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At Moffitt, a push to ease cancer's toll in the workplace

Cathy Bishop, a retired teacher and assistant principal in Hillsborough County, is in remission after treating stage IV colon cancer at Moffitt Cancer Center in Tampa. The disease affected key decisions about her career and retirement. [Photo courtesy of Moffitt Cancer Center]
Cathy Bishop, a retired teacher and assistant principal in Hillsborough County, is in remission after treating stage IV colon cancer at Moffitt Cancer Center in Tampa. The disease affected key decisions about her career and retirement. [Photo courtesy of Moffitt Cancer Center]
Published Feb. 6, 2018

Cathy Bishop worked as a teacher and assistant principal at Hillsborough County schools for nearly 35 years when she found out she had colon cancer.

Diagnosed after a routine colonoscopy, she had to make a tough decision about how she was going to let the disease impact her career. She would rely on the health insurance offered to her through the school district to pay for medical bills that stacked up because of chemotherapy and surgery. But ultimately, Bishop chose to work through her diagnosis and treatment plan instead of taking medical leave.

"My retirement is a teacher's pension, which is half a salary. Basically, not much," Bishop said. "I have two sons, and one of them was in law school at the time. I had to make a decision that was best for my family."

Bishop told her story Monday to a room full of professionals from some of the Tampa Bay region's largest employers. Tech Data, Port Tampa Bay, the YMCA and the city of Orlando government were just a few of the organizations in the audience at the Moffitt Cancer Center in Tampa. Moffitt hosted its first ever "Employer Forum," where doctors and administrators shed light on the cost of cancer and its huge impact on the workforce. They also proposed a new way of collaborating with insurers to make treatments more affordable for patients like Bishop.

"It's a topic that's hardly ever mentioned in the workplace, but the employer plays a big role in terms of support for the patient and their family," said Dr. Louis Harrison, chief partnership officer at Moffitt and one of several physicians who shared stories about how difficult it can be for patients to balance work and cancer.

"Just recently I was treating a patient with neck and head cancer who was worried a test was going to take too long," he said. "He told me he had to get back to work or else they were going to be angry with him. What a predicament."

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Cancer is the leading cause of long-term disability in working adults, said Mariana Bugallo-Muros, Moffitt's chief human resources officer. The disease costs organizations $264 billion a year in medical care and lost productivity. It's also among the top 25 diseases that employees are most at risk for. And cancer is the second-leading cause of death in Florida, followed by heart disease, according to the Centers for Disease Control and Prevention.

"It can be catastrophic to an organization," Bugallo-Muros said. "We're facing some challenging health care trends, where we have to figure out how to sustain increased costs on a day-to-day basis."

Moffitt recognizes this glaring problem and wants to do something about it, said Cindy Terrano, the vice president of payer services at the center. The goal of Monday's forum was to reach out to employers about the issue, and offer the chance to collaborate with Moffitt on a solution. Terrano says that can be through health insurance partnerships directly with Moffitt, which include telemedicine, prevention screening and developing new payment models that make sense for companies and those they insure.

"We realize that employers are intimately involved in the design of their health insurance plans," Terrano said. "We think that by sharing our thoughts with them directly, they can influence change that will help patients, or partner with us on new programs."

Moffitt has several pilot payment programs in the works with major insurers like Cigna and Aetna for specific treatment plans, like colonoscopies or prostate exams. Terrano says Moffitt can customize other health care solutions for employers, like return-to-work programs for cancer patients out of surgery and in remission.

The opportunity exists for data sharing, too. For example, screening employees who smoke and encouraging them to take wellness exams and check-ups at more frequent or earlier routes.

"We realize that there's no one medical treatment plan that works for every individual patient. So we've come up with personalized care, which we think can be cost effective to employers who pay for these plans," Terrano said. "Today was all about sharing our thoughts and engaging directly to see how we can help."

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When Bishop was diagnosed with cancer in 2014, she knew she wanted to be treated by the oncologists at Moffitt. But she struggled to get an appointment because Moffitt wasn't in her primary care doctor's network. Her efforts were denied twice.

Through the help of friends and patient advocates at Moffitt, she was able to get an appointment.

And Bishop is thankful she did, because the cancer eventually spread to her liver, putting her at Stage IV status.

"You just don't know how long you're going to be out of work or what's going to happen," she said.

Bishop said she felt pressured to take a medical or sick leave from the school district at the time of her diagnosis. But medical leave came with no salary, which was not an option for her and her family.

"How am I going to pay for the health insurance I need without a salary? My husband is self-employed," she said.

Health insurance costs Bishop and her family about $1,000 a month, or about $600 just for herself. She also started paying for a supplemental cancer insurance add-on when she was about 40 years old because she knew cancer ran in her family.

Friends and coworkers offered to donate sick days to her when needed. Bishop took the summer of 2015 to rest after a surgery in May that year, but returned that November to finish out what would be her last school year.

"My strength came from the staff at school," Bishop said "I knew I had to be strong to face the kids every day."

Contact Justine Griffin at jgriffin@tampabay.com or (727) 893-8467. Follow @SunBizGriffin.

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