Community Oncology’s Biggest Battles, and How to Fight Back: Diana Verrilli, MS

Community oncology practices are navigating an increasingly difficult landscape, and Diana Verrilli, MS, senior vice president and general manager of Navista, isn’t sugarcoating it. Speaking with The American Journal of Managed Care^® at the 2026 Community Oncology Conference, hosted by the Community Oncology Alliance, Verrilli outlined the 3 major challenges she sees defining the field right now: regulatory pressures, payer contracting, and cybersecurity.

At the top of her list is the regulatory environment and the administrative burden that payers impose on practices, particularly through policies like prior authorization. These requirements eat into clinical time and slow down care delivery, creating friction at every step of the patient journey. Cybersecurity, she said, rounds out the top 3—and it may be the most underappreciated threat.

“Given the threats that we have daily within our environment, it’s an area that, at Navista, we spend a lot of time thinking about and helping community practices navigate,” Verrilli said. Many practices simply aren’t equipped to handle the sophistication of today’s cyber threats, making it a growing vulnerability across the sector.

On the access front, Verrilli pointed to California as a concrete example of how systemic barriers play out at the practice level. Medi-Cal patients in her practice are currently unable to receive advanced therapies, a gap her team is working to close through direct legislative engagement at the State House in Sacramento and by educating patients on how to proactively engage with their health plans. She emphasized that local infrastructure matters, too: building comprehensive programs and forging partnerships with hospitals are essential to making advanced therapies a real option for underserved populations.

When it comes to making the case for innovative therapies to payers and employers, Verrilli said the conversation has to center on total cost of care, a point she feels is frequently overlooked. Comparing the cumulative expense of multiple lines of conventional therapy, including repeated hospitalizations, against the cost of a single advanced therapy intervention can dramatically shift the calculus. Employers, she noted, are a particularly receptive audience for this argument, especially in markets where large employer groups are present near sites of care.

Ultimately, Verrilli returned repeatedly to one core idea: the importance of grounding every conversation in clinical rationale and patient-centered value. “Why are you recommending that therapy, what’s the overall cost and cost avoidance, and what’s the value to the patient from a patient lifetime lens is really critical, and that’s why that employer argument is equally impressive in this dialogue," she said.

For Navista, the ability to respond to these challenges comes down to scale. The network’s size, Verrilli argued, allows it to move quickly and strategically in ways that individual practices cannot, giving community oncologists a powerful partner as they face mounting pressure from all sides.