85% of cancer patients are treated in community practices.1 Compared to other sites, independent community oncology practices deliver high quality and lower cost of care in cancer clinics located right in patients’ neighborhoods while providing access to the best of cancer care resources, including clinical trials and evidence-based treatment options.2–4

According to ASCO 2020 State of Oncology Workforce in America, 1 in 6 Americans live in rural areas. 32 million Americans live in rural counties with no access to an oncologist.5 Most patients in these areas are treated by independent solo practitioners or physicians who make visits to remote areas from their hubs at least once a week.

Independent oncology operates in a paradox - it is uniquely poised to adapt and implement new technologies but doing so is often costlier for small practices than it is for larger organizations. Innovation in cancer care is increasing - from drug development technologies to data analytic and digital tools and AI. However, such innovations tend to be expensive and inaccessible to smaller practices. Indeed, tools that democratize knowledge and bring technology to multidisciplinary teams and tumor boards to enable precision oncology to clinics are now a reality, but such tools are costly.

While affordability of new technology is a challenge for independent practices, such practices also have a unique advantage in their ability to make nimble decisions and adapt quickly in implementing the tools.

As an example, telehealth allowed patients to connect to their doctors from home, an important tool that is still limited due to a huge diversity in patient internet access and ability. Implementing telehealth not only requires these tools, but an infrastructure with the right workforce to provide equal care to all patients. In my practice, we have been able to make this important, but difficult decision even if the permanent payment model has not been established since the pandemic.

To provide this high-quality care, many independent oncology clinics figured out that creating clinically integrated networks such as Quality Cancer Care Alliance Network (QCCA) enabled them to access innovation, research, technology, and approach to value-based care by sharing best practices. The goal is to remain independent so that we can deliver the best possible cancer care, located right where patients need them.

If independent oncology disappears, this country will face a much larger problem with healthcare inequity. The number of patients without access to cancer care - especially in rural areas - will increase. And as the number of oncologists and healthcare workers continues to diminish, the oncology workforce will not be adequate. Community oncology deserves to be recognized and supported by the U.S. government. Focus on consolidation by healthcare systems that utilize 340B should end. There is a place for all models of care.