You are an employer of a large construction company (1,000 employees) for whom you are responsible for covering healthcare benefits. In your community there are two main centers that provide cancer care. Cancer Center A offers discounted rates compared to Cancer Center B, but Cancer Center A does not provide care for 5% of rare cancers. Cancer Center B provides comprehensive cancer care including access to clinical trials for rare cancers. Cancer Center B’s average negotiated rates are 15% higher than those of Cancer Center A. If you choose Cancer Center A and have an employee with a rare cancer, you will be responsible to cover costs of care at Cancer Center B at fee for service rates. How would you navigate this conundrum?