Earlier Referrals, Streamlined Care Could Improve Cancer Outcomes

Efforts to streamline referrals, diagnosis, treatment, and prior authorization, alongside artificial intelligence (AI) tools, could improve timely cancer care and patient outcomes, according to Susan Sabo-Wagner, MSN, RN, OCN, NEA-BC, vice president of clinical innovation at the American Oncology Network (AON).

In part 2 of her interview with The American Journal of Managed Care^® following the 2026 Community Oncology Alliance Payer Exchange & Innovation Summit last month, she discussed how earlier referrals, faster diagnosis, and streamlined prior authorization can improve outcomes for patients facing access barriers.

Success ultimately means patients receiving quality care and achieving better outcomes, Sabo-Wagner said. Patients with limited access are sometimes misdiagnosed before reaching an oncologist, so their disease has often progressed by their first visit, making it harder to treat and manage. The goal, she noted, is to speed up the referral, diagnosis, first oncology appointment, and ultimately the start of treatment.

Through AON's work with payers and Evolent Health as the utilization management group, prior authorization can become more efficient, limited, or removed entirely, so patients start treatment sooner after diagnosis. Sabo-Wagner called that step critical for patients who have already waited longer to receive a diagnosis.

There is also an opportunity for AI on the front end of care, she said. Although rural areas may have less access to AI tools than larger facilities and academic centers, Sabo-Wagner noted that platforms exist to help primary care physicians recognize when a patient's presentation warrants an oncology referral. Symptoms are sometimes attributed to an infection or recurrent infection, she explained, but earlier referrals can catch disease at an earlier stage, improving outcomes. Algorithm-based platforms that flag when a referral would be beneficial are a worthwhile area for investment, Sabo-Wagner emphasized.

Building payer trust follows the same model as AON's partnership, she said, with physicians demonstrating that they order appropriately, help build value pools, and deliver efficient, cost-effective care with good outcomes. This gives payers confidence in both the cost and appropriateness of care, Sabo-Wagner added, potentially reducing the need for prior authorization and the delays or denials that can accompany it. Delayed care, she noted, is itself an access issue.

"When we see fewer access issues in terms of delayed care, then we know that outcomes will always be better," Sabo-Wagner concluded.