Leveraging Data to Build Payer Trust in Community Oncology

In this clip, Susan Sabo-Wagner, MSN, RN, OCN, NEA-BC, vice president of clinical innovation at the American Oncology Network (AON), describes how practices within AON’s network use data to build payer trust, as well as why community oncology is positioned to close gaps in access to advanced cancer care.

She spoke with The American Journal of Managed Care^® following the 2026 Community Oncology Alliance (COA) Payer Exchange & Innovation Summit last month. At the meeting, on September 14, Sabo-Wagner served as a panelist during the session titled “The Evolution of Utilization Management: Data-Driven Decision-Making.”

In one of its most recent pilots, AON partnered with Evolent Health and a specific payer to examine utilization, the evidence-based pathways its physicians use, and additional criteria the group calls value pools, she explained; the collaboration has become a trust model that gives Evolent Health insight into ordering patterns and quality of care across providers. The goal, Sabo-Wagner noted, is to continue proving trustworthiness through data to potentially remove prior authorization across the board with the current payer and eventually extend that approach to others.

Demonstrating value requires showing that ordered regimens are high quality and deliver value for patients, with outcomes tracked down to supportive care, she said. She pointed to the COA Quality & Value Study, conducted with Flatiron Health, as evidence that community oncology "can be trusted to really show quality outcomes." With that data and prior authorization relief, community practices can deliver care that is both higher quality and less expensive, Sabo-Wagner noted.

She also highlighted community oncology's role in rural and underserved regions where academic centers and large hospital systems often lack locations. Barriers such as lack of transportation, childcare, or the financial means to travel often limit patients' options. AON offers therapies such as chimeric antigen receptor T-cell therapy, bispecific therapy, and radioligand therapy in these areas, Sabo-Wagner noted, sparing patients long drives or the need to forgo treatment.

“Being able to provide these opportunities for patients in areas that otherwise wouldn't be able to [access them] really sets the quality and outcomes for that patient population at a higher level,” she concluded.