A study of 130 HR and benefits decision-makers reveals a widening gap between what employers prioritize, what they believe, and what they've actually built.
Six in ten HR and benefits leaders say cancer is one of their top three cost drivers. Nearly three-quarters strongly agree that early expert intervention improves outcomes and reduces downstream costs. Yet more than a third still have meaningful blind spots in their cancer spend data, and roughly half of organizations whose top priority is improving outcomes don't currently offer an expert second opinion benefit.
That pattern intensifies at scale. The largest employers in this study carry the strongest convictions about expert care and the most formal strategies on paper, but they also report the lowest spend visibility and the lowest rates of expert second opinion programs in place.
The story underneath these numbers is about employers reaching faster than their infrastructure can keep up, not employers falling short of their employees.
When asked where cancer ranks in their organization's healthcare costs, more than six in ten leaders place it in their top three. Yet only 63% say they have clear data on what their organization actually spends. The rest are operating with gaps, limited visibility, or no tracking at all on a category they've identified as one of the highest-cost areas they manage.
"Our biggest gap is earlier identification and faster routing. If we can catch cases sooner and guide people to the right care immediately, everything downstream gets better."
Cancer commands a disproportionate share of catastrophic claims, yet more than a third of organizations can't measure that exposure with the same precision they apply to lower-cost categories. The visibility gap stems from tooling and integration constraints rather than a lack of will, often rooted in fragmented carrier data and lagging claims feeds.
Ninety-four percent of HR and benefits leaders agree that early expert intervention can meaningfully improve outcomes and reduce downstream costs. Seventy-two percent strongly agree. Yet only half currently offer an expert second opinion or expert review program. Among the leaders who name improving clinical outcomes as their top priority for the next 12 to 18 months, more than half don't yet have an expert review benefit in place.
"It's mainly shaped by claims experience and real high-cost case reviews. Earlier access to high-quality care often improves outcomes and reduces total long-term costs."
Almost every leader in the dataset believes that getting employees to oncology expertise faster improves clinical and financial outcomes. The bottleneck is converting that conviction into an actual benefit on the plan. Among the organizations that name outcomes as their top priority, this gap is widest. These are the buyers most likely to act in the next 12 to 18 months.
Among large and enterprise employers (2,500+ employees), 56% have either built an integrated cancer care strategy or are actively working to consolidate point solutions into one. Only 30% say they're satisfied with a multi-point-solution approach. The drivers, in respondents' own words, are fragmentation, employee experience friction, and the vendor-management overhead of stitching a dozen disconnected programs together.
"I'd eliminate the data silos between our primary health carrier and our independent point solutions, to enable an automated trigger the moment a cancer diagnosis code is entered. That would instantly bypass administrative delays and connect the patient with specialized navigation."
Employer experience is becoming the deciding factor, not catalog breadth. Leaders who chose "improving employee experience and navigation" as their top priority (36%, the largest single bucket) outnumbered those focused on cost reduction nearly three to one. The center of gravity is shifting toward connected, coordinated cancer care, with a single guided pathway from diagnosis to survivorship.
The 54 enterprise employers in this study (10,000+ employees) collectively represent more than 1.3 million covered lives. They have the most mature cancer benefits programs in the dataset: 74% have a formal, documented cancer strategy, a higher rate than any other segment. They also hold the strongest convictions about expert care, with 80% strongly agreeing that early expert intervention improves outcomes. Yet enterprise employers report the lowest visibility into their cancer spend, and they are less likely than mid-market peers to offer an expert second opinion benefit. Scale brings sophistication. It also brings fragmentation.
"Currently, the health carrier handles chemo, a TPA handles FMLA leave, a PBM handles the drugs, and an EAP handles mental health. The employee is stuck acting as their own project manager. We need to unify these islands into a single, cohesive experience."
"We've realized that the cost problem is actually a symptom of a broken employee experience. When a frontline worker gets diagnosed, they don't know where to turn, so they default to the nearest emergency room or the first local clinic that has an opening."
Eight in ten enterprise leaders strongly believe early expert intervention improves outcomes, the highest conviction of any segment. Yet fewer than half offer an expert second opinion benefit today, and nearly half operate with data gaps on a cost category they've already identified as a top concern. When enterprise leaders describe what's driving them toward integration, they use one word more than any other: experience. The next wave of enterprise cancer benefits decisions will be made on how connected the journey feels for the employee, not how many vendors sit on the slide.
AccessHope is an employee cancer care benefit that connects every diagnosis with the latest expertise from National Cancer Institute–designated Comprehensive Cancer Centers. Subspecialist case reviews, treatment plan validation, and ongoing case support sit alongside the plan you already have, without asking employees to switch doctors or leave home.
For employers seeking to move from belief in early expert care to actually delivering it, AccessHope is the bridge.
Fighting cancer with everything we know.™
AccessHope fielded an online conversational survey of HR and benefits decision-makers between May and June 2026. Respondents were senior leaders with direct ownership or influence over cancer benefits strategy at organizations with 500 or more employees. Quotas were applied across organization size to support segmentation. All percentages are calculated against the full respondent base unless otherwise noted. The 130 organizations in the study collectively represent more than 1.6 million covered lives, with enterprise employers (10,000+ employees) accounting for the majority of that population.
All percentages have been rounded to the nearest whole number using a largest-remainder method, so pie and doughnut chart totals sum to exactly 100%. Multi-select questions (cancer resources offered) reflect the percentage of respondents who selected each option and therefore exceed 100% when summed. Open-ended responses were classified into a unified set of buckets across the entire respondent base. Quotes have been lightly edited for length and clarity. Organization size data is sourced from PureSpectrum panel B2B profiling.