Independent Together: ONCare Alliance’s Road Map for Community Oncology

At the 2025 Patient-Centered Oncology Care conference, leaders from ONCare Alliance outlined how the coalition is scaling services that most solo practices cannot build alone—all without surrendering local control. Established in early 2024 by bringing together the Quality Cancer Care Alliance and the National Cancer Care Alliance, ONCare was created to provide community oncology practices with common infrastructure, shared clinical programs, and a unified approach to research and value-based care.¹

“We are a group of independent practices looking to strengthen every single one of our practices without requiring ownership,” said Barbara McAneny, MD, FASCO, MACP, who is CEO of New Mexico Oncology Hematology Consultants. “The theory is, one needs friends and allies, but you don’t need ownership…we can provide a lot of the infrastructure support by learning from one another, so that we can all grow and thrive.”

Sibel Blau, MD, who serves as president and CEO of ONCare Alliance, emphasized that the alliance’s model emerged from a decade of collaborative, practice-led problem solving. “To be independent, you need to depend on each other,” she said. She added that practices remain “completely unowned by other entities,” which allows local teams to preserve payer relationships, adapt to market conditions, and keep decision-making at the point of care for each patient.

The alliance also stressed its commitment to health equity. At its annual meeting, ONCare Alliance raised more than $300,000 for the national Cancer Safety Net Foundation to help patients who are underserved address social needs that interfere with cancer care. For practices that do not have their own foundation, McAneny said this one will teach them the importance of how to start a patient foundation and make it successful.

“Your patients who are trying to decide whether they’re going to buy food for their kids, or whether they’re going to move or get cancer care, they shouldn’t have to make that choice, and we allow them to not have to make that choice,” McAneny said.

Building Shared Infrastructure

Speakers described 3 pillars underpinning ONCare’s growth:

• Data and real-world evidence
• Theranostics programs
• Coordinated research access

ONCare’s data warehouse aggregates practice-level clinical information to support quality improvement, adaptive pathways, and payer engagement. Blau noted the strategic value of community-owned data.

“We can do whatever we want with those data,” she said. “In that data engine, what we’re creating is a lot of solutions…we want to bring it to the next generation,” including more adaptive decision support at the point of care. “All the clinical pathways in the current state—how it’s been utilized—are going to be very stale pretty soon,” Blau added.

Danielle Geiger, MSN, APRN-NP, who is chief operating officer of Nebraska Cancer Specialists, explained how her practice developed a theranostics service and helped alliance members establish similar offerings. “When we have newer treatments that require more effort put into them, you need to hire certain people, you need to adapt clinic spaces to provide that treatment,” she said. “It’s an opportunity for us to lean on each other and share our expertise and what we’ve learned.” Blau added that Nebraska Cancer Specialists holds the comprehensive distinction from the Society of Nuclear Medicine and Molecular Imaging Accreditation Program—an achievement that signals capability to sponsors and has accelerated access to theranostics studies across the network.

Through ONCare’s collaboration with the Exigent research network, community sites gain access to trials—including early-phase studies—that might otherwise be limited to academic centers. “When you’re part of the Exigent network, you get access to trials that you may not have been able to get access to in your own clinic,” Geiger said, noting the barriers independent practices face in accessing phase 1 trials. “We’ve been able to do a lot of first-in-human, first-in-world clinical trials, partially because of our theranostics designation, but also through our relationship with Exigent.”

These shared platforms translate into measurable research capacity across member sites. McAneny described how her practice restarted its research program after pausing for financial reasons. “We decided, having seen the success of other ONCare Alliance practices, that we would open it back up and rebuild it and use some of the expertise of Sibel and Danielle and others,” she said. “Now we’re putting 20 to 30 patients a month on trial.”

Advancing Value-Based Care and Operational Excellence

ONCare’s infrastructure is tied to 4 payer-relevant outcomes:

• Appropriate site of care
• Safer infusion operations
• Lower total episode costs
• Timely access to innovation

With that foundation in place, panelists connected program growth to payment reform. McAneny argued that prevailing fee-for-service rates underpay essential cognitive work such as new patient consults, thus pushing practices to cross-subsidize with drug margins. McAneny called this dynamic unsustainable, explaining how the ONCare Alliance uses real cost and outcomes data to design practical value-based models. “If you show physicians in physician practices that by restructuring the payment system, it allows you to do things that you consider valuable for your patients…then I think you can get people to look at what we could do together.”

Operational excellence was another core theme, especially for nonphysician leaders. “Every practice has nonphysician leaders as well, and it’s so important to make sure that they’re up to date and they understand,” Geiger said. “Teaching those leaders how to bring our practices into success in the future is important as well.”

Policy Headwinds

As discussed earlier at PCOC and at other community oncology meetings, practices face threats from payer mandates for white- and brown-bagging, which are efforts to block oncology practices from dispensing their own cancer therapies. Other threats include attempts by pharmacy benefit managers (PBMs) to steer patients to PBM-preferred pharmacies through site-of-service payment differentials.

“There’s a large movement by some payers to try to make us white bag or brown bag, and that’s a threat to our ability to manage our patients in the infusion center,” McAneny said, noting daily infusion reactions require immediate, experienced clinical response, especially if patients have adverse reactions. She also cautioned that PBM- or payer-operated infusion suites could fragment care for people receiving complex cancer therapies. The alliance is sharing protocols, safety practices, and business models to keep infusion services local, safe, and financially viable.

Beyond programs and policy, the panelists underscored a culture of mentorship and long-horizon planning to keep oncology care available close to home. “We own our own destiny, and we have our shared mission and shared fate,” Blau said.

References

1. Caffrey M. QCCA, NCCA merge to form ONCare among independent oncology practices. AJMC. February 29, 2024. Accessed October 28, 2025. https://www.ajmc.com/view/qcca-ncca-merge-to-form-oncare-among-independent-oncology-practices