An analysis of AccessHope case reviews found that experts recommended changes in more than 80% of cases. About half were implemented, saving a median of $18,636 per case.
Remote expert review of complex cancer cases led changes in recommended care for more than 80% of patients, according to a poster presented at the 2026 American Society of Clinical Oncology Quality Care Symposium, held October 16 and 17, 2026, in Boston, Massachusetts. Changes adopted in about half of the cases produced substantial savings.¹
City of Hope in Duarte, California, launched AccessHope in 2020 as a wholly owned subsidiary. It gives employers and health plans access to expertise from National Cancer Institute–designated comprehensive cancer centers.² The network now spans 7 centers. Its oncologists conduct asynchronous case reviews and send recommendations to the patient’s health plan and treating oncologist.¹
Who received recommendations?
Debra Wong, MD, a medical oncologist at City of Hope and medical director of AccessHope, and colleagues analyzed 1417 cases from 47 states reviewed from January 2024 through December 2025. The median patient age was 56 years. Hematologic/lymphoid cancers were most common (28%).¹
Experts identified at least 1 opportunity to improve care in 1148 cases (81%). These most often involved anticancer therapy (39%), diagnostics (37%), and imaging/surveillance (34%). Odds of a recommended change were higher for these groups¹:
Adoption and savings
Claims data confirmed that changes were implemented in 582 cases (51%) among those where there were opportunities to improve care. Adoption was highest for imaging/surveillance recommendations (57%). In adjusted models, only patients younger than 26 years had higher odds of adoption (aOR, 2.54; 95% CI, 1.09-5.92).¹
When recommendations were adopted, the median per-case savings over 12 months was $18,636 (95% CI, $14,625-$19,876). The median rose to $60,759 when the adopted change involved anticancer therapy.¹
“Remote expert review may help address gaps in evidence-based cancer care while delivering measurable cost savings,” the authors concluded.¹
Wong answered questions in response to a request from The American Journal of Managed Care® (AJMC).
AJMC: Patient age was associated with adoption of AccessHope recommendations. With the rising incidence of early-onset cancers, does this finding carry increased importance for your care partners—and the patients they treat?
Wong: Employers, health plans, and our partners are understandably concerned about the rising rates of cancer incidence among younger patients. Our data show that younger patients are more likely to see their change-in-care recommendations adopted, though no other characteristic impacted likelihood of adoption. This is also an important finding. It suggests that community oncologists are open to adopting recommendations that improve care for their patients, regardless of geography or cancer diagnosis.
Our partners know their entire cancer population is supported, and the impact is validated.
AJMC: The median savings was $18K and with the highest median savings $60K. How important is the opportunity for savings to your employer partners?
Wong: For employers, health plans, and partners nationwide, cancer has been the top cost driver for a number of years now. Of course, our clients are concerned about how to manage cancer costs as interventions become more expensive, and patients are on treatment for longer periods. More importantly, our clients want to make sure their members are on the best treatment possible and experience the best outcomes possible. By providing these expert reviews, we can impact both cost and quality.
AJMC: Does the ability of your partners to gain second opinion insights offer cost reductions from payers? Are you able to measure this?
Wong: Yes. We are able to measure whether the recommendation is adopted, and based on a total cost of care approach, we can demonstrate cost reductions due to better outcomes and lower health care utilization. This approach is validated in our ability to follow up and based on a large body of cancer health economics literature.
AJMC: Your data demonstrate the value of AccessHope’s service to patients in rural areas, especially those with less common cancers. How has the profile of this type of patient served by AccessHope evolved?
Wong: Our initial focus was on a subset of cancer diagnoses that were traditionally thought to be complex. Today, with oncology evidence generation evolving incredibly rapidly (2025 saw over 50 new cancer drugs and indications approved by the FDA), we consider all cancers complex. AccessHope can provide a meaningful expert review in almost all cancer settings.
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