Cancer care trends payers should watch in 2026

The oncology landscape is evolving at unprecedented speed — with breakthrough treatments, growing cost pressures, and new expectations for value-based care. For payers, this creates both opportunity and urgency: how do you support better outcomes for your members, while lowering the total cost of care?

Recent insights from leaders across the industry highlight what’s next for cancer care, the role of value-based oncology care partnerships in driving value, and the importance of connecting members with trusted support.

Rising cancer costs meet extraordinary innovations

The tension between innovation and affordability has never been greater. Breakthrough therapies are driving remarkable improvements in survival and quality of life, yet many cancer drugs now exceed $100,000 per year, creating mounting financial and operational strain on payers and members. As costs rise, patients are making difficult trade-offs. Studies show that half of older adults skip or delay their prescribed cancer therapies when out-of-pocket costs exceed $2,000 – a pattern that drives disparities in outcomes and threatens long-term sustainability.

At the same time, aging populations and rising incidence among younger adults are driving oncology utilization to new heights. The challenge for payers is clear: How can we make sure patients get timely access to the most effective therapies while maintaining a sustainable, outcomes-driven system? 

Access and demographic shifts within cancer care

Oncology staff shortages

Beyond cost, access remains one of the most persistent barriers in cancer care. Many patients still face weeks-long delays between diagnosis and consultation due to oncology staff shortages and systemic inefficiencies. A recent report found that 68% of Americans aged 55 and older live in counties at risk of insufficient oncologist coverage,  and by 2037, rural areas will meet less than 30% of the demand for oncologists. It’s evident that oncology care is at a pivotal time where systemic change is necessary to reduce admin burden and empower providers to  focus on delivering the best care.

The impact of SDOH (social determinants of health)

For those in underserved communities, social factors such as transportation, housing, and health literacy create additional hurdles and compound delays to care. Rural patients, for example, are up to 30% more likely to present with late-stage cancer due to long distances contribute to delayed chemotherapy and radiation therapy. These access gaps underscore the need for stronger connectivity across the care journey continuum — ensuring members receive timely, coordinated care regardless of geography or circumstance.

Rising rate of younger cancer populations

Meanwhile, younger cancer populations also present new considerations for commercial payers and employers, from early detection and screening benefits to survivorship programs. Incidence is increasing for many cancer types across younger adults, and the growing need for wraparound cancer care support before and after treatment is necessary for individuals and their caregivers now more than ever.

Why payers need value-based care partnerships

Despite growing consensus that value-based oncology is the path forward, implementation remains uneven across the industry.  The majority of members with cancer are treated in fee-for-service arrangements, which reward volume over outcomes. Programs like CMS’s Oncology Care Model (OCM) and Enhancing Oncology Model (EOM) have laid the groundwork for value-based cancer care, yet they represent only the beginning of a broader shift towards sustainable cancer care delivery. 

True transformation and success require payers to work with trusted, data-driven partnerships that align incentives across the care continuum. In successful models, payers must seek out more than just value-based contracts — they need collaborative value-based partners that can help streamline data and resources through scalable tech and infrastructure. 

Creating value-based partnerships requires built trust, alignment on quality, and addressing waste; these are key to sustainable progress. By investing in clinically aligned partners and removing administrative barriers, payers can accelerate the transition to outcomes-based oncology, ensuring a positive impact for every member, across more members.

Why proactive cancer care navigation is key to building trust with members

Cancer care is uniquely complex. Without timely, coordinated support, members face delays in treatment, unnecessary ER visits, and higher total costs. While care management has long been a core payer function, generalized programs often fall short in meeting the specialized needs of members with cancer. This is why cancer navigation is a critical strategy for payers to improve outcomes and reduce avoidable hospitalizations. However, executing with just payer-led care management programs can be challenging, as members often lose trust when outreach feels generic rather than personalized to their unique cancer journey and needs.

That’s where dedicated oncology navigation bridges this gap. These programs combine clinical oncology-specific expertise with human-centered support to proactively guide members through treatment, anticipate barriers, and connect them to the right care and resources at the right time.

Unlike traditional case management, oncology navigation offers frequent, personalized engagement and close collaboration with oncology providers. This approach builds member trust, reduces fragmentation, and improves outcomes by aligning payers, providers, and members around a shared goal — ensuring every member receives seamless, compassionate, and cost-effective care. For payers, this means navigation is not just a supportive service — it’s a strategic enabler.

AI and behavioral health: Two accelerators of holistic oncology care

As oncology grows more complex, artificial intelligence (AI) and behavioral health integration are redefining how payers and providers deliver whole-person care.

AI is poised to reshape the oncology ecosystem — not by making denial decisions, but by improving workflows, analyzing clinical data, and surfacing insights that help care teams act faster. Used responsibly, AI can streamline processes and support holistic decision-making to boost member engagement, while maintaining a human-centered approach to member care.

At the same time, behavioral health integration is equally vital. Mental health challenges are common across cancer populations, and siloed support models often leave members behind. Embedding behavioral health within oncology care programs is essential to improving engagement and adherence. Cancer Medicine reported that members receiving both psychological support and standard cancer therapy had significantly better outcomes than those receiving cancer treatment alone.

Together, AI and behavioral health represent the next frontier in comprehensive, patient-centered cancer care.

The future of cancer care for payers, 2026 and onward

As cancer care evolves, so must the payer’s playbook. Rising costs, rapid innovation, and persistent access inequities require adaptable strategies grounded in partnership and empathy.

Payers that invest in collaborative, value-based partnerships and clinically leading oncology navigation will lead the next era of oncology care. These strategies not only improve affordability and outcomes but also build lasting trust between members, providers, and payers.

At Thyme Care, we believe the path forward in oncology is about delivering oncology care that’s personal, proactive, and human.

If you'd like to dive deeper into how your team can prepare for what's next in oncology, connect with our team here.

Note: This is a webinar recap of a co-hosted Becker’s Payer Webinar, which featured Dr. Lucy Langer, National Medical Director and Chief Medical Officer of Oncology Genomics and Laboratory at UnitedHealthcare, and Dr. Ali Kahn, Vice President and Chief Medical Officer at Aetna Medicare. The discussion was moderated by Dr. Bobby Green, Co-Founder of Thyme Care.