Cancer care is at a turning point. Rapid therapeutic innovation, shifting demographics, and growing financial pressures are reshaping the oncology landscape—and payers are under increasing pressure to adapt. In a recent Becker’s Healthcare webinar, three physician-leaders discussed the latest developments in cancer care and what they mean for patients, providers and health plans.
The panel featured Dr. Bobby Green, co-founder of Thyme Care, Dr. Lucy Langer, National Medical Director and Chief Medical Officer of Oncology Genomics and Laboratory at UnitedHealthcare, and Dr. Ali Khan, Vice President and Chief Medical Officer at Aetna Medicare. Together, they explored the complex challenges of oncology—from access and affordability to the role of value-based care and emerging technologies like artificial intelligence.
Rising costs meet unprecedented innovation
One of the biggest tensions in oncology today is the rising cost of therapies alongside extraordinary improvements in outcomes. Many new cancer drugs exceed $100,000 annually, a trend that concerns payers and patients alike.
Yet these therapies can be life-changing. Dr. Green shared the story of a friend’s father with advanced multiple myeloma who responded to a bispecific antibody after exhausting other options. Today, he is in remission—a scenario unthinkable just a few years ago.
“The question is, how do we reconcile the rising cost of care with all of the great new advances that are happening in a way that makes the system ultimately sustainable?” Dr. Green said.
Access and demographic shifts
Cost is only part of the equation. Patients continue to face major barriers to timely cancer care, from delays in diagnosis to shortages of oncologists. Dr. Green recounted a case where a patient with advanced colon cancer waited a month before seeing an oncologist due to limited availability—a reminder that innovation is only meaningful if patients can access it.
Panelists noted that underserved populations face even higher barriers, such as transportation challenges and housing instability, underscoring the need for consistent connectivity to ensure no patient is left alone.
Meanwhile, demographic trends complicate the picture. An aging population is driving cancer incidence upward, while rising diagnoses among younger adults are creating new pressures on commercial insurers and employers. “We’re seeing more cancer at both ends of the age spectrum, which poses very different challenges for screening, survivorship and affordability,” Dr. Langer noted.
The payer perspective: partnerships over transactions
Both Dr. Langer and Dr. Khan emphasized that value-based care in oncology is essential but still underdeveloped. Despite efforts like CMS’s Oncology Care Model and Enhancing Oncology Model, most cancer patients in the U.S. are still treated under fee-for-service arrangements.
Dr. Langer argued for reframing payer-provider dynamics: “I am no longer about creating value-based contracts or arrangements. I’m about creating value-based partnerships.” Building trust, aligning on quality, and addressing waste collaboratively are key to sustainable progress.
Dr. Khan echoed this point, stressing that payers must do more than set up contracts—they must actively support success. “If you’re telling me these are the oncologists and navigators you want to work with, I should be creating easy buttons—automatic authorizations, streamlined benefits, better transportation support. Patients and providers need to feel the system is working for them, not against them,” he said.
Care navigation and trust
Cancer navigation is emerging as a critical strategy to improve outcomes and reduce avoidable ER visits and hospitalizations. Yet execution remains difficult. Dr. Langer admitted that many payer-run care management programs face trust gaps: “Our biggest challenge is that people don’t answer the phone.”
This is where partnerships with provider-connected navigation services can make a difference. As Dr. Khan put it, patients want “easy buttons” and trusted relationships—connections that make them feel supported throughout their cancer journey.
The role of AI and behavioral health
Both panelists agreed that artificial intelligence will play a transformative role in oncology, but with caveats. Neither UnitedHealthcare nor Aetna intends to use AI to make denial decisions. Instead, the focus is on integrating clinical data, smoothing processes, and supporting holistic decision-making. “AI could open up the gate for an entire care pathway instead of just one authorization,” Dr. Langer said.
Behavioral health also emerged as a vital, often overlooked element of cancer care. Dr. Khan noted that oncology patients frequently face mental health challenges, and integration—not siloed services—is key. “We know from decades of evidence that these are things that really matter. Effective models make behavioral health a thread running through the entire cancer journey,” he said.
Looking ahead
The conversation closed on a reflective note: both Dr. Langer and Dr. Khan emphasized the value of maintaining their clinical practice, even if just part-time. Remaining close to patients, they said, grounds their payer work in the realities of the exam room.
Cancer care will continue to evolve rapidly, and with it, the payer playbook will also evolve. As costs climb, therapies improve, and access challenges persist, the future of oncology will depend on partnerships, innovation, and a commitment to keeping patients at the center.
