NAHCP’s Mike Thompson Highlights Crucial Strategies for Enhancing Employee Health and Equity

Mike Thompson | Image Credit: NAHCP

At this year’s invite-only Community Oncology Alliance (COA) Payer Exchange Summit on Oncology Payment Reform, held October 23-24 in Reston, Virginia, leaders from across all facets of the cancer care space—providers, payers, employers, employer health groups, and benefits consultants—engaged in thought-provoking panel discussions and debates. They have a common aim: to optimize cancer care delivery and ensure patients have a positive experience throughout their cancer care journey.

In this interview with The American Journal of Managed Care®, Mike Thompson, president and CEO, National Alliance of Healthcare Purchaser Coalitions, hit on several factors of vital importance to this aim. He addresses how employers can leverage health care strategies to improve employee health outcomes, especially regarding mental health, work-life balance, and equitable access to care; implementing health equity initiatives at the population and clinical level to enhance care services and outcomes; optimizing the whole person cancer journey; and why collaboration between stakeholders in sustaining health programs is necessary.

This interview has been lightly edited for conciseness and clarity.

The American Journal of Managed Care® (AJMC®): How can employers best leverage their health care strategies to improve the overall health outcomes and well-being of employees and their families, especially in addressing mental health, work-life balance, and equitable care access?

Thompson: Employers at the end of the day are focused on value, and the way to think about value is improvements in well-being divided by cost, to the extent that programs that are spending money on health care that's unnecessary or overpriced, that doesn't improve well-being. What does improve well-being are investments in mental health, investments in financial well-being—all the key elements of improving the lives of employees both at work and at home.

What smart employers are doing is figuring out how to save money on health care costs in a way that doesn't impact well-being and reinvesting that in unusual needs, including things like college education or loans, and other elements that improve. Caregiving is a big area. Mental health is an area that not only do they invest in the support of people who might be experiencing mental health issues, but they also invest in the environment itself. Because the workplace itself can be a key driver. And so they work with supervisors on better understanding how they're affecting the mental well-being of their employees, but also how to identify and refer people to resources when they need it.

AJMC: How can initiatives that promote health equity be adapted and implemented at the population and clinical levels to enhance health care services and promote better health outcomes? Does the NAHCP have any initiatives in this area?

Thompson: Health equity is a major initiative for the National Alliance. We believe very strongly that we need to be more aware and intentional about addressing differences in who's achieving what outcomes. This really starts with understanding and measuring where there are gaps and differences within the population that can be based on race or income or ethnicity, LGBTQ. All of those are potential drivers, and employers need to be cognizant of measuring their key performance indicators with an eye toward are they seeing differences. When they actually find differences, sometimes that identifies blind spots in both issues that they need to be more intentional about addressing or things that they were inadvertently doing that were causing some to engage and others not to or some to achieve outcomes and others not to.

At the end, there is a common experience for every individual. And what it really comes back to is treating the individual where they're at. That is really what we think of in terms of whole-person health: Looking at an individual, they're not one thing, they’re many things. So meeting them and understanding them. It’s valuation on a subgroup basis, but execution on a highly personalized basis.

AJMC: Based on your participation in the panel discussion, “Multistakeholder Collaboration to Optimize the Whole Person Cancer Journey,” can you speak to key insights that oncology stakeholders should consider to create a comprehensive ecosystem for cancer?

Thompson: I think sometimes we think about cancer as, the patient journey for cancer starts with diagnosis and ends when they leave the hospital. But in fact, it's a much longer journey. You start with understanding how can we prevent cancers? What are the issues that particularly employers can lean into to educate on prevention strategies, early identification? If you can identify early, then frankly, it's survivability and back to work. Those are all part of that patient journey. But importantly, all of that journey is more complicated than just the clinically issues around cancer.

Oftentimes when somebody gets cancer, they also experience mental health issues. They might have social needs, transportation or other needs, caregiving—all of those issues need to be considered. Employers play a very important role in helping to navigate those things with the employee. And frankly, providers also have to lean into those issues as well and make sure the overall whole person needs are being met if you're going to achieve optimal outcomes.

AJMC: Can you elaborate on any proven methods to achieve financial optimization while preserving quality care? How can such a purchase be sustained over the short and long term?

Thompson: For years, there was a sense within oncology, specifically, that employers were a little hands off. This is a very life-threatening condition and one that they wanted to make sure that employees had maximum freedom to get what they needed. But over time, it's become increasingly unaffordable, even under today's benefit plans, to be treated for cancer. And I think employers increasingly are going to lean into being more selective on how they provide preferred access to some providers—both through primary care, but also through specialty care—so that they can offer an alternative that is much more affordable and preserves very-high-quality access.

We know that for rare cancers, there may be a need for National Centers of Excellence, but for the great majority of cancers, great care can occur and does occur in your local community. And then the question is, can you create accountabilities and relationships that support employees and their families and preserve local access so they're not taken far from their loved ones?

AJMC: What roles does collaboration between stakeholders play in sustaining these programs?

Thompson: At the end of the day, it's very difficult to imagine that a provider can know what every employer is offering, because it varies. And when you're dealing with a patient, in some ways, if support services aren't offered to that patient, it's probably too late for them to look to the employer to step in. More likely is that we can lean in together on looking at where the gaps are and building a system of support across employers and across the provider community that is mutually beneficial. That's where engagement at the community level among coalitions, employers, and providers can make a difference to identify where are the opportunities to make it better and how do we work together to close gaps.