only 1.6 percent of the commercial population, they generate around 10 percent of an employer s annual medical claims. 2 A study of major employers found that patients with cancer cost over five times as much to insure than patients without cancer (approximately $16,000 vs. $3,000 in annual costs). 3 That s a $13,000 savings for each employee who might otherwise have developed cancer had they not taken preventative measures and/or detected their cancers early. Cancer costs may contribute up to 6.5 percent of total annual healthcare and disability costs, resulting in approximately $225 in excess costs per active employee per year - $172 resulting from direct medical costs and $53 from excessive work loss. 4. Q5. Can employers achieve actual cost savings by investing in cancer prevention? A5. Yes. An actuarial study conducted by Milliman, Inc. showed that it would take an investment of only $2.95 per member per month for the typical employer to reach near full compliance among their employees to cover breast, colorectal and cervical cancer screening, and that this would yield savings of up to $3.75 per member per month. 5 2

Similarly, investments in smoking cessation can begin generating cost benefits for an employer in just one year. It is estimated that employers could provide a comprehensive tobacco cessation plan for only $.79 per member per month, whereas companies can spend up to $1,850 in excess medical costs for each employee per year with a tobacco-related illness. 6,7,8 Q6. How can employers ensure coverage and increase utilization among their employees? A6. There are a number of things employers can do to provide cancer prevention benefits and encourage employees to take advantage of them, including: 1. Eliminate co-pays and deductibles for cancer screening tests and smoking-cessation programs 2. Provide individual incentives to employees who follow screening guidelines and engage in tobacco cessation efforts 3. Distribute educational materials to employees reminding them of screening guidelines and the importance of smoking cessation 4. Ensure that all eligible employees use these services Q7. What resources are available to help employers make decisions about preventive healthcare as part of their corporate health benefit? A7. The National Business Group on Health (NBGH), a non-profit organization dedicated to helping employers with important healthcare decisions, has developed a comprehensive guide for employers detailing the rationale and cost benefit of covering evidence-based preventive health services as part of corporate health plans. This resource, the NBGH Purchasers Guide to Health, includes detailed information on the cost of providing tobacco cessation programs and breast, colorectal and cervical cancer screening. Employers can find out more about the Purchasers Guide to Health by visiting the organization s Web site (www.businessgrouphealth.org). Q8. For those employers that already provide the C-Change benefits package, is there anything they should consider? A8. Consider becoming a CEO Cancer Gold Standard-Accredited company. Join companies, such as Johnson & Johnson, SAS Institute, and GlaxoSmithKline, who are fighting the war on cancer by implementing initiatives that reduce the risk of cancer, enable early diagnosis, facilitate better access to best-available treatments, and hasten the discovery of novel diagnostic tools and anticancer therapies among their employees. For more information, please visit the CEO Roundtable s Web site (www.ceoroundtableoncancer.org). Q9. Why is it important for employers to make cancer prevention a priority for their employees? A9. Cancer prevention is proven to save lives while also providing a positive financial return on the investment. Four cancer prevention services are recommended, including; tobacco cessation programs and breast, colorectal and cervical cancer screening. These four services are extremely effective in preventing cancer (in the case of tobacco cessation and colorectal cancer screening) or identifying cancer at the earliest possible time when it is most treatable, reducing the burden of cancer to employers and employees. The economic benefits of investing in cancer prevention are also compelling healthier individuals cost employers less money. Given the high direct and indirect costs of cancer the old adage really is true: an ounce of prevention is worth a pound of cure. Q10. Why did C-Change choose tobacco cessation programs and breast, colorectal and cervical cancer screening for its Making the Business Case efforts? A10. An established body of data has shown that certain prevention services - tobacco cessation programs and breast, colorectal and cervical cancer screenings - are extremely effective in preventing cancer or detecting it at the earliest possible time when it is most treatable. The National Commission on Prevention Priorities has designated each of the four services as being extremely effective in preventing disease. Smoking cessation programs are among other top 3

priorities on Commission s list of recommended prevention services because of their significant efficacy and impact on the overall health of individuals. Q11. Does C-Change recommend employers provide any additional cancer prevention services, such as health and wellness programs to decrease obesity? A11. C-Change supports all efforts that are proven to reduce the country s cancer burden, including health and wellness programs. For its Making the Business Case efforts, C-Change focused on four cancer prevention services with proven efficacy and cost benefits. However, the organization believes there is great value in providing additional support to employees to decrease the burden of a host of chronic diseases, including cancer, heart disease and diabetes. Those employers already offering C-Change health benefits plan should consider becoming a CEO Cancer Gold Standard-Accredited company. Join companies, such as Johnson & Johnson, SAS Institute, and GlaxoSmithKline, who are fighting the war on cancer by implementing initiatives that reduce the risk of cancer, enable early diagnosis, facilitate better access to bestavailable treatments, and hasten the discovery of novel diagnostic tools and anti-cancer therapies among their employees. For more information, please visit the CEO Roundtable s Web site (www.ceoroundtableoncancer.org). Q12. Why didn t C-Change include the new cervical cancer vaccine in its Making the Business Case for cancer prevention and early detection efforts? A12. C-Change welcomes the addition of the first vaccine approved to prevent cancer and hopes that the vaccine becomes widely used to prevent further illness and death from cervical cancer. Because the cervical cancer vaccine is new we do not yet have the anticipated definitive data on its cost effectiveness. However, as is the case for all immunizations against vaccine preventable diseases, we firmly believe that this benefit should be provided for eligible employees and their age appropriate dependents. Q13. Lung cancer is the leading cause of cancer deaths. Why is lung cancer screening not included in the C-Change recommendations? A13. Because many lung cancers are related to tobacco use, C-Change has focused the Making the Business Case recommendations on well proven tobacco cessation programs until more information becomes available. The medical benefits and related cost effectiveness of lung cancer screening has not yet been determined and is currently being studied by the scientific community. Q14. Did C-Change consider including prostate cancer screening in its recommendations? A14. C-Change encourages prostate cancer screenings and recognizes that due to the widespread implementation of early detection, many prostate cancer cases are diagnosed early and survival rates are high. However, universal PSA screening is not recommended by the U.S. Preventive Services Task Force due to insufficient evidence of benefit. 9 Q15. Why is C-Change asking employers to invest in cancer prevention services? A15. C-Change is asking employers to invest in cancer prevention because of the great benefits prevention can have on reducing the incidence and mortality of cancer in this country. Employers are uniquely poised to provide solutions to this major public health problem, and data show that the investment will save companies money in the long run. About C-Change Q16. What is C-Change? A16. C-Change is a multi-disciplinary organization that brings together more than 100 nationallyrecognized leaders from across the public, private and not-for profit sectors to reduce the cancer burden in this country and eliminate cancer as a major public health problem. The goal of C- Change is to prevent an additional one million new cancer cases and 500,000 cancer deaths by 2010 through the individual and combined efforts of C-Change members. 4

Q17. What are the critical functions of C-Change? A17. The critical functions of C-Change are: To convene C-Change To identify major strategic issues To facilitate individual and collaborative action To leverage leadership To serve as a networking resource and bridge to key constituencies To track and report on progress To acknowledge and celebrate major developments and impact To provide a link to media and member services Q18. Who are C-Change members? A18. C-Change members are a group of nationally-recognized leaders from more than 100 different organizations and institutions across the public, private and not-for-profit sectors. The group includes leaders of key professional and patient advocacy organizations, heads of government agencies, state and federal legislators and executives, leading cancer researchers, physicians and allied health professionals, as well as CEOs of major corporations. Q19. How does C-Change facilitate individual and collaborative action? A19. C-Change facilitates individual and collaborative action by encouraging an interdisciplinary approach. C-Change is the first and only organization to employ such an approach to cancer. Members are asked to (a) take individual action according to their respective mandates, priorities and capabilities, (b) join groups of C-Change members and other stakeholders with mutual interests such as C-Change teams and work groups, and to (c) use a collective voice in resolving issues and overcoming barriers to accomplish what none of the members can achieve on their own. Q20. How does C-Change capitalize on the strengths of members? A20. The strengths of C-Change members contribute to the collective voice and force of C-Change as a whole. Members are engaged according to their areas of expertise and influence through their contributions to teams and work groups. Q21. Does C-Change connect to other key constituents? A21. Yes. C-Change believes it is important to broaden its reach with other groups that can influence cancer care in the United States which is inherit in the C-Change mission. Q22. Will C-Change track and report on its progress against cancer? A22. Yes. C-Change will use measures and benchmarks to highlight movement toward its goal of reducing cancer deaths. C-Change also will report to the public promising new developments, interventions, opportunities, collaborative successes and progress being made in preventing, detecting and treating cancer. Q23. Why does the United States need C-Change? A23. Great progress has been made in recent years because of cancer research. However, more than 1.5 million Americans will receive a diagnosis of cancer and about 566,000 will die of the disease this year. 10 It is being recognized that societal action and public health programs that address the cancer continuum, from prevention through late-stage treatment, are needed to conquer cancer. The nation s cancer effort needs the involvement of the public, private and not-for-profit sectors and a true multi-disciplinary organization is required to bring these concerns together. C-Change is uniquely positioned to tackle the current barriers to effective prevention, early detection and treatment of cancer, because it is the first and only organization that brings together representatives from every part of the cancer community. 5

### REFERENCES 1 Campbell, K.P., A. Lanza, R. Dixon, S. Chattopadhyay, N. Molinari, and R.A. Finch, eds. 2006. A Purchaser s Guide to Clinical Preventive Services: Moving Science into Coverage. Washington, DC: National Business Group on Health. 2 Pyenson, Bruce and Patricia A. Zenner, Milliman, Inc. 2005. Cancer Screening: Payer Cost/Benefit thru Employee Benefits Programs. Commissioned by C-Change and the American Cancer Society. 3 Barnett A, Birnbaum H, Cremieux P, Fendrick AM, Slavin M. The Costs of Cancer to a Major Employer in the United States: A Case-Control Analysis. Am J Manag Care. 2000;6(11):1243-1251. 4 Barnett, A. and H. Birnbaum, et al. 2000. The Costs of Cancer to a Major Employer in the United States: A Case- Control Analysis. The American Journal of Managed Care 6(11): 1243-1251. 5 Pyenson, Bruce and Patricia A. Zenner, Milliman, Inc. 2005. Cancer Screening: Payer Cost/Benefit thru Employee Benefits Programs. Commissioned by C-Change and the American Cancer Society. 6 Executive Summary: Making the Business Case for Smoking Cessation. America s Health Insurance Plans. 2005. Available at: http://www.businesscaseroi.org/roi/apps/execsum.aspx. Accessed: October 18. 7 Campbell KP, Lanza A, Dixon R, Chattopadhyay S, Molinari N, Finch RA, eds. A Purchaser s Guide to Clinical Preventive Services: Moving Science into Coverage. Washington, D.C.: National Business Group on Health. 8 Fellows JL, Trosclair A, Rivera CC. Annual Smoking Attributable Mortality, Years of Potential Life Lost, and Economic Costs - United States, 1995-1999. MMWR. JAMA-J Am Med Assoc. 2002;287(18):2355-2356. 9 http://www.ahrq.gov/clinic/uspstf/uspsprca.htm 10 Cancer Facts and Figures 2008. Atlanta, Ga: American Cancer Society; 2008. Available at: http://cancer.org/statistics. Accessed March 18, 2008. 6