How human connection can transform outcomes in cancer care

David Debono, MD, Oncology Medical Director, Carelon

Cancer remains one of the most complex and emotionally charged challenges in healthcare — for patients, families, providers, and the health plans that support them.

More than 2 million new cancer cases will be diagnosed  in the U.S. in 2025. As the population ages, it’s expected that more than 40% of Americans will be diagnosed  with some form of cancer during their lifetime.

This alarming projection, along with the expanding scope of emerging treatments and the resulting rise in care costs, places unprecedented pressure on everyone involved. But complexity doesn’t have to mean chaos.

What if we could deliver better, more connected cancer care — the kind that not only supports the right treatment, but surrounds members with the right guidance, at the right time?

We believe the answer is surprisingly simple: proactive navigation that’s deeply rooted in each member’s needs and powered by predictive analytics.
 

Reducing the emotional cost of cancer care

For too long, cancer care has focused on clinical evidence alone. Yet the lived experience of cancer — the uncertainty, the complexity, and the missed information — is what truly challenges members and caregivers. Many struggle to balance scheduling appointments, coping with side effects, securing behavioral health support, and even arranging transportation.

Cancer Care Engagement (CCE), our oncology navigation solution, is designed to close that gap. CCE isn’t disease management. It’s a model that starts with data science. Specifically, CCE uses predictive models and analytics to identify the members that are at the highest risk — before a crisis occurs. We connect those members with certified oncology navigators trained in supporting real people, with very real health challenges, at their most vulnerable.

Cancer Navigators tailor their support to each member’s unique needs and priorities — coordinating care, monitoring side effects, fast-tracking behavioral-health access, offering nutrition guidance, and serving as compassionate liaisons between overwhelmed members and the care teams they trust. And we do all this proactively — before an ER visit occurs, before confusion leads to nonadherence, before another diagnosis, and before trust is fractured.

It’s whole-person care, delivered by professionals trained specifically in cancer, who stay connected to members throughout their care journey and recovery.
 

Turning insights into outcomes

CCE is one part of our broader Oncology Medical Home (OMH) approach — a coordinated model that connects clinical guidelines, data, and human touchpoints into a unified experience.

Cancer Navigators support members with medication adherence, symptom tracking, behavioral health access, and palliative care referrals.

This wraparound model doesn’t just improve member experience — it drives measurable outcomes, resulting in fewer ER visits, less drug waste, and more consistent adherence to evidence-based care.
 

A better experience is within reach

Oncology Provider Enablement Clinicians (OPECs) equip providers with real-time dashboards that display pathway adherence and practice-specific metrics. This actionable data empowers providers to reduce variability and promote safer, more effective therapies.

OPECs partner directly with practices — sharing quality metrics, pathway insights, and transformation guidance — that make success in OMH attainable. This provider enablement strategy strengthens trust, streamlines care coordination, and makes value-based transformation feel not only possible, but welcome.

For health plans, the model enhances network engagement, advances value-based strategies, and drives real financial results. But most importantly, it signals a shift away from reactive utilization management toward a proactive, member-centric future.
 

What’s next for health plans

In 2025 and beyond, the future of cancer care will belong to those who prioritize the human experience of care — not just the disease.

That means integrating behavioral, social, and clinical needs. It means knowing who needs help before they ask. It means being more than a payer — also being a partner.

That’s the future we’re building with Cancer Care Engagement.