A Market Under Pressure to Make Care Coordination Accountable

Rising oncology costs and growing performance accountability are making reliable coordination measurable, reimbursable, and financially consequential.

Why the Economics Are Changing

U.S. cancer care spending is projected to reach $246 billion by 20301 — and a growing share of it now sits under contracts that hold health systems accountable for coordination, timeliness, and outcomes.

Cancer centers increasingly operate under clinical pathways, quality incentives, and value-based contracts that tie financial performance to timeliness and outcomes. Payers face parallel pressure to manage oncology spend and reduce avoidable utilization.

Both need the same thing: a reliable way to confirm planned care actually happens on time, and to catch gaps before they become costly.

Stethoscope resting on a financial chart

Who We Serve

Clinical team wearing hospital badges

Health Systems & Cancer Centers

Hospitals, cancer centers, and oncology physician organizations are increasingly accountable for outcomes and reimbursement tied to coordination and timeliness — not just treatment delivery. Coreo helps them demonstrate and improve the metrics value-based models now measure.

Reimbursable under existing CMS navigation, chronic care management, and remote monitoring codes — with published research showing $781 per patient per quarter in reduced admissions and ED visits.2

Healthcare executives and clinicians in a boardroom discussion

Payers

Payers absorb the cost of delayed diagnosis, uncoordinated treatment, and preventable hospitalizations. Coreo’s focus on execution — making sure planned steps happen on time — supports the outcomes payers are building reimbursement around.

Why Now

The problem isn’t new. The incentive structure around it has changed.

  1. CMS now reimburses navigation services under the 2024 Medicare Physician Fee Schedule3 — creating direct financial incentive to formalize work that was previously uncompensated.

  2. Value-based oncology models, including the Enhancing Oncology Model, tie reimbursement to documented coordination and timeliness rather than volume.

  3. Navigator caseloads keep outpacing staffing, making manual coordination increasingly difficult to sustain at the scale value-based care requires.

Health systems are no longer asking whether to invest in coordination infrastructure — they’re asking how to do it without adding burden. That’s the question Coreo answers.

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References

  1. Panchal R, Brendle M, Ilham S, Kharat A, Schmutz HW, Huggar D, McBride A, Copher R, Au T, Willis C, Brixner D. The implementation of value-based frameworks, clinical care pathways, and alternative payment models for cancer care in the United States. J Manag Care Spec Pharm. 2023;29(7):1-10.
  2. Rocque et al., 2017 (University of Alabama at Birmingham) — reduced hospital admissions and emergency department visits from comprehensive oncology navigation.
  3. Centers for Medicare & Medicaid Services. CMS Physician Payment Rule Advances Health Equity [Press Release]. July 2023.