Why cancer misdiagnosis is quietly draining self-insured health plans, and what benefits leaders can do about it.
Cancer is now the #1 driver of high-cost claims for self-insured employers, yet the conversation typically focuses on the wrong number. The real crisis isn’t the headline price tag of a treatment plan — it’s the treatment plans that should never have been written in the first place.
Up to 40% of initial cancer diagnoses are revised after expert review, and nearly as many treatment plans change as a result. For benefits leaders, that’s not a clinical statistic. It’s a budget problem hiding in plain sight.
In this conversation, Dr. Kamal Jethwani (Moffitt Cancer Center), Nisha Gandhi (ClearOnc), and patient advocate Dr. Grace Cordovano unpack where the money is leaking, why standard utilization-management tools miss it, and what employers are doing now to put Moffitt-grade expertise in front of members within days of diagnosis.
We can walk you through what employer partners typically uncover in the first 90 days of expert review — and what it’s worth to your plan.