This Is Our Moment to Expand Access to Clinical Trials as a Care Option

Most people diagnosed with cancer in the United States receive their care in community-based settings, not at large academic medical centers. Yet clinical trials – the engine of innovation in oncology – remain largely concentrated in a small number of academic institutions, often far from where patients actually live and receive treatment. While telemedicine, remote monitoring, and digital health tools have dramatically expanded access to care, access to clinical research has not kept pace. As a result, clinical trials remain inaccessible to most patients, even when those trials represent a meaningful care option.

This gap is not due to a lack of interest or commitment from community oncologists. Providers are the primary gateway to trials, but only a small fraction participate in research today. For many clinicians, discussing trials simply isn’t realistic within the constraints of modern practice. Identifying appropriate trials, screening a patient, and guiding them through enrollment can take hours. Eligibility reviews are complex. Care coordination across sites is burdensome. Insurance coverage, prior authorization, and network restrictions add further friction. In increasingly consolidated health systems, even internal referrals can introduce delays and dead ends.

The result is that trials are often discussed late – if at all – despite being most impactful when offered earlier in a patient’s care journey. These barriers don’t just strain providers; they systematically exclude patients who lack proximity, time, or advocacy to navigate an already complex system. If clinical trials are to fulfill their promise as a care option, this model must change.

To do so, we must reimagine clinical research as a routine part of care delivery, not a parallel or secondary system. Providers need support that makes offering trials feasible without adding unsustainable workload. Trials must be accessible, financially viable, and logistically manageable for patients – regardless of where they receive care.

Unlocking Access

Technology alone will not solve the access gap, but thoughtfully applied, it can dramatically reduce friction. Modern platforms can help identify eligible patients in real time, match them to appropriate trials at in-network or nearby sites, and surface options that align with a patient’s diagnosis, stage, and treatment history. Critically, these tools can verify insurance coverage, flag prior authorization requirements, and coordinate next steps – before a referral is ever made.

Equally important are dedicated navigation teams that can take on the administrative and logistical burden. These teams can manage eligibility screening, coordinate records, schedule appointments, and guide patients through the enrollment process. By shifting this work away from already-overextended providers, trials become something clinicians can confidently introduce earlier and more often, knowing their patients will receive the support they need.

This integrated approach transforms trial access from a disconnected, high-friction process into a coordinated extension of care – one that aligns with how oncology is actually practiced today.

The Role of Payers

Employers with self-insured plans and health plans themselves have a critical, and often underappreciated, role to play. Today, many patients never receive a second opinion on clinical trials, even when in-network options exist. Coverage complexity and uncertainty deter referrals, while lack of navigation leaves patients unaware of opportunities that may already be available to them.

Payers can change this. By supporting clinical trial navigation, ensuring timely prior authorization, and promoting awareness of in-network trial options, payers can help preserve continuity of care while expanding access. This alignment benefits everyone. Patients gain access to potentially life-changing therapies. Providers can offer research-integrated care without administrative overload. And payers can reduce downstream costs, particularly when sponsors cover investigational drug expenses and associated services.

Expanded trial access is not just a research imperative; it is a value-based care strategy that can improve outcomes, lower total cost of care, and strengthen employee and member well-being.

A New Standard

Providers should not have to choose between delivering high-quality care and offering clinical trials. They should be able to do both, seamlessly. Achieving this requires technology that fits real-world workflows, navigation teams that shoulder operational complexity, and payer alignment to ensure trials are both accessible and financially feasible. Most importantly, it requires a shift in mindset: clinical trials should be part of the care continuum from the start, not a last resort.

As we look to 2026 and beyond, we have a rare opportunity to reshape how research reaches patients. By aligning providers, health systems, employers, and payers, we can make clinical trials a practical, equitable, and routine care option- so that every eligible patient has access to the full spectrum of care they deserve.