Cutting Cancer Care Costs, Rethinking ACA Policy: Justin Favaro, MD

At the Institute for Value-Based Medicine^®, held on March 31, 2026, in Charlotte, North Carolina, Justin Favaro, MD, PhD, a medical oncology provider at Carolina Oncology Specialists, contributed to the panel “Building Value Through Multistakeholder Partnerships in Oncology,” where discussions focused on reducing costs and improving access through innovative care models. His remarks highlighted both practice-level solutions and broader systemic challenges driving US health care spending.

Favaro emphasized the financial advantages of independent oncology practices compared with hospital-based systems. By affiliating with a management services organization rather than a hospital, practices can maintain clinical autonomy while significantly lowering costs.

“We retain ownership of the practice… but we deliver care at a much lower cost compared to hospital-based practices,” he said.

Citing evidence, he noted a “6.5-fold reduction in the cost of chemotherapy” in independent settings and approximately $1000 in annual savings per Medicare patient—demonstrating the value of alternative care delivery models.

Beyond practice structure, Favaro addressed the growing financial strain on the US health care system, linking it to expanding government expenditures. He pointed out that health care now accounts for roughly 27% of federal spending, contributing to long-term fiscal pressures. These concerns align with broader IVBM discussions about balancing innovation with sustainability in oncology care.

Favaro also examined the unintended consequences of the Affordable Care Act (ACA), particularly the removal of the individual mandate. Without requiring healthy individuals to maintain coverage, he argued, the insurance pool has become less stable, driving up premiums.

“People didn’t have to buy insurance when they were healthy… and that put a big strain on the system,” he said, noting that rising costs and limited flexibility in plan design have reduced affordability and choice for patients.

Ultimately, Favaro called for systemic reform, advocating for a more privatized and flexible approach to health care.

“We need to come together… and advocate to reprivatize our health care system,” he said, underscoring the need for collaboration across clinicians, policymakers, and industry stakeholders.

His perspective reinforced a central IVBM theme: meaningful cost reduction will require both innovative care models and comprehensive policy change.