As oncology spending continues to rise, health plans continue to focus on drug costs, utilization management, and provider contracting to help manage oncology care. However, three key developments are becoming harder to ignore:

• Treatment location directly affects access to care and adherence.
• Barriers to care often create downstream medical and administrative costs.
• Optimizing site-of-care can improve affordability, health outcomes, and the member experience.

For health plans seeking sustainable oncology care strategies, member experience is an important part of the equation. Members who can easily access and sustain treatment are more likely to adhere to therapy, achieve better outcomes, and avoid unnecessary healthcare costs.

Clinical Appropriateness is Only Part of the Equation

Health plans have made significant progress in standardizing oncology care through evidence-based guidelines and utilization management (UM). These efforts help promote clinical consistency and control unnecessary spending. But even the most clinically appropriate treatment plan can fall short if members face practical challenges that make care difficult to access or sustain. Travel requirements, caregiver availability, work schedules, transportation limitations, and time spent receiving treatment can all affect a member’s ability to stay on therapy.

Research shows that travel burden remains a barrier to oncology care. Studies report that average travel times exceeding 50 minutes for oncology treatment and longer travel distances are associated with reduced adherence in some populations.^1,2,3 The burden extends beyond the member. Caregivers often miss work and personal obligations while supporting treatment visits, spending an average of 4.5 hours per day on treatment-related activities.^3,6 Together, these demands create financial, logistical, and emotional strain that may affect a member’s ability to continue therapy as planned.

For health plans, treatment success depends on more than selecting the right therapy. It also requires ensuring members can realistically access and sustain care throughout their treatment journey.

The Hidden Costs of a Poor Member Experience

Member experience is often viewed as a subjective metric, but its impact extends far beyond patient perception. When members face barriers to timely treatment, they may experience missed appointments, delayed therapy, and treatment interruptions. These disruptions can contribute to disease progression, avoidable emergency department visits, and inpatient admissions, all of which can increase healthcare costs over time.⁵

The consequences are not limited to individual members. When care needs shift to higher-acuity settings, the demand for hospitals and infusion centers increases. As capacity tightens, access challenges can create a ripple effect that makes it more difficult for other members to receive timely treatment. Over time, these pressures can contribute to higher costs, operational strain, and longer waits for care across the healthcare system.

From a health plan perspective, a poor member experience can also create administrative burden and increased operational cost through additional outreach needs, escalated interventions, and care coordination efforts. These challenges may also affect performance metrics, as barriers related to access, timeliness, and care coordination can negatively influence member perceptions and contribute to lower CAHPS scores and Star ratings.

Site-of-Care Strategy is a Member Experience Strategy

Site-of-care decisions are often viewed through an operational or financial lens, yet they also represent a powerful lever for improving the member experience. For members receiving oncology treatment, where care is delivered can influence travel burden, caregiver demands, treatment accessibility, and the ability to remain on therapy as planned.

Health plans are beginning to shift their mindsets from thinking only about what care is delivered to where that care is delivered. While the therapy remains the same, the member experience and cost of delivery can vary significantly by setting. Alternative care sites, including the home, ambulatory infusion center (AIC), and ambulatory infusion suite (AIS), may reduce travel requirements, minimize disruptions to daily life, and make treatment easier to access and sustain.

These considerations matter because members evaluate care not only by clinical outcomes, but also by how easily care fits into their lives. By aligning clinical needs, access, affordability, and member preferences, health plans can better support treatment adherence and improve the overall care experience.

In CareCentrix analyses of select immunotherapy drugs, site-of-care costs were up to 44% lower when compared with hospital outpatient departments, demonstrating that improving the member experience and reducing costs do not have to be mutually exclusive.⁴

Moving Oncology Care Closer to the Member

For many members, the logistics of treatment are just as important as the treatment itself. Alternative care sites can reduce travel demands, lessen caregiver burden, and make treatment easier to access while maintaining clinical appropriateness. In one study, 73% of cancer patients reported a preference for receiving infusions at home rather than in a hospital setting.⁷

The goal is not to move every member to an alternative site of care. It is to match each member with the most appropriate setting based on clinical needs, safety considerations, treatment complexity, personal preferences, and individual circumstances. The most effective oncology care strategies recognize that care delivery should be tailored to the member, not standardized around a single delivery model.

Rethinking Oncology Performance

Cancer incidence, healthcare costs, and workforce constraints are expected to place increasing pressure on oncology delivery models in the years ahead. As health plans evaluate future strategies, the question may no longer be whether member experience matters, but how it can be incorporated more intentionally into oncology care delivery.

Health plans may want to consider several important questions:

• Are oncology programs designed around clinical pathways alone, or around the realities members face every day?
• Where might treatment-related burdens be contributing to avoidable utilization, costs, or poor outcomes?
• How can care delivery be structured to better support treatment adherence while meeting members’ clinical and personal needs?

As oncology care continues to evolve, health plans may need to broaden how they define value. Clinical effectiveness remains essential, but treatment success also depends on whether members can realistically access and sustain care throughout their treatment journey. When barriers to care are reduced, health plans have an opportunity to improve adherence, outcomes, member satisfaction, and affordability.

Increasingly, one of the most important questions may not simply be what treatment is delivered, but whether members can successfully receive it.

At CareCentrix, we believe in a member-centric approach to improving oncology outcomes, which involves the right therapy in a setting that is convenient and easy for the patient. Through our Oncology at Home solution, we help health plans expand access to clinically appropriate infusion care in settings that align with members’ needs throughout their treatment journey, supporting continuity of care, treatment adherence, a better member experience, and reduced costs.

Sources

1. “Analysis of travel burden and travel support among patients treated at a comprehensive cancer center in the Southeastern United States,” Support Care Cancer, 2024.
2. “The Relationship Between Travel Distance for Treatment and Outcomes in Patients Undergoing Radiation Therapy: A Systematic Review,” Advances in Radiation Oncology, Volume 9, Issue 12, 2024.
3. “Time and productivity loss associated with immunotherapy infusion for treatment of melanoma in the United States: a survey of health care professionals and patients,” BMC Health Services Research, 2023.
4. Average savings per member based on average from internal CareCentrix data utilizing a subset (39) of the commonly utilized immunotherapy drugs. Savings may vary by population and in-scope drug list, 2026.
5. “Enhancing Therapy Adherence: Impact on Clinical Outcomes, Healthcare Costs, and Patient Quality of Life,” Medicina (Kaunas), 2025.
6. “Consuming Patients’ Days: Time Spent on Ambulatory Appointments by People with Cancer,” The Oncologist, Volume 29, Issue 50, 2024.
7. “Cancer Care Beyond Walls (CCBW): A randomized pragmatic trial of home-based versus in-clinic cancer therapy administration,” Journal of Clinical Oncology, 43, 2025.