Medical Oncology Solution
Optimize your members’ cancer care
Our Medical Oncology Solution helps improve care provided to your members with cancer. We do this through an evidence- and value-based approach, like our cancer treatment pathways, our provider-preferred clinical review, and our enhanced reimbursement and pathway adherence reporting. Covering 95 percent of spending on cancer drugs, our solution manages therapeutic and supportive drugs.
Lines of business
• Commercial
• Medicare
• Medicaid
• Federal employee
Imagine how a proven oncology partner can improve care for your members
Decisions to improve cancer care are never simple, especially at scale. We help health plans make the right ones. With our solution, your health plan gains the building blocks that make an exponential impact on cancer care, like an emphasis on safety and appropriateness, rapid, provider-friendly decision support, and clear value metrics.
Optimize your members’ cancer care
Cancer treatment can create physical, emotional, and financial concerns for your members. Our Medical Oncology Solution helps improve the care they receive through optimal cancer care backed by rigorous evidence and aligned with specialty medical society guidelines.
Build closer relationships with oncology providers
Improving cancer care for your members requires deep partnerships with providers. We help build them. By partnering with us, you and your providers gain education and ongoing support to deliver care through our proprietary cancer treatment pathways.
Ease your cost management and shift to value
Oncology is one of the most expensive specialties. But it’s not always clear where your spending is going. We shed light on it and create potential savings. With our solution, your health plan can better manage rapidly increasing cancer costs and shift to value-based reimbursement more easily.
Inside our Medical Oncology Solution
Cancer care works best when the healthcare system works together. We’ve designed our solution for just that. Our solution’s features foster collaboration among your providers, your business, and others that can make an impact on whole health, like palliative care teams.
Clinical appropriateness review
Optimized cancer treatment pathways
Management of biosimilars and other preferred drugs (optional)
Clinical setting optimization
Dedicated practice-engagement team
Advanced analytics for you and your providers
Cancer Care Engagement
How our solution works
Request
Your providers submit requests to us online or over the phone.
Review
Our automated platform reviews the requests in real time for alignment with medical policy and our pathways.
Determine
Our platform approves requests that align with policy and pathways. Our board-certified medical oncologists and nurses are available to consult with your providers about requests that don’t meet policy. We also notify your providers of their eligibility for enhanced reimbursement when prescribing our pathways.
Synchronize
Request data is shared with your system(s) for claims, care management, and/or reporting purposes.
Explore related solutions
Ask us about our Medical Oncology Solution
Health plan leaders, contact us to learn more about the possibilities and impact of our Medical Oncology Solution.
Are you a health plan member?
If you’re a health plan member and have a question about your health plan, please call the member services number on the back of your health plan ID card.
Provider inquiries
For questions about a request or the Provider Portal: Call 1-800-252-2021 or contact our support team
Business hours: 8:00 a.m. – 5:00 p.m. CST.
