A Market Under Pressure to Make Care Coordination Accountable

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

The Market Opportunity

Cancer-related medical care costs in the United States exceeded $200 billion in 2020 and are projected to reach $246 billion by 2030 based on population growth alone.1

Although fee-for-service remains the predominant reimbursement model, cancer centers and health systems increasingly operate under clinical pathways, quality incentives, value-based contracts, and alternative payment arrangements that tie a portion of financial performance to quality, utilization, total cost of care, and outcomes. At the same time, payers face growing pressure to manage oncology spending, reduce avoidable utilization, and improve outcomes across increasingly complex patient journeys.

Together, these pressures create a shared need for a reliable way to track whether planned care occurs on time, identify gaps before they become costly delays or complications, and demonstrate accountable care delivery.

Stethoscope resting on a financial chart

Who We Serve

Clinical team wearing hospital badges

Health Systems, Hospitals, Cancer Centers, and Physician Organizations Specializing in Oncology

Organizations delivering oncology care are increasingly accountable for outcomes, quality metrics, and reimbursement tied to coordination and timeliness — not just treatment delivery itself. Coreo is built to help these organizations demonstrate and improve on the coordination metrics value-based models now measure.

Healthcare executives and clinicians in a boardroom discussion

Payers

Payers bear significant cost from delayed diagnosis, uncoordinated treatment, and preventable hospitalizations in cancer care. Coreo’s focus on care execution — ensuring planned steps happen on time — directly supports the outcomes payers are increasingly designing reimbursement models around.

Why Now

The pressure to solve oncology care coordination isn’t new. What’s changed is the incentive structure around it:

  1. CMS reimbursement for navigation services, introduced under the 2024 Medicare Physician Fee Schedule2, created a direct financial incentive for health systems to formalize coordination work that was previously informal and largely uncompensated.

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

  3. Nurse navigator caseloads continue to outpace staffing, making manual, unassisted coordination increasingly difficult to sustain at the scale value-based care requires.

Together, these shifts mean health systems are no longer asking whether to invest in care coordination infrastructure — they’re asking how to do it without adding burden to already-stretched care teams. That’s the question Coreo is built to answer.

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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. Centers for Medicare & Medicaid Services. CMS Physician Payment Rule Advances Health Equity [Press Release]. July 2023.