Improving Cancer Care With Data-Driven Collaboration
Contributing experts: David Debono, MD, and Craig Hunter
Cancer isn’t just one disease; it’s many, each with a unique disease course and treatment plan. To deliver the best possible outcomes and patient experiences, it's essential that the healthcare system coordinates across disciplines to provide personalized, high-quality, more affordable patient-centered oncology care.
Carelon works with oncology practices and cancer centers through clinical support and payment models, programs, and solutions such as:
Oncology Medical Home: This incentive and risk-sharing model provides financial support for enhanced care coordination, combined with the opportunity for practices to share in the savings that can be realized through the successful provision of quality, holistic patient care.
Treatment Pathways: These highly specific cancer treatment regimen recommendations help enable personalized patient care, reduce unnecessary costs, and optimize health outcomes. Within our Oncology Medical Home program, practices are incentivized to follow these clinically rigorous evidence-based pathways. On-pathway regimens have been associated with significant cost savings and a better patient experience.
Cancer Care Engagement: Using oncology-specific cancer care navigators, we help patients throughout their cancer journey. Navigators coordinate care using personalized care plans guided by the clinical care team's direction; educate patients on their condition and treatment; support patients when they need it; and connect patients with resources for their physical, behavioral, or social needs.
Oncology Practice Enablement: Our clinical cancer care specialists build deep partnerships with oncology practices and cancer centers, assisting with delivery of the best possible care and promoting their success in the Oncology Medical Home model with data-driven insights.
By providing key quality metrics and supporting participants in our oncology programs, we help oncology practices make patient-centered, value-oriented treatment decisions to enhance the quality and affordability of cancer care.
100+
provider groups in Carelon’s Oncology Medical Home with over 3,200 unique national provider identifiers1
86%
engagement among patients identified for Cancer Care Engagement2
7.5%
lower year-over-year inpatient utilization trend3
85%
of chemotherapy drug spend informed by cancer care pathways4
Helping Care Providers Succeed
Carelon's Oncology Medical Home (OMH) model recently launched a provider dashboard embedded within our existing single-sign-on provider portal. Care providers will continue to use this portal to get treatment authorizations and will now also benefit from integrated access to patient-level pathways and authorization data; practice-level clinical quality metrics; details on patients engaged within the CCE program; and a summary of overall practice performance within the model, all via an easy-to-use interface.
This cohesive solution allows care providers to proactively track their practice and patient activities while furthering transparency and collaboration to improve patient outcomes, enhance the patient experience, and enable provider success in the OMH model.
We are also strengthening our ties with CarelonRx, Carelon Health Palliative Care, and Carelon Behavioral Health to facilitate substantive collaboration and coordination between oncology practices and these companion organizations. These connections will benefit people with advanced cancer, as well as oncology care practices because they'll foster meaningful care connections, support shared care plans, and allow improved care management across the continuum to help patients be as healthy as possible.
Related Stories
Elevance Health Impact
Addressing Behavioral Health Emergencies: The Role of Crisis Call CentersMental health is a critical part of our overall health and well-being, and when a person is experiencing a crisis, every second counts. Behavioral health emergencies must be addressed with as much urgency as physical health emergencies. Crisis call centers do just that, serving an essential role in the emergency care system by providing prompt, compassionate, specialized knowledge and support in behavioral health emergencies.
A Consumer-Centered Health System Story
Specialty Pharmacies Fill a Critical Role in Treating Complex IllnessNora sat on the bench outside her doctor’s office to process the news she just received. She has cancer. Amid the devastating news, she heard a key phrase: It’s treatable. Part of the treatment includes medications that aren’t available through her usual pharmacy. Nora will need to use a specialty pharmacy to get her cancer treatment medications.
A Whole Health Story
Why Employers Need to Pay Attention to Youth Mental Health ConcernsThe mental health of the nation’s youth may not be at the top of the agenda for business leaders, but it’s front and center for their employees. According to Dr. James Polo, chief medical officer at Carelon Behavioral Health, employers need to consider how children’s mental health can affect their parents’ health overall. Parents often carry concerns for their children into their work environments.
Subscribe
Keep up with our latest news, research, and stories.
Subscribe to financial alerts on our investors site
1 Carelon OMH attribution report, 2024.
2 Elevance Health internal analysis, 2024.
3 Carelon internal analysis, January 2025. For members in fully insured commercial plans, compared to non-cancer inpatient utilization trends, 2023 to 2024.
4 Elevance Health internal analysis, 2023.