The Next Decade of Cancer Care Is Coming Home: Who Will Be in the Driver’s Seat?

A recent panel, “Focus on the Future: The Next Decade of Patient Care,” at Patient-Centered Oncology Care®brought together oncology practice leaders to forecast changes to cancer care. Although the conversation moved through several topics, it consistently returned to one location: the patient’s home.¹ This poses the following question: If this is the decade that sees the growth of home-based cancer care, who is going to be in the driver’s seat?

As evidenced by the panel, community practice leaders are keen to set the tone for this shift rather than react to changes imposed by payers or pharmacy benefit managers. The panel did not fully agree on how to get there, but most panelists accepted that the move toward the home is coming. The question now is how providers can implement it well and how practice leaders can be in the driver’s seat for once.¹ One panelist captured what is at stake: Practices often find themselves reacting to changes set by others, and home infusion finally offers a chance to get ahead of the change.¹ Getting ahead of it, however, depends on getting the model right, and one condition the panel set for a successful home infusion model stood out: It must work for the patient, the provider, and the payer.¹ A home infusion model that fails any one of those 3 stakeholders will not last.

Some leaders in community oncology see risks. Although the safety of home infusion for appropriate patients and drugs has largely been borne out in the literature,^2,3 the potential for care gaps to arise if home infusion creates disconnects between the provider and the patient gives many practices pause. That risk is greatest with white and brown bagging, in which an outside pharmacy ships the drug. The American Society of Clinical Oncology opposes mandatory white bagging for this reason, warning that when practices lose control over drug sourcing, care can be delayed and disrupted.⁴ A well-designed home infusion model avoids that problem by relying on clear bagging, in which the practice’s own pharmacy dispenses the drug and never gives up the chain of custody. That distinction is the heart of how home infusion should work, and it is the one point I would want every practice leader to take home from this panel. Home infusion through an outside pharmacy takes control away from the practice. Home infusion built on the practice’s own pharmacy keeps it there.

This is not a new idea. When Penn Medicine expanded home cancer treatment through its own home infusion pharmacy and nurses, referrals rose 700% in 7 weeks, and the team concluded that for appropriate drugs and patients, home treatment can replace outpatient care.² However, the operational burden of implementing a model like this alone is often too much for a single practice. To keep that burden from becoming a barrier to offering home infusion, one panelist pointed to a practical answer: If their practice could stay in the driver’s seat and dispense the drug, working with a partner to give it at home could be a win-win.¹

The key is that the partner acts as an integrated extension of the practice rather than as an external vendor. Luminate’s Lotus program makes this partnership approach accessible to any practice or health system, whatever its size or infrastructure, by extending clear bagging into the home. Now live in New England, the model is available to practices and health systems across the United States; it is currently onboarding practices and health systems across the Unites States. practice’s physician prescribes the therapy, and the practice’s own pharmacy dispenses the drug, just as the panel agreed it should. A Lotus oncology-credentialed nurse then administers the treatment in the patient’s home, and ensures home visit notes are available in the provider’s electronic health record. The patient stays with the same physicians throughout rather than splintering across providers, and the drug never passes through an outside pharmacy, so the practice keeps the oversight it has historically feared losing. It is the panel’s idea of partnership made real, with a partner delivering treatment at home while the practice stays firmly in the driver’s seat.

Among the panelists, the sharpest objection to home infusion was financial: Drug margins are still what sustain community practices, and many fear that moving care into the home would mean losing those margins.¹ That is why keeping care from splintering across providers matters for reimbursement as much as for patients. Home infusion has traditionally meant handing dispensing to an outside vendor, with the drug revenue leaving with it, even though the practice remains responsible for managing the disease.¹ This new care delivery model addresses that concern because the practice never stops dispensing, so the patient, the dispensing, and the revenue all stay with the practice.

Patients benefit financially as well. Those suitable for the Lotus model are in the maintenance phase of therapy, so their co-pays typically go down once billing moves to the pharmacy benefit, where Medicare Part D caps out-of-pocket costs at $2100 in 2026.^5,6 This comes in addition to the gas, parking, and added time off work that patients and caregivers no longer spend traveling to the clinic, making the savings add up quickly. The practice keeps its revenue and gains capacity at no cost, the patient pays less, and the payer spends less, so the Lotus model meets the test the panel set by delivering a win for all 3 stakeholders.

Within 3 months, one oncology practice using the Lotus model identified more than 150 patients eligible for treatment at home, although the decision about where each patient receives care ultimately rests with the clinical team and the patient.⁵ Patients do not have to commit to just one setting: Some already alternate between home and clinic, depending on their treatment plan and their preference.⁵ The patients explain the value better than any number can. One patient, who has been on therapy for more than 15 years, has had her life transformed by home treatment and simply stated, “I wish I could have taken advantage of this back then.” Another woman, who said she is “managing so much with [her] own cancer diagnosis now too,” has found some comfort under an overwhelming burden because her husband’s treatment at home has enabled her to be both a patient and a caregiver.

The title of the panel was “Focus on the Future: The Next Decade of Patient Care.” For those patients, it is already here. So, who will be in the driver’s seat for the next decade of home-based cancer care? Practices that keep dispensing in-house, choose partners that protect their revenue, and put safety first will decide what home infusion looks like for everyone else. Practices can let this change happen to them, or they can lead it, and I hope they choose to lead.

Author Information

Emma Moran, MS, is the healthcare partnerships lead for Luminate Medical, which provides the Lotus home infusion model described in this article.

References

1. Caffrey M. Will cancer care come home by 2030? PCOC panelists differ on strategy. AJMC. October 6, 2026. Accessed October 14, 2026. https://www.ajmc.com/view/will-cancer-care-come-home-by-2030-pcoc-panelists-differ-on-strategy
2. Laughlin AI, Begley M, Delaney T, et al. Accelerating the delivery of cancer care at home during the Covid-19 pandemic. NEJM Catal. Published online July 7, 2020. doi:10.1056/CAT.20.0258
3. Dronca RS, Jones JC, Maniaci MJ, et al. Cancer CARE (Connected Access and Remote Expertise) beyond walls: safety, feasibility, and patient experience of home-based chemotherapy. NEJM Catal Innov Care Deliv. 2026;7(4). doi:10.1056/CAT.25.0168
4. Position statement on white bagging. American Society of Clinical Oncology. August 24, 2023. Accessed October 14, 2026. https://cdn.bfldr.com/KOIHB2Q3/as/g6jk38f6pr5bsnmgjc9tr3rq/2023-White-Bagging-Position-Statement
5. Luminate Medical. Lotus model program data. Data on file. October 2026.
6. How much does Medicare drug coverage cost? Medicare.gov. Accessed October 8, 2026. https://www.medicare.gov/health-drug-plans/part-d/basics/costs