Arpit Chhabra, Co-Founder of Bridge Oncology, Associate Professor of Radiation Oncology at Mount Sinai Health System, shared on LinkedIn:
“One of the most overlooked opportunities in oncology isn’t operational improvement—it’s ensuring payer contracts reflect the value of the care being delivered.
Over the past year, we have seen this firsthand across both community oncology practices and health systems.
Working with a multi-site hematology/medical oncology practice, we identified a substantial annual financial opportunity by reviewing its payer contracts and helping the organization more clearly demonstrate the value of the care it was already delivering. No changes to clinical care, staffing, or operations were required.
We are seeing similar opportunities within health systems.
In one current engagement, we are working with a radiation oncology department to reevaluate payer agreements as the organization continues investing in advanced cancer therapies. The conversation is not simply about reimbursement. It is about ensuring the long-term viability of those programs and preserving patient access to specialized care.
Too often, organizations assume contracts are fixed. In reality, many have not been meaningfully reviewed in years.
The strongest negotiations do not begin with simply asking for higher reimbursement. They begin with clearly articulating value.
That value may include:
- Access to advanced therapies and specialized oncology services
- High-quality, patient-centered care
- Clinical outcomes and quality performance
- Keeping patients close to home
- Supporting payer network adequacy
- Reducing unnecessary downstream costs
- Investments in innovation, multidisciplinary care, technology, and clinical expertise
When supported by data, outcomes, access metrics, and a compelling value proposition, there is often room for a meaningful conversation with payers.
The goal is not higher reimbursement for its own sake.
The goal is ensuring oncology programs remain financially sustainable so they can continue investing in innovation, expanding access, and delivering exceptional care for patients.
Sometimes the highest-return initiative is not changing how you deliver care.
It is making sure your contracts reflect the value you already provide.
How often does your organization formally review its payer contracts and overall contracting strategy?”
Jordan Johnson, Founding Partner at Bridge Oncology, Board Member at the National Association of Medication Access & Patient Advocacy (NAMAPA), Founder of The Healthcare Hub, and Founder of LegacybyImpact, shared a post by Arpit Chhabra, adding:
“I couldn’t agree more that payer contracting is no longer just a finance exercise-it is a strategic capability.
At Bridge Oncology, we are seeing this play out across radiation oncology, medical oncology, and integrated cancer programs nationwide. The organizations achieving the greatest long-term success are not simply asking for better reimbursement. They are bringing sophisticated data, operational analytics, quality outcomes, access metrics, and total cost of care evidence to the negotiating table.
That is where the industry is heading.
The conversation has shifted from “What does this service cost?” to “What value does this program create?”
Our work extends far beyond contract language. We help organizations quantify and communicate their value through:
- Operational and financial performance analytics
- Total cost of care modeling
- Site-of-care optimization
- Network adequacy and market access strategy
- Program sustainability assessments
- Revenue cycle and payer performance analytics
- Enterprise oncology strategy aligned with evolving CMS policy
Perhaps most importantly, we help organizations prepare for where reimbursement is going—not where it has been.
CMS has made it increasingly clear that future payment models will reward measurable value, efficiency, accountability, and outcomes. The days of relying on historical reimbursement methodologies or negotiating based solely on increasing costs are rapidly coming to an end.
The organizations that will thrive are those that can demonstrate they improve access, deliver exceptional clinical outcomes, operate efficiently, and lower the total cost of cancer care.
That is exactly the work we enjoy doing every day with our clients.”