COA Findings Counter Payer Assumptions: Stephen "Fred" Divers, MD

Building on the Community Oncology Alliance (COA) Quality & Value Study findings discussed in part 1, Stephen "Fred" Divers, MD, explained how the data reshape the narrative around community oncology's sustainability and value, along with how the field plans to build on these results moving forward.

In part 2 of his interview at the 2026 COA Payer Exchange & Innovation Summit, Divers noted that although the cost advantage of community oncology has long been well documented, the study's quality results now suggest patient outcomes in the community setting are on par with those seen in tertiary care. Together, he said, this completes the picture of the patient journey, addressing both cost and absolute outcomes and filling a longstanding data void.

Going forward, community oncology must prioritize continued reporting of these outcomes, Divers emphasized. A follow-up study is already planned to evaluate gastrointestinal and colorectal cancers to see whether similar findings hold. It will also continue the work of identifying what drives strong outcomes, such as timeliness of care, biomarker testing rates, and guideline-concordant therapy.

Divers also addressed a persistent bias he has encountered in payer negotiations: the assumption that care quality in the community setting is inferior to that of larger academic or "brand" institutions. The study's findings push back on that assumption, he said, providing reassurance to payers that steering patients toward lower-cost community care does not mean accepting worse outcomes. Divers added that community practices have shown rapid adoption of novel therapies, including bispecifics and chimeric antigen receptor T-cell therapies, along with high rates of guideline-concordant treatment, reinforcing that the community care continuum is both effective and cost-efficient.

He next emphasized the findings' significance for physicians early in their careers; trainees can take comfort in knowing they can deliver high-level care without leaving their communities. He described this as a meaningful contributor to the field's long-term sustainability, allowing fellows to practice at the top of their license while remaining close to the patients they serve.

Looking ahead, Divers said the priority is to continue generating real-time data to identify and close any quality gaps, positioning community oncology to consistently demonstrate value as a cost-effective, high-quality care delivery model.

“In real time, I think that’s going to be a strategic imperative for the delivery platform of community oncology,” he concluded.