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Over the last decade, oncology care has evolved toward holistic, patient-centered care models that recognize optimal outcomes require more than clinical excellence alone. Health-related social needs (HRSNs) and other factors can create barriers to care and affect outcomes. As rising cancer care costs, fragmented social-support systems, and evolving demands continue to shape the landscape, identifying and addressing non-clinical patient needs while delivering high-quality, cutting-edge treatments can be challenging for practices. Through participation in the Enhancing Oncology Model (EOM), care teams can extend their focus beyond cancer treatment to a more comprehensive approach that supports whole-person well-being.
The EOM serves as a framework for The US Oncology Network (The Network), an organization of independent, community-based providers supported by McKesson, to evaluate approaches for delivering coordinated care, addressing patients’ full range of needs and managing costs. The results The Network achieved for EOM Performance Periods (PP) 1 and 2 generated millions of dollars in Medicare savings compared to benchmark while identifying HRSNs for thousands of patients that can impact outcomes. Examining the strategies behind these results may offer insight for value-based care (VBC) models seeking to deliver cost-effective, comprehensive care beyond the clinic.
Cost savings overview
Eleven practices in The Network participate in the EOM, representing more than half of the model’s national footprint based on patient episode count and total cost of care (TCOC). Across PP 1 and 2 (July 1, 2023, through June 30, 2024), participating practices delivered $87.4 million in gross Medicare savings compared to benchmark costs. Practices used several strategies to achieve these results:
- Collaboration across teams
Through a dedicated value‑based care team and collaboration with practices, The Network led the consistent implementation of EOM requirements. This team assessed readiness, identified resource needs, and developed standardized approaches to support participation.
- Pharmaceutical cost management
Drawing on experience from prior VBC models, The Network focused on drug‑related spending, which accounts for roughly 75% of TCOC. Five targeted drug initiatives — including formulary alignment and pathway adherence — were developed to reduce cost variation while maintaining alignment with evidence‑based standards for care. Practices monitored and managed drug use to reduce overall drug‑related expenses.
- Support services and documentation
Navigation and social work resources were expanded through efforts including centralization of resources, standardization of workflows, and targeting high-risk patients to reduce emergency department visits and hospitalizations. Practices also worked to strengthen documentation related to comorbidities and patient complexity.
- Analytics to deliver actionable insights
The Network provided an analytics platform that allowed practices to evaluate monthly Centers for Medicare & Medicaid Services (CMS) data. By identifying patterns influencing TCOC — including variation trends, emerging performance signals, and areas needing targeted intervention —practices could adjust processes that directly influenced performance.
Identifying needs beyond the clinic
While cost savings were a major focus during PP 1 and 2, screening for HRSNs is also a core component of the EOM. Participating practices completed more than 1,000,000 patient distress assessments, helping identify HRSNs and document factors affecting patients’ overall well‑being.
Practices used an evidence‑based, oncology‑specific tool — the National Comprehensive Cancer Network® (NCCN) distress thermometer — to capture patient‑reported concerns. The Network developed screening recommendations, trained providers on timing and frequency, and embedded the tool into workflows. Integration within Ontada’s iKnowMed® electronic health record (EHR) allowed clinicians to document assessments directly, while analytics and dashboards enabled providers to quickly access data to determine screening volume, patient distress levels, and types of concerns identified.
As screening frequency increased, practices gained visibility into common non‑clinical needs and evaluated whether existing staffing levels for social workers, navigators, and resource coordinators were sufficient. With appropriate staffing, social workers could focus on counseling and other license‑level responsibilities.
Electronic patient‑reported outcomes (ePROs) were incorporated later, allowing patients to complete assessments before visits. Submitted information flowed into the EHR and triggered alerts when urgent issues required clinician follow‑up.
Collaborations to meet non-clinical needs
Although the EOM requires practices to screen patients for distress and barriers to care, it does not require them to resolve identified issues. The Network took an approach that emphasizes addressing these needs whenever possible, recognizing that non‑clinical factors can influence outcomes.
As screening volume increased, practices identified the need for additional resources to support patients with non‑clinical concerns. While individual practices had established relationships with community organizations, The Network pursued a broader, systemwide option. In March 2023, prior to the start of PP 1, The Network worked with Findhelp, a national social services support platform. Through this collaboration, practices gained access to a wide range of community‑based programs and could identify local resources by ZIP code. Staff could make and track referrals, and the platform’s closed‑loop system notified teams when patients connected with services. Patients, caregivers, and family members could also use the tool independently.
Analytics provided visibility into the most frequently searched needs, total search volume and the number of patients who accessed community resources. During PP 1, practices conducted more than 50,000 Findhelp searches (with additional figures forthcoming for PP 2). User‑level data also showed how many individuals sought assistance during the first two performance periods.
As screenings continued to rise, practices saw the opportunity for more personnel trained to assist patients with non‑clinical concerns. To address this, The Network collaborated with the American Cancer Society’s navigation credentialing program, enabling practices to expand their capacity to support patients during PP 1 and 2.
Doing the right thing for patients
Given the rising cost of cancer care, VBC models like the EOM play an important role in balancing high‑quality care with cost accountability. Results from PP 1 and 2 show that participating practices generated significant Medicare savings and shared savings while strengthening patient support by identifying and addressing HRSNs.
Many practices in The Network were already offering services like those required under the EOM, and participation provided a structure to formalize this work. The Network continues to focus on value‑based approaches that integrate clinical and non‑clinical support, and it plans to work with CMS and other payers to help inform development of future models aimed at delivering comprehensive, sustainable cancer care.
Stuart Staggs
Stuart Staggs is vice president of Transformation, Quality & Shared Services for The US Oncology Network, where he has supported community oncology practices for more than 15 years. He leads transformation and valuebased care initiatives and oversees shared services that enhance quality, access, and care sustainability. With more than 25 years of healthcare operations experience, Stuart focuses on advancing highvalue, patientcentered cancer care.
Dana Weber
Dana Weber is senior director of Transformation & Quality for The US Oncology Network, supporting oncology practices in value-based care programs and commercial models. With over 10 years of oncology nursing experience, she leads quality improvement and practice transformation efforts grounded in evidence-based, patient-centered care.
Jessica Neeb
Jessica Neeb is a healthcare leader and nurse with deep expertise across the oncology care ecosystem. She currently serves as senior director of Business Modernization at McKesson, where she brings extensive experience spanning clinical and administrative operations, value‑based care models, oncology payer strategy, and large‑scale program implementation.
