Episode 31 – AccessHope – Fighting cancer with everything we know™

Mike Stull:

Hi, everyone, and welcome to this month’s episode of HR Benecast, your source for expert commentary and insights on current health benefits-related news and strategies. This is your host, Mike Stull.

It’s hard to believe summer is almost over. I’m happy to report that our sales team has stayed extremely busy this summer. We have a number of new clients joining us so far for 2023, which relates to over $200 million in new pharmacy spend that will be added to our programs. We participated in more than 200 evaluations by independent consultants so far this year, and we’re truly thankful for our existing clients, those prospective clients, along with their consultants who put their trust in our team.

A special thanks to all of our existing clients who served as references. You are the best part of the process in terms of giving prospective clients a voice to hear as far as what the actual experience is of participating in an Employers Health program. So, thank you to everyone who participated as a reference this year.

With the end of summer also comes our annual market check results, and we have some great ones to share with our clients again this year. The improvements to our contract are achieved through better pricing, so we’re talking about better discounts off the list price of drugs, better dispensing fees and better rebates. And then also we take the opportunity to tighten up the contract in terms of definitions and other terms where it’s needed. So, be on the lookout for your specific results. And then, also be sure to stay tuned for our always popular market check webinar that will feature Dave Uldricks, where he’ll share details on this year’s market check results.

Our 2022 annual meeting will also be available again virtually, so save the date for November 16th. Again, it’ll be virtual and in person here in Canton, Ohio. We’ll be down at the Hall of Fame, and we’ll be hearing from our legal team. You can also be sure to stay up to date on all upcoming Employers Health events by checking out the website at employershealthco.com.

Today’s speaker joined us at our last Innovations in Benefits Conference in May. We really enjoyed having him and hearing the mission of his organization and so, invited him to join us here on the podcast so he could share his story with those who couldn’t make it to the conference. Brian Beran is Vice President of Channel Partner Sales at Access Hope, and works to promote the organization’s missions to deploy the latest in cancer care knowledge to the places it’s needed most and when it’s needed most. Through Access Hope, Brian works to make sure that the best and brightest in cancer care is available to all. So, let’s hear from Brian and discover how Access Hope is working to make cancer care more accessible to everyone.

All right. Welcome, Brian. It’s great to talk to you today. To get us started, can you tell us a little bit about yourself and your journey to Access Hope?

Brian Beran:

Yeah, thanks for having me. So, a couple of things actually led me to Access Hope. One, I had the pleasure of working for Mark Stadler, our CEO, several jobs ago in my career path and had just an enjoyable experience working with not just a great boss, but a great human being. So, when there was an opportunity to rejoin and work for him again at Access Hope, I had to jump at it.

But I also had some personal experiences with cancer. So, my wife was unfortunately diagnosed with colorectal cancer two weeks into the shutdown for the pandemic, so early April of 2020. And during that time, I kept watching all the news articles and media attention tied to Access Hope and the good that they were doing in the fight against cancer. And with that personal experience, I really wanted to join that fight and do everything I could to use Access Hope more as a platform for getting my story out there, finding a way to help people where they need it most and really get them the care that they deserve, no matter where they are, where they live, what they do. But creating that equal opportunity for everybody on the path of survivorship.

Mike:

Excellent. So, a very personal mission, very personal purpose at Access Hope. So, what did you do before?

Brian:

So, I’ve been all over the industry. I started in 2009 on the wellness side, working for a company that offered biometric screenings and flu vaccinations as part of a corporate wellness program. From there, that’s when I had the pleasure of working with Mark at a Centers of Excellence organization. Then I moved on to digital navigation to a startup PBM and then eventually Access Hope. So, I’ve been in multiple verticals within the health care and wellness industry, but it finally led me to a mission-driven career path.

Mike:

That’s awesome. So, tell us a little bit more about Access Hope. Tell us how it got started. What does it do to support employers and their employees that are dealing with a cancer diagnosis?

Brian:

Yeah. So, Access Hope was originally founded by City of Hope. And if you’re not familiar, City of Hope is a world-renowned cancer hospital, National Cancer Institute comprehensive cancer center based here in Southern California. But the idea was based on the fact that there’s a gap in cancer care knowledge in the U.S. between the National Cancer Institute comprehensive cancer centers, where there are about 51 nationally. So, the top tier academic institutions, and the community health systems, where 80% of the patients are currently being treated for cancer. And the gap isn’t necessarily the local oncologist’s lack of knowledge. They’re just burdened with a lot more responsibility, less time and resources to really focus on all the new target therapies and treatments available in cancer care. So, City of Hope’s idea was not, how do we get members into the system or patients into the system, but rather, how do we take that knowledge and extract it out to the community, creating an equitable solution that lifts up the level of cancer care in the community and closes that gap in cancer care knowledge.

So, we were founded in 2017, and incorporated in 2019. Since then, we have brought on additional comprehensive cancer center foundational partners. We partnered with Northwestern Medicine in November of 2020, we partnered with Dana Farber in June of 2021. Most recently, we partnered with Emery out of Atlanta in January of this year, and we are hoping to announce a fifth partnership in the next 30 days. So again, focusing on the National Cancer Institute’s comprehensive cancer centers and finding a way to close that gap in cancer care knowledge by extracting the knowledge out to the community. So, all the partners are aligned in our mission of democratizing cancer care and really lifting up that community. And through those partners, we have access to over 300 multidisciplinary subspecialists for our reviews.

So, when we are focusing on these cases for review, we’re looking at it down to the “N”of one and individualized for that specific patient. So, when we have a cancer case come in, that case is then triaged and reviewed by a consulting oncologist through one of our foundational partners who is a practicing oncologist in the academic institution. And they have the ability to pull in the multidisciplinary experts as they see fit, which can be radiation therapists, surgeons, pathologists, etc. In that multidisciplinary review, we are able to replicate what patients would be receiving from a consultation standpoint as if they were physically going to one of these centers. Our model is designed so that we can keep the patients where they are and that unique patient, provide a relationship in their community, but leverage the knowledge of those multidisciplinary experts to design the treatment plan and optimize it for the best outcomes.

So, the goal is to optimize that treatment plan, empower the local treating oncologist, lift up the community, closing that gap in cancer care knowledge. And what we’ve done is we’ve designed two main products around that one product. Accountable Precision Oncology is our flagship product. It’s where we started. It focuses on complex cancers only and it’s driven by data. So, case identification is driven by medical claims data received from the health plan and third-party administrator partners. And with that data, we’re able to run proprietary algorithms to identify the complex cancers. Once those cancers are identified we then move into medical record collection by reaching out to the local treating oncologist making them aware of who we are, what we do, the fact that we’re not taking their patient away from them and out of their system. And we are also not going to be billing them for the service because of how the contracts are designed to support the plan.

Once we’ve made that introduction and collect the medical records, which can oftentimes be hundreds, if not thousands of records per case, it then moves into that multidisciplinary review. Following the review, we’re able to develop a personalized precision report that is delivered back to the local treating oncologist where it lists out all of our recommendations, all of the medical record information we’ve collected, any clinical trials we’ve identified to be relevant for that individual, and then ultimately all referenceable sites and peer-reviewed studies used in making those recommendations. And finally, a biography on the local consulting oncologist providing those recommendations so that the local treating oncologist understands that these recommendations are coming from somebody currently practicing at the top tier academic institutions.

Finally, we do offer longitudinal support for that local treating oncologist by offering them unlimited clinical consultation calls with our team of Access Hope medical directors so that they can focus on any questions that they have regarding that personalized precision report. In addition to accountable precision oncology, we also have a member-facing solution where they can initiate any expert opinions that they choose based on any cancer type that they’re facing.

Mike:

So, I think the important thing when I first heard about this was that the treatment is still happening in the local community and cancer treatment is changing. Thankfully, the science continues to evolve in this case, and so I think the treatment continues to change. So, having access to all the latest and greatest research is of benefit to that local treating physician. What’s the response been like from the local physicians? How often are they taking the recommendations?

Brian:

Yeah, you’re spot on. The fight against cancer is moving forward in a great way with target therapies and off-label usage, et cetera, but that’s increasing the burden on the community oncologists and keeping up with the pace of change. So, medical knowledge is doubling every 73 days, which makes it very difficult. And four-out-of-five community oncologists are acknowledging the fact that they can’t keep up with the pace of change in genomic and precision medicine. So, the adoption really comes at the local level.

So, first off, we’re not mandating anything. These are all recommendations that we’re making to the treating oncologist, so it’s still their decision with their patient on the path that they move forward. The feedback we’ve received is that the recommendations we’re making have been fantastic. And in 89% of the cases we review, we are making some form of recommendation to that localized treatment plan. This is also referenced in a peer-reviewed study that’s available through the medical journal JCO Oncology practice, where in that peer-reviewed study, there were 93% of the cases we review had some form of recommendations in that study. So, again, not to say that the care delivery in the community is not where we need it to be, but they are just faced with a much bigger challenge in keeping up. One of our medical directors shared with me that he’s reading peer-reviewed articles every hour of every day and the community oncologists don’t have that kind of time or bandwidth. So, that’s where connecting the two through somewhat of a virtual hallway between the community and the academic institutions is a way to really scale and provide the support they need at the local level.

Mike:

Excellent. So, employers are one of your targets. Could you talk about how many employers you work with today?

Brian:

Yeah, currently we have more than 75 clients, but we are providing our services to more than 3 million members. So, the employers we’re working with are typically the large innovative employers. They were the first to adopt our services and the impact has been tremendous. We’ve seen great success across all of these groups. We do have 23 of the Fortune 500 and we’re continuing to grow. We’re continuing to see accelerated growth now through additional partnerships and other large market employers looking to join our portfolio.

Mike:

And obviously, cancer shows up in the top conditions for really all of all of our clients. How do you measure the impact that you’re having, whether it’s from a spend perspective, or a patient satisfaction perspective, or work, or any of those other types of measures?

Brian:

Yeah, so we have a couple of different measures that we’re looking at. So, first the number one, our mission and our goal is to improve clinical outcomes and provide humanistic impact. In theory, if you’re improving clinical outcomes, the savings will follow. In our data-driven, complex cancer-focused product we have measured, and this is supported also in that peer-reviewed study in JCO oncology practice, we are seeing three-to-one ROI across our book of business for accountable precision oncology. That again is a byproduct of the impact we’re having on humanistic outcomes. In our member-facing solution, we are consistently seeing north of 70 on our Net Promoter Score. So again, providing top-tier member support and member experiences met by the Net Promoter Score.

Mike:

Excellent. You talked about the humanistic side. Obviously social determinants play a big role in all of health care. But could you talk a little bit about how social determinants of health play a role, specifically as it relates to cancer?

Brian:

Absolutely. So, there are a lot of statistics out there for social determinants and higher-risk individuals when it comes to cancer. Access Hope was designed as an equitable solution, giving everybody equal opportunity in the fight against cancer. So, no matter where you live, no matter what job you have, or what your socioeconomic status is, you will have equal opportunity in survivorship based on the optimized treatment plan.

Where the greatest impact is delivered is going to be in these communities where you see the higher cancer incidence rates and individuals who are at higher risk. So, our goal at Access Hope, as you’ve heard from this conversation, is really how can we give everybody the same chance in that fight against cancer without having to get on planes and travel around the country. Let’s keep them where they are. There’s a huge component in the fight against cancer that’s driven by the community lifting up the individuals emotionally and mentally in that fight against cancer. That is a huge piece of it. So, by keeping them in that community and the community support system, the friends, family, colleagues, et cetera, we’re able to empower that individual and really get them to return to their quality of life.

Mike:

One of the other big challenges for employers is just their policies around those who are caregivers for individuals with cancer. So, at Access Hope, I know you’re focused a lot on the treating physician and getting the right treatment options in place. Are there any kind of peripheral programs that help your employer clients with those that are caregivers for individuals with cancer, similar to the role you found yourself in?

Brian:

Yeah, absolutely. So, we have our cancer support team, which is a team of oncology nurses that are available 12-hours a day, Monday to Friday, to talk about anything related to cancer. So, you don’t need a diagnosis to talk to them. They’re available to everybody. So, it could be a caregiver that’s supporting their mom or dad, and they just have questions on, how do I help my mom and dad get through this fight that they’re seeing? It could be somebody who was treated or was diagnosed with cancer, beat it, in survivorship for 40 years and something just seems a little off. So, they want to talk to somebody, so they’re there to talk to them through everything. So, they’re almost like the caregiver for the caregiver.

As a caregiver myself, I can tell you it’s an emotional roller coaster. You carry a lot of burden in what’s the right information, who’s doing the right thing, trying to tell everybody not to Google everything that you’re seeing because you’re going to go down a dark hole and you’d rather just listen to your doctor. But that’s not easy to do when you’re waiting two weeks between appointments to see your doctor, and you need answers now.

So having access to this cancer support team is really a way to support the individuals in this emotional roller coaster that they’re facing. Because there’s a lot of push and pull and tugging going on, a lot of people trying to tell you what to do and what not to do based on what they’ve heard from their friends going through it. But if you’ve seen one cancer, you’ve seen one cancer, and everybody’s fight Is different. So, it needs to be individualized. And we try to create that empathetic connection between our cancer support team oncology RNs and the member and keep that relationship intact so that they can build trust and really develop that relationship over time to be part of their community as they’re going through that fight. But the caregiver is something that’s often overlooked in this fight, and the burden and the weight that they carry in helping their loved one fight that cancer piece. So, the Cancer Support team is really that full 360-degree wrap-around view of what we can do to just support individuals whenever they have questions tied to cancer.

Mike:

Yeah, well, I know since we first talked, I feel like that was forever ago, but I know I’ve been inspired by the work that you all are doing, and hopefully, a lot of our clients will listen to the podcast. Hopefully, a lot of them stopped by at the innovations conference and checked out your session. But for those employers that want to learn more, where do they go?

Brian:

Yeah, so they can go to our website. It’s myaccesshope.org. We also have blog posts, newsletters that you can subscribe to, resources on cancer support, and employee benefits, we also have a LinkedIn page as well, so multiple ways to get in touch with us and seek out more information on what we’re doing in this fight against cancer.

Mike:

Excellent. And if you didn’t say it, say the website one more time.

Brian:

Yes. Just to repeat it’s myaccesshope.org.

Mike:

Awesome. So, for employers that are interested in getting more info, that’s the place to go. And Brian, it was a pleasure to talk to you again, and I really appreciate you taking the time to be with us today.

Brian:

Thanks so much, Mike. Really appreciate it.

Mike:

Thanks, Brian. It was great to hear how Access Hope is working to improve clinical outcomes and ultimately achieve savings and positively improve those humanistic outcomes. To learn more about Access Hope, visit myaccesshope.org.

Next, I want to share the keyword for this month’s episode for the $50 gift card drawing. The keyword is accessibility. So, if you’d like to be considered for the $50 gift card, please submit the keyword “accessibility” along with your name and email address on the link on the landing page. Also, if you have any questions, you can submit those on the landing page as well.

Before we go, I want to thank our sponsors for helping not only make this podcast possible but for supporting us and providing great employee benefits-related content. Thanks to our annual supporters CVS Health, Optum Rx, and Elixir and our executive supporters Delta Dental, Pear Therapeutics, Pfizer, and US-Rx Care. Visit employershealthcare.com/supporters for a full list of sponsors.

Again, don’t forget to submit your questions by completing the field on our landing page or clicking the link titled Submit Your Questions Here. And then be sure to subscribe to HR Benecast to be notified when the latest episode is out, and hopefully, we’ll get to answer some of those questions in a future episode.

There’s always something new at Employers Health, so be sure to follow us on our social media accounts, LinkedIn and Twitter to stay up to date. So, that’s a wrap on this month’s episode. Thanks again to Brian and everyone at Access Hope for the work that they do and thank you for taking the time to listen and for your continued membership, participation, and interest in Employers Health. Be well, and we’ll see you soon.