Why UnitedHealth expanded its cancer prevention benefits

As employers have embraced cancer care and support as a vital part of their employee benefit packages, UnitedHealth is offering a new option to bring these offerings to the next level by covering diagnostic tests screening for colorectal and breast cancer.   

Early intervention is a critical prevention strategy, especially as approximately 1.9 million people get diagnosed with cancer each year, according to the American Cancer Society. Yet the rate for cancer screenings are still lower than they should be — specifically those for breast cancer and colorectal cancer, which have adherence rates of about 70%, according to the Center for Disease Control. 

"We are seeing more and more young individuals get diagnosed with cancers like colorectal cancer and breast cancers at earlier ages than prior generations," says Dr. Rhonda Randall, chief medical officer at UnitedHealth. "We wanted to find any opportunity we had to remove any real or perceived barriers to those people getting necessary tests done." 

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Routine and annual cancer screenings, which are performed and treated as standard preventative care, are typically fully covered under most health insurance plans, especially after the passing of the Affordable Care Act. However, diagnostic tests, which are either performed following a screening's findings or because symptoms have already begun, are frequently considered non-preventative and subject to copay, deductible and coinsurance costs, which discourages many employees from following up. In some cases, it even keeps them from scheduling screenings at all in fear that they'll find something. Without early intervention, employees' chances of needing more extensive care grows significantly. 

"We chose to focus on those cancers for a couple of reasons," Dr. Randall says. "Number one is that they are the two cancer screenings with the biggest opportunity to be done at higher rates. The second is they are also the two screenings we found to have a higher tendency to result in a follow-up diagnostic claim from healthcare professionals and providers." 

By broadening their coverage, UnitedHealth's goal is that it encourages employees to start the cancer screening process sooner and go through with it completely; which is also a significant benefit for employers, who could see lowered healthcare costs as a result of improved adherence rates. 

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"There are many reasons it's important to catch things early when they're in their earliest stages and when they're the easiest to treat," Dr. Randall says. "If employees and their dependents are getting answers earlier they'll have an easier course of treatment, miss less work and stay healthier longer." 

Although this coverage will only extend to breast cancer and colorectal cancer for now, Dr. Randall stresses the importance for benefit leaders to improve the conversation around screenings and diagnostic tests for all cancers because preventative care goes beyond a single appointment. 

"We can't prevent all cancers and we can't detect every cancer early," Dr. Randall says. "But for the ones that we know we can, there is a significant correlation between better experience, better outcomes, lower costs for members and employers in promoting and improving access to good preventative care."