The published numbers on cancer care coordination.

Health plans pay for review and for delay today. Every figure on this page comes from the cited literature or from CMS. None of it is an Arca result. What a pilot on Arca measures is the last section.

1,500+Commission on Cancer accredited programs in the US
74%of newly diagnosed US patients are treated at one
2.1Mprojected new US cancer cases in 2026

A treatment delay is a clinical event.

The largest analysis of treatment delay puts a mortality number on every month a cancer case waits.

13 of 17 treatment indications: delay raised mortality34 studies · 1,272,681 patients · systematic review and meta-analysisAdded mortality per four weeks of delayColectomyhazard ratio 1.06+6%Breast surgeryhazard ratio 1.08+8%Head and neck radiotherapyhazard ratio 1.09+9%A board date, a referral, a scheduling queue: each four weeks a case waits carries a survival cost.

Hanna TP et al., “Mortality due to cancer treatment delay: systematic review and meta-analysis,” BMJ 2020;371:m4087.

Coordination is a published budget line, and it rose 57% last year.

Medicare pays monthly, per patient, for oncology coordination and navigation. These are the rates, by year.

20162018202020222024202620282030$70$110$160$160 per patient-month · Oncology Care Model2016 to 2022$70 · Enhancing Oncology Model · from July 2023$110 · from January 2025 · +57%cohort 1 runs to June 2030Plus fee-for-service navigation since 2024: G0023, $79 per hour · G0024, $49 per additional 30 minutes · no practitioner, frequency, or duration limits.Coordination revenue exists today. What CMS attaches to it is evidence of the activity, which is what a decision record holds.

CMS: OCM and EOM Monthly Enhanced Oncology Services rates; CY2024 Physician Fee Schedule final rule (Principal Illness Navigation, G0023/G0024).

Paying for staff hours to coordinate returned 2.1%, and lost money.

The Oncology Care Model is the natural experiment: six years of paying practices $160 per patient-month to coordinate with added staff.

One six-month chemotherapy episode · $36,1902.1% saved ≈ $760saved per episode≈ $760paid to coordinate$960The coordination worked. The staff hours doing manual tracking cost more than they returned.

Abt Associates, OCM evaluation reports. The per-episode arithmetic is derived here from the published 2.1% and $160 per month figures and labeled as such.

The avoidable spend sits in acute care after chemotherapy.

CMS defines it, the literature bounds it, and it is the slice of the episode coordination can reach. Worked through in three steps.

The episode · $36,190inpatient care · $5,493 · 15.2%The inpatient slice · potentially avoidable share35% to 67% of OP-35 events: dehydration, fever, nausea, neutropenia, sepsis, pain. A range, never a point.Reachable per patient-month, at a 20 to 30% capture assumption$0$50$100$150$200$64 to $184$70 EOM$110 EOM$160 OCMWhat coordination can reach and what CMS pays for it cover the same range. The capture rate is an assumption, stated as one.

CMS OP-35 measure specification; OCM service-line cost reports; published cohort studies on acute care during chemotherapy (45.3% of patients had an acute-care event within 180 days of starting chemotherapy, n=2,922). The savings band is derived arithmetic with its capture assumption labeled.

What a pilot on Arca measures.

The targets are written down before signature, against the program's own baseline. The record produces the measurement either way.

What the record measuresThe target it is measured against
Share of new analytic cases presented to a boardEvery case, with the exceptions documented
Days from diagnosis to first treatmentSet with the program from its own baseline, decomposed by handoff
Recommendations closed on timeEvery recommendation owned; closure tracked from day one
Pathway documentationA documented pathway status on every presented case
The loop to the referrerRecommendation and plan status returned on every referred case

Whitepaper: the economics of cancer care coordination.

Seven pages on what Medicare pays for coordination, what the staffed version returned, and where the avoidable spend sits, with the arithmetic worked in the open and every figure sourced. Enter a work email and the link arrives in your inbox. All guides and whitepapers

Get the paper

For risk-bearing oncology groups, health plans that delegate oncology risk, and program leaders.

Walk through these numbers with your program's own baseline.

Send us your boards, your volumes, and your current diagnosis-to-treatment interval if you know it. We reply with the same arithmetic run on your figures, sources attached.

Run the numbers on your program