Community Oncology Matches Academic Care: Stephen "Fred" Divers, MD

While community oncology’s value has traditionally been measured by cost alone, a new analysis comparing outcomes for patients treated in community and academic settings suggests independent practices deliver care that is just as strong, if not stronger, according to Stephen “Fred” Divers, MD, at the 2026 Community Oncology Alliance (COA) Payer Exchange & Innovation Summit on September 15.

Divers is a medical oncologist with Genesis Cancer and Blood Institute and chief medical officer at the American Oncology Network. At this year’s COA Payer Exchange & Innovation Summit, he was a panelist during the session “The Quality of Community Oncology: Leveraging the COA Quality & Value Study," where he and other experts reviewed findings from the COA Quality & Value Study. The discussion explored what the data reveal about care delivered in independent practices and how these insights demonstrate the value of community oncology, identify opportunities, and strengthen patient care.

In part 1 of his interview with The American Journal of Managed Care^®, Divers explained that with no established numerator for the outcomes-to-cost ratio, the field faced what he called a "data desert." As a result, the COA Quality & Value Study aimed to address this gap by evaluating patient outcomes specifically within the community oncology setting, rather than relying solely on cost comparisons to justify its value.

The research focused on breast cancer and non–small cell lung cancer (NSCLC), chosen as representative of the core caseload typically treated in community practices. Divers noted that investigators compared outcomes for patients treated within the Flatiron Health Research Network database against a risk-adjusted cohort from the Surveillance, Epidemiology, and End Results (SEER) Program.

Results showed patients treated in the community performed as well as, or better than, their SEER counterparts, Divers highlighted. Among patients with de novo metastatic breast cancer, overall survival in the Flatiron cohort was 48 months vs 40 months in the SEER cohort. For NSCLC, based on Kaplan-Meier analysis, median overall survival was 15 months in the Flatiron cohort vs 13 months in the SEER population.

As a retrospective cohort study, Divers noted that the findings offer reassurance rather than definitive proof of superiority.

“The interpretation of this in a retrospective cohort study is [that] patients can take comfort in knowing that they do not have an inferior survival if they're seeking care in the community where they live and work,” he concluded. “So, their outcomes should be as good, if not perhaps better.”