A journey through value-based oncology care

In this interview, we speak with Chevon Rariy (Chief Health Officer & SVP of Digital Health at Oncology Care Partners, AZ, USA) about how artificial intelligence (AI) and value-based care could influence healthcare delivery to create better care journeys for cancer patients.

Can you tell us about the challenges associated with value-based oncology care?

There are several challenges we see in adopting value-based care in oncology. Cancer treatment is complex and given this, cancer care often involves multimodal treatments such as surgery, chemotherapy, radiation therapy, targeted therapy and immunotherapy. Because of this, coordinating treatments effectively while considering individual patient needs can be challenging and patient attribution models in value-based cancer care may not be straightforward.

Additionally, cancer treatments can be incredibly expensive, especially newer therapies such as immunotherapy and targeted therapies. Managing costs while ensuring patients have access to these potentially life-saving treatments is a significant challenge in value-based oncology care.

Effective implementation of value-based care requires robust data collection and analysis systems. Oncology practices need to collect data on patient outcomes, treatment effectiveness and costs to assess value accurately. Ensuring the accuracy, completeness and interoperability of these data can be a significant challenge.

Providers may be concerned about financial sustainability, especially if reimbursement rates do not adequately cover the costs of providing high-quality care. Additionally, transitioning to value-based reimbursement requires changes in practice workflows and care delivery models, which can be disruptive.

Finally, ensuring equitable access to high-quality cancer care for all patients is a fundamental challenge across cancer care. Disparities in access to care based on factors such as race, ethnicity, socioeconomic status and geographic location can impact patient outcomes and undermine the goals of any value-based care.

In your opinion, what are the best strategies to overcome these hurdles?

Overcoming the challenges associated with value-based oncology care requires a multifaceted approach.

• Investment in robust data infrastructure and analytics capabilities is required to collect, manage and analyze data. This includes leveraging electronic health records, interoperable data systems and advanced analytics tools to derive insights that inform decision-making.
• Empowering patients to actively participate in their care through education, shared decision-making and access to resources that support informed decision-making. This includes providing patients with information about their treatment options, potential outcomes, and associated costs, as well as shared-decision making when developing treatment plans.
• Aligning reimbursement incentives with value-based care principles by implementing alternative payment models that reward providers for delivering high-quality, cost-effective care. This may include bundled payments, pay-for-performance initiatives and shared savings arrangements that incentivize collaboration and coordination among providers while ensuring accountability for outcomes and costs.
• Implementing targeted interventions to address disparities in access to cancer care, including strategies to reduce barriers related to race, ethnicity, socioeconomic status, geographic location and health literacy. This may involve community-based outreach and education programs, culturally sensitive care delivery models, as well as partnerships with community organizations to improve access to screening, diagnosis, treatment and supportive care services.
• Lastly, embracing technology and innovation to streamline care delivery processes, improve care coordination, and enhance patient engagement. Leveraging telehealth and remote monitoring solutions to expand access to care, implementing care management platforms to coordinate care across multidisciplinary teams, and deploying AI and machine learning algorithms to support clinical decision-making and predictive analytics.

How would you like to see AI further integrated into cancer care?

The integration of AI into cancer care has the potential to revolutionize various aspects of oncology, leading to more personalized, efficient and effective treatments. For example, AI-powered algorithms can aid in early detection and diagnosis. AI can also facilitate prompt intervention and improve patient outcomes.

There is also an ability to analyze large-scale genomic and molecular data to identify specific genetic mutations and biomarkers associated with cancer subtypes. This information can help oncologists tailor treatment plans to individual patients, selecting therapies that are most likely to be effective and minimizing the risk of adverse effects.

Clinical decision support systems can provide oncologists with real-time, evidence-based recommendations for diagnosis, treatment planning and follow-up care. AI-driven drug discovery platforms can accelerate the identification and development of novel cancer therapies by analyzing large-scale biological data, predicting drug-target interactions and simulating drug efficacy in silico. This can expedite the translation of scientific discoveries into clinical applications and expand therapeutic options.

AI-enabled remote monitoring tools can continuously analyze patient data, such as vital signs, biomarkers and symptom reports, to monitor disease progression, detect treatment-related toxicities and predict patient outcomes. This proactive approach can facilitate early intervention and personalized supportive care.

How would you like to see the field advance over the next 5 years?

Over the next 5 years, I would like to see significant advancements in various aspects of cancer care that leverage emerging technologies.

• Continued advancement in precision medicine approaches, with increased integration of genomic, molecular and imaging data to tailor cancer treatments to individual patients.
• Continued progress in cancer immunotherapy, including the development of next-generation immune checkpoint inhibitors, adoptive cell therapies, cancer vaccines and immune-based combination therapies.
• Advancements in liquid biopsy technologies for the non-invasive detection and monitoring of minimal residual disease, treatment response and disease progression.
• Increased adoption of health information technology solutions, interoperable electronic health records and advanced data analytics platforms to facilitate data-driven decision-making, care coordination and quality improvement initiatives in oncology. This includes leveraging artificial intelligence, machine learning, and predictive analytics to optimize cancer care delivery, resource allocation and population health management.
• Accelerated translation of scientific discoveries into clinical applications through innovative clinical trial designs, collaborative research networks and public-private partnerships.

What concept in value-based oncology care are you most excited about?

The concept of whole-person care in oncology emphasizes addressing the physical, emotional, social and spiritual needs of cancer patients throughout their cancer journey. It recognizes that cancer affects not only the body but also the mind, spirit and social well-being of patients and their families. Integrating technology and telemedicine into whole-person care has the potential to transform oncology practice and support value-based care. I am most excited about the possibilities here. The ability to leverage technology to:

• Improve access to care
• Enhance care coordination
• Initiate proactive monitoring and symptom management
• Patient education and empowerment
• Data-driven population health management

Interviewee profile:

In addition to being a healthcare executive and Harvard medical school graduate, Dr Rariy is an endocrinologist, investor, keynote speaker and author of peer-reviewed and industry publications and op-eds, and serves on several non-profit and private boards that support the advancement of digital health, technology and equity. In 2023, she spoke at The White House in a dynamic roundtable discussion with the Institute for Education. Hosted by White House Presidential Innovation Fellows, this group of innovators and experts dove into the dynamic convergence of Tech, Bio and AI shaping the future of healthcare and advocacy.

Dr Rariy brings more than 15 years of experience within the digital health and medical technology industries. She is the co-founder of Equity in STEMM, Innovation, and AI (EQ SI). She partners with other industry leaders to break barriers in healthcare—amplifying the potential of underrepresented communities to advance equity and progress in healthcare. She has advised several women-led startup entrepreneurs on funding opportunities fueling the growth of their company visions. She previously held senior executive roles in various industries including pharmaceuticals, government, academic, private and Fortune 5 “Big Tech” (Amazon, Inc.). Dr Rariy previously led clinical strategy for the clinical care delivery arm of Amazon Care and served as VP for enterprise virtual health at Cancer Treatment Centers of America (now City of Hope) where she led the team into the exciting frontier of digital health adoption in oncology.

Dr Rariy currently serves as chief health officer and senior vice president of digital health at Oncology Care Partners, a first-of-its kind, purpose-built value-based oncology care company leveraging technology to both deliver oncology care and also provides integrated, high-touch, high-tech whole person oncology care improving patients’ experience and outcomes, while lowering unnecessary costs. She oversees oncology innovation delivery systems and leads digital transformation, AI and machine learning and an emerging technologies strategy. In addition to being a healthcare executive, she is a practicing endocrinologist with a focus on endocrine oncology. View Oncology Care Partners LinkedIn page here >>>.

With such a unique combination of expertise and perspective, she has been recognized by ASCO/AVBCC’s “40 under 40” in Cancer Innovation. Dr Rariy is board certified in internal medicine and endocrinology, fellowship trained in clinical and research at Harvard Medical School’s Brigham & Women’s Hospital (MA, USA) and University of Pittsburgh Medical Center (UPMC, PA, USA), with a medical degree from Harvard Medical School.

The opinions expressed in this article are those of the author and do not necessarily reflect the views of Oncology Central or Taylor & Francis Group.