Manage cancer care while lowering costs, supporting patients

Cancer care is complex for health plans, payors, providers and patients. Health plans and payors can help balance and manage aspects of the journey of a patient with cancer. Providers work to provide treatment and care, while also keeping pace with the rapidly changing standards of cancer care and what clinically effective medication or therapies to prescribe. 

After patients receive a diagnosis, they embark on complicated individual cancer journeys, which are impacted by: 

• the type of cancer they have
• at what point it was discovered
• what kind of treatment they’re prescribed
• how well they respond to that treatment
• how well they’re supported as they navigate their cancer journey
• personal or social environments

Patients receive a diagnosis from their providers along with information about how the cancer will be treated. Moving from their diagnosis to treatment, patients can receive care management support at this critical stage to set them up for better outcomes and experience throughout their complex cancer journey. Care management is accessed and delivered through a combination of a connected, high-touch nurse-led team along with using digital tools. The team and connectivity are available as the patient starts treatment to help answer questions and address symptoms. Digital tools can help to manage symptoms proactively. 

Nurses work to inform patients early in their journey about symptoms and tracking symptoms can help to keep them on appropriate therapies with greater adherence and earlier identification of adverse events.¹ Frequent touchpoints and data sharing help drive better patient experience and reduce hospitalizations and costs.

Patients continue to be supported by a nurse-led care team while preparing advanced directives and post-treatment care. This proactive approach helps with managing palliative care or at other critical places along the way. Transform Oncology Care (TOC) management supports each patient through every stage of the cancer journey. 

TOC helps manage the complex journey efficiently and effectively while improving the patient experience.

• Diagnosis
  • Experiencing symptoms
  • Screening tests (e.g., mammogram or colonoscopy)
  • Meeting with provider for consultation
• Treatment
  • Treatment prescribed
  • Learning about the treatment
  • Scheduling of chemotherapy, surgery and/or radiation, if necessary
  • Managing insurance and finances
  • Coordinating continual treatment 
• Post-Treatment
  • Connecting with nurse-led support and caregivers
  • Managing symptoms from cancer and treatments
  • Navigating additional social and financial hurdles
  • Creating a plan for post-treatment
  • Arranging pallative care

CVS Health addresses challenges and provides support for oncology patients with flexible solutions to address care.

The source for data in this document is CVS Health Enterprise Analytics, unless otherwise noted.

Adherence results may vary based upon a variety of factors such as plan design, demographics and programs adopted by the plan.

Client-specific modeling available upon request.

CVS Health uses and shares data as allowed by applicable law, and by our agreements and our information firewall.