Cancer is one of the largest cost drivers in any self-funded plan, and most of the strategies built to manage it focus on price. Peter Bridges argues the bigger lever is making sure the patient is on the right treatment in the first place.
Only about 20% of cancer patients are treated at one of the country's 57 NCI-designated comprehensive cancer centers. The other 80% get care locally, from oncologists seeing a full schedule across multiple cancer types while the science moves faster than any one doctor can track. That gap shows up in outcomes, and it shows up in claims.
AccessHope closes it by bringing subspecialists from centers like Dana-Farber, Johns Hopkins, and Fred Hutch directly to the local oncologist. The diagnosis is identified in claims data, the treating physician is contacted, and the patient never has to travel, switch doctors, or ask for help.
We get into why lung cancer isn't a single diagnosis, why most local oncologists welcome an expert review rather than resist it, and why working-age adults now make up more than half of new cancer cases. Peter also explains why getting someone onto the right treatment early is the better financial decision for the plan, and what an employer actually has to do to put this in place.
If cancer claims are a line item you worry about every renewal, this is the episode for you. Tune in.
"Over 90% of the time, there is some change recommended to the care path someone is on. Oftentimes we make two to four separate recommendations." - Peter Bridges, AccessHope
Thank you to our 2026 sponsors!
ParetoHealth: ParetoHealth empowers midsize employers with a long-term solution to reduce volatility and lower overall health benefits costs. Visit https://www.paretohealth.com/fully-insured-vs-self-funding-with-paretohealth-spencer-podcast/?utm_source=youtube&utm_medium=referral&utm_campaign=SelfFundedwSpencer to learn more.
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Vālenz Health: We're Vālenz Health, your partner in improving health literacy, reducing plan spend, and delivering high-value healthcare. Visit ValenzHealth.com to learn more.
Imagine360: Imagine360 helps self-funded employers save on healthcare with smarter health plans. Cut expenses by 20-30% with custom solutions. Contact us today at Imagine360.com.
Chapters:
(00:00:00) Intro: Bordering on Cruel
(00:05:12) Meet Peter Bridges and AccessHope
(00:11:40) The 80% Treated Outside Top Cancer Centers
(00:17:25) Lung Cancer Isn't One Diagnosis
(00:23:08) Finding Cancer Patients in Claims Data
(00:28:44) Inside an Expert Review
(00:34:30) Why 90% of Reviews Change the Care Path
(00:40:02) Why Local Oncologists Say Yes
(00:45:37) Cancer in Working-Age Adults
(00:51:15) Why the Right Treatment Is the Cheaper Treatment
(00:57:06) Putting It in Place as an Employer
(01:03:22) Stories From the Field
(01:08:40) Closing Thoughts
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