Partnerships in Oncology Care Can “Span Everything”

Collaboration among partners who can fulfill different elements of cancer care—whether from nearby or distant locations—can be vital to meeting patients’ varied needs, according to panelists who took part in a discussion to conclude the first day of the 2025 Patient-Centered Oncology Care Conference, held September 25 in Nashville, Tennessee.

Fostering Positive Partnerships in Cancer Care

Moderator Emily Touloukian, DO, FASCO, the president and CEO of Coastal Cancer Center, in Myrtle Beach, South Carolina, led a group discussion on how partnerships serve different purposes and can form and evolve for various reasons. “I think we can all agree that oncology is a team sport and having effective partnerships really helps us field the appropriate team to be able to take care of our patients,” Touloukian said.

Josh Eaves, chief development and strategy officer for Florida Cancer Specialists & Research Institute (FCS), explained that independent physicians feel they need to band together to approach oncology, especially since it can be challenging to specialize in this field. “Our partnerships span everything.… We actually have a partnership for a health system [where] we take care of all their oncology patients—all their employees,” he said, due to the expense of providing oncology care. Innovations in this partnership go “all the way to cellular therapy bundles,” Eaves said.

Traditional joint ventures tend to be partnerships that FCS avoids, as financial outcomes often fail to fulfill the objectives sought by each member of the partnership—and this can make arrangements hard to sever. Casey Chiasson, MBA, executive director of Willamette Valley Cancer Institute in Oregon, highlighted the organization’s healthy partnership with a local hospital and the Oregon Cancer Foundation. However, Chiasson specifically noted that local university medical centers are strong partners for awareness.

“Those 2 partnerships [with the University of Oregon and Oregon State University] are really just around raising awareness in our communities about cancer. At the football games, as well as some of the other sporting events, we work together and honor cancer patients,” he explained.

Kimberlee Rowett, DNP, MSN, MBA, RN, LNC, teleoncology clinical manager at Intermountain Health, described how the health system operates across multiple states—specifically in Utah, Idaho, Montana, Wyoming, Nevada, and Alaska—with plans to expand into Arizona, Colorado, and New Mexico, which makes partnerships to treat patients in rural areas even more important. She highlighted a relatively new partnership established with the Tanana Chiefs Conference in Fairbanks, Alaska, which aims to serve a population that had been forgoing or receiving incomplete cancer care at higher rates due to the distance patients had to travel to receive cancer care from remote areas within the state.

“[With] our partnership…we are essentially treating the infusion center as a cancer department where the patient won’t go to the local hospital—they’ll be roomed and we’ll use telehealth technology to connect the provider to the patient where they can go through the consultation that way,” explained Rowett. “Then if they are needing treatment, then we keep them local as much as possible.”

Limitations in what rural hospitals can complete are a challenge in this space, especially when patients require operations such as bone marrow biopsies or PET/CT scans that some hospitals are not equipped to perform. The navigation program helps ensure that, in cases where travel is necessary, it is kept to a minimum.

How do partnerships begin? Chiasson noted that having a shared problem to solve is a good first step to beginning a relationship. “In business school, we were taught the first thing you need to do is define the problem. And a lot of times, when you go through that exercise with a partner in the beginning of a conversation and you define what the problem is, my experience is that we have always started off on the right foot,” he said.

Chiasson also noted that, as long as both partners are developing the means to solve the problem and autonomy exists for both partners, then a contractual relationship is not always necessary to maintain the partnership. Eaves agreed, saying that referral relationships are equally as valuable as a legal structure. Should partners be looking to formalize, they should ask themselves the purpose of doing so, including in evaluating the trade-offs that smaller entities may have to perform in order for the partnership to work.

When it comes to building trust, Rowett said the first thing that needs to be done is to identify what they are looking to accomplish and make sure that both partners are aligned. She also recommended site visits to foster relationships through face-to-face conversations, as well as scheduled check-ins. This can also help break down any cultural barriers and ensure that all patients are comfortable.

“An example that comes to mind of how we had to shift quickly is, initially, when we put in our telehealth technology, the camera was mounted on the ceiling, which is our traditional approach.… [Tanana Chiefs] gave us feedback that, because of this population, that felt like a surveillance camera, and we had never thought of that,” explained Rowett. “Having that trust goes both ways, making sure that they feel like they can trust us and we can trust them and having that open dialogue so that we can, at the end of the day, provide the best patient care possible.”

Long-Term Health of These Partnerships Requires Buy-In

Buy-in from the partnership is crucial when considering a long-term partnership, whether it involves an entity that can complement an organization’s services or even a former competitor.

“A lot of these partnerships and relationships you’ve been talking about require partnership with people who may not be natural partners,” said Touloukian. “We may be with a competing group in town; it may be with a hospital with whom animosity has existed for some time.”

Eaves emphasized that finding common ground is the first step in maintaining good relations between all parties. Evaluating oneself before entering talks with potential partners can help establish what each partner is currently lacking and what they hope to gain by working together.

“I think an important part to lay out in the beginning, after you find a common ground, is that you have to have a way to check each other. And if you don’t, then what happens over time is that the culture of the partnership or the relationship, it just chisels away a little bit at a time,” added Chiasson. “And then what each partner ends up doing is talking poorly about the other partner internally…until there’s this huge divide in between.”

Eaves said that translation problems should be avoided at all times, not necessarily with different languages, but rather by using words that have different meanings to different people. “You first have to create that common language that you can utilize to talk through problems, define problems, put them on the table, so that you can make sure that you’ve got it all out there,” he said.

Touloukian also noted that getting that information to employees is important to ensure the buy-in from all. “We had that when we created our radiation oncology partnership. The staff of radiation was concerned they were all getting fired and that everything was changing,” she said. “What is a good way to alleviate some of that angst and to get that buy-in so partnerships can ultimately be successful?”

Chiasson emphasized the importance of communicating often and early in the process, as well as developing a story that encapsulates the goals of the partnership. Eaves noted that the method of communication can also depend on the company culture, whether it be strictly business or a business built on trust.

“If the way you communicate through a change or a challenge like this is not true to how you’ve communicated in the past, you’ll end up eroding trust, and it’ll be really hard to recover your culture from that,” said Eaves.

For Rowett, the buy-in can be different due to most partnerships coming to them. Intermountain Health has published a white paper on the first location, detailing the time and money saved for the patients, the revenue generated by keeping the patients local, and what this means for the hospital.

“Using [those] data beyond just the story that [they tell], I think, is also going to help with the buy-in because you can then connect the emotion with logic, and that can really root down that change or that potential partnership,” she explained.

The tightrope of managing oncology partnerships is delicate but, when balanced well, can lead to significant benefits for patients who require timely care. Hospitals, clinics, and health systems working together to provide care for patients, specifically for care that an individual location may not be able to provide, is essential to delivering holistic care, making these partnerships essential for all involved.