Community oncology’s expanding role as cancer care grows more complex

McKesson’s Kirk Kaminsky says community practices are central to innovation, access and affordability in oncology’s next chapter.

More than half of U.S. cancer patients now receive care in community settings, a share that is only expected to grow as oncology evolves into an increasingly complex and chronic field.

Kirk Kaminsky, executive vice president and group president of North American Pharmaceutical Services at McKesson, emphasized the vital role of community oncology in today’s cancer care. He noted that as scientific advancements continue to transform the ways patients are diagnosed, treated, and monitored, community oncology will be a central pillar supporting these changes.

“People are living with cancer much longer,” Kaminsky said. “Because of that, patients need frequent interaction with their oncologist, and you really want that care close to home.”

Over the past two decades, cancer care has changed dramatically. Diagnoses are now far more precise, often defined by specific molecular mutations rather than broad tumor types. Treatment options have multiplied, outcomes have improved and survivorship has increased. 

Those gains come with new demands on oncologists, particularly in the community setting, where many physicians are also small business owners. They face mounting reimbursement pressures and a flood of new therapies (all while trying to deliver high-quality, personalized care).

“That change goes way beyond just the science,” Kaminsky said. “Oncology practices are balancing the demand of running a business with the responsibility of delivering the highest quality care.”

To help community practices manage increasing complexity, McKesson and The US Oncology Network provide support and resources to help physicians spend their time on the patient. For example, providing physicians with new technology helps them navigate evolving treatment options and regimens, helping to create a best-in-class patient experience. 

This support also translates into cost savings and quality care. More than 900 US Oncology Network providers participated in the Center for Medicaid & Medicare Innovation Oncology Care Model (OCM), saving Medicare $337+ million and improving care quality.

Clinical trials, Kaminsky said, are “the lifeblood of cancer care.” They are another area where historical underrepresentation has slowed progress, but community oncology is poised to play a larger role. The collaboration between McKesson's oncology research venture, Sarah Cannon Research Institute, and The US Oncology Network aims to expand research trial access across more community sites.

The results have been encouraging so far. Kaminsky said accrual rates, or rates at which patients are enrolling in trials, across The Network have increased over the past year, aided by broader trial menus, improved operational support and technologies that better match patients to studies based on molecular profiles.

For pharmaceutical companies, scale and efficiency could help address one of the industry’s biggest bottlenecks: enrolling patients quickly enough to accelerate access to new therapies. The Sarah Cannon Research Institute recently launched Accelero, a framework designed to speed trial activation, streamline recruitment and automate data collection through electronic health record integration.

Innovation, especially artificial intelligence, is also reshaping community oncology. In a national double-blind survey, McKesson found that 84% of community oncologists believe AI will have a major impact on both clinical and administrative workflows. Early deployments include AI-powered clinical scribes to reduce documentation burden and tools that use machine learning to predict insurance claim denials before they happen.

Looking ahead, Kaminsky does not expect a single seismic shift to define the next decade of community oncology. Instead, he sees multiple changes converging at once, from the rise of cell and gene therapies to the growing importance of biomarker-driven trials.

“Our job is to help community oncologists adapt so they can continue to provide best-in-class care,” he said. “I’m incredibly excited about the future of cancer care.”