Blakely Takes on CMO Role for COA: “Bridging the Gap Between Practice and Practicality”

Johnetta Blakely, MD, MS, MMHC, wears both official and unofficial hats at Tennessee Oncology, where she has been a medical oncologist for nearly 15 years. As the executive vice president of quality and clinic operations, she has been the point person for ensuring that all patients get the best care and overseeing how that is measured. That has made Blakely a key player in deciding how Tennessee Oncology uses technology—so she is also a “beta tester” for software being pitched to the practice.

Add in experience with payment models, policy advocacy, and a role in standing up delivery of chimeric antigen receptor (CAR) T-cell therapy, and you have all the pieces for Blakely’s latest role: chief medical officer (CMO) for the Community Oncology Alliance (COA). The organization that represents independent practices announced Blakely’s appointment on May 7, 2026, on the heels of its largest-ever Community Oncology Conference in Orlando, Florida, for which Blakely served as a cochair.¹

“I see myself as a go-to person for practices or practice leaders,” Blakely said, when The American Journal of Managed Care^® (AJMC^®) asked her to describe her new role. COA offers its members help navigating new services and technology, as well as advocacy, and Blakely explained that her role as CMO will encompass both realms, as well as serving as CMO to the National Cancer Treatment Alliance, a COA subsidiary that connects practices with employers.¹

“I want to make sure that we are continuing to look at policy from the [view] of the oncologist,” she said. “I still practice 3 days a week, so I’m very much still in the throes of what the [Inflation Reduction Act] is going to do to our practice, and what value-based care arrangements and these alternative payment models can do to practices,” she said.

As a practicing physician, Blakely will also be a resource for COA staff as they put together programs and respond to members—and start work on next year’s conference. “I see it as bridging the gap between practice and practicality—I’m the person who is in practice, and somebody who people can ask, ‘What are we doing?’ And then, the COA folks can ask me, ‘Does this make sense from a clinical perspective?’”

Immersed in Measuring Quality of Care

After a fellowship at The University of Texas MD Anderson Cancer Center and 7 years at what is now West Cancer Clinic, Blakely came to Tennessee Oncology, where she later enrolled in Vanderbilt University’s Owen Graduate School of Management just as the Oncology Care Model (OCM) was getting started. Tennessee Oncology became a leader in the OCM and was touting savings to Medicare by the start of the pandemic, along with perfect quality scores.² By that time, Blakely’s role at the practice had increasingly turned toward quality measurement and health outcomes.

That experience is valuable in her role with COA. “I’ve been in the depths of clinic operations for the past 7 years,” Blakely said. “I understand the minute details, from workflows to getting new patients in to see physicians, to telephone triage, to how we are going to implement bispecifics in the community and do that safely.”

Quality of care is a focus for COA. Its spring conference featured the release of a study using Surveillance, Epidemiology, and End Results Program data to show that patients with common cancers had better overall survival when treated at community oncology practices than the general population with those same cancers.³

From the OCM to the Enhancing Oncology Model (EOM) to commercial variations, “payment models certainly are at a crossroads,” Blakely said. She expects to be among the many faces from COA to interact with CMS over the current reimbursement issues: The EOM has fallen short of expectations, the Inflation Reduction Act threatens practices’ survival, and surprises such as recent shortfalls in radiation oncology reimbursement are part of the never-ending upheaval that seems to come from Medicare.

“I certainly have every intent that I will interact with CMS and continue to advocate on the policy side,” Blakely said. “We do like to spread that around. We don’t want just one person being the face of COA. That’s important, because we are a group.”

The 340B Policy Debate Flares Anew for COA

As Blakely started her tenure, the ongoing debate over the 340B drug discount program had flared anew. The program escaped Congress’ February 2026 spending package, but recent media attention and the Trump administration’s focus on waste and fraud have most policy watchers convinced the program is ripe for an overhaul, especially after a pair of federal court rulings blocked attempts to resolve these issues through administrative proceedings.^4,5

The program, named for a section of the tax code, was created to aid safety net hospitals and has mushroomed in the past decade. COA cites 340B as a source of unfair competition: The group says drug discounts have been applied inappropriately to suburban affiliates of large hospital systems, allowing hospital competitors to put community oncology clinics out of business or force them to sell to health systems.

Days after Blakely became CMO, the American Society of Clinical Oncology (ASCO) released an updated policy statement, in which it proposed “keeping the current 340B formula in place for hospitals seeking 340B status,” while adding an “indigent care ratio (ICR)” to potentially allow community practices to seek eligibility.⁶ In the AJMC interview, Blakely said that while ASCO and COA can agree on abuses of the 340B program, “I’m not sure that I completely agree with their statement.”

Rather, she said, COA’s position is clearly spelled out in the recently released “Prescription for Healthcare Reform 2.0.”⁷ The document calls on Congress to “transform 340B into a patient-centered program instead of a facility-centered program. 340B discounts should follow eligible patients in need, regardless of the care setting, providing direct out-of-pocket cost relief for qualifying individuals.”

Patient eligibility, the document states, can be determined based on tax returns, which can be used for “Medicaid enrollment or rebates paid to the entity purchasing the drugs.”⁵

“We’ve said this for years,” Blakely said. “The 340B program should follow the patient.”

A Resource for Time-Strapped Practices

Along with the other challenges that community oncology faces, Blakely said the lack of time is a significant barrier to change. And that is a big problem when artificial intelligence (AI) holds promise to improve workflows and help address staffing shortages—if only practices can decide which tools to use.

“COA is very interested in being a resource for practices, especially around innovation,” she said. “AI is all around us, but it’s also expensive, and it’s time-consuming to vet all of these different types of vendors. Practices that have already dipped their toe in can be resources for those that are considering [AI], and I’d like to be able to be the bridge for that as well. It is something that is near and dear to me, because it is something I work on with Tennessee Oncology.”

“I also think of innovation in terms of things like making sure that CAR T is available in the community, and that patients don’t have to necessarily go to an academic center,” Blakely continued. Long drives can be too expensive, both for CAR T and for bispecifics, which are moving into earlier lines of care for many types of cancer.

“If you look at what’s going on in oncology, innovation is the perfect word. Because it’s not just technological innovation, it’s innovation where therapies are concerned, which is super exciting,” she said. “Diseases that I treated right out of fellowship that were essentially a death sentence—now we’re having long-term survival, even for metastatic disease. So I think trying to make sure that community practices can continue to participate in those types of innovation is really important as well.”

References

1. Community Oncology Alliance welcomes Johnetta Blakely, MD, MS, MMHC, as chief medical officer. News release. COA. May 7, 2026. Accessed May 23, 2026. https://mycoa.communityoncology.org/news-updates/press-releases/coa-welcomes-johnetta-blakely-as-chief-medical-officer
2. Tennessee Oncology receives perfect quality score while saving Medicare $5 million during last year of Oncology Care Model. Accessed May 24, 2026. Tennessee Oncology. https://tnoncology.com/news/tennessee-oncology-receives-perfect-quality-score-while-saving-medicare-5-million-during-last-year-of-oncology-care-model/
3. Caffrey M. Patients treated for common cancers in community settings live longer, COA study finds. AJMC. April 28, 2026. Accessed May 24, 2026. https://www.ajmc.com/view/patients-treated-for-common-cancers-in-community-settings-live-longer-coa-study-finds
4. Court strikes HRSA 340B policy restricting initial hospital drug purchases through GPOs. American Hospital Association. April 6, 2026. Accessed May 23, 2026. https://www.aha.org/news/headline/2026-04-06-court-strikes-hrsa-340b-policy-restricting-initial-hospital-drug-purchases-through-gpos
5. 340B program alert: Federal court ruling vacates HRSA notice related to child site registration requirements. Quarles. March 5, 2026. Accessed May 24, 2026. https://www.quarles.com/newsroom/publications/340b-program-alert-federal-court-ruling-vacates-340b-eligibility-waiver-to-child-site-registration-requirements
6. ASCO updates policy statement on 340B drug pricing program. News release. American Society of Clinical Oncology. May 5, 2026. Accessed May 24, 2026. https://www.asco.org/about-asco/press-center/news-releases/asco-updates-policy-statement-340B-drug-pricing-program
7. Prescription for Health Care Reform 2.0. Community Oncology Alliance. Accessed May 23, 2026. https://mycoa.communityoncology.org/publications/studies-and-reports/coa-prescription