Oncology Care Management Programs for Health Plans

The Optum® Cancer Support Program (CSP) is an integrated approach that closes gaps in care. With CSP, members have access to a specialized nurse case manager and support from an entire team of cancer experts.

CSP nurse case managers provide network guidance, education, pain management, treatment adherence, and palliative and end-of-life care.

Ensuring the patient’s condition is properly managed helps avoid hospitalizations, emergency department visits and inappropriate treatment, thus reducing the total cost of care for clients.

• Participant Net Promoter Score® of 68⁵
• Cancer Support Program is used to support of 17 million+ members across multiple clients⁶

CGP supports 29 million members across multiple clients. The program has 7 case studies demonstrating a 4:1+ ROI.⁷

The results

• 85% of requests entered by provider through CGP website (time frame: 2022–2023)⁸
• 96% preferred product adherence (time frame: 2022–2023)⁸
• 20% adherence in pathway adoption (time frame: 2022–2023)⁸

The Specialty Guidance Program (SGP) and CGP are closely connected. CGP focuses on cancer conditions, while SGP focuses on specialty non-cancer conditions.

Cancer Resource Services (CRS) provides access to top-performing cancer centers across the country, known as our Cancer Centers of Excellence (COE) network. It is particularly useful for individuals looking for a second opinion on their cancer diagnosis or treatment.

The Optum COE network includes 39 leading cancer centers that meet strict evaluation criteria such as:

• A multidisciplinary approach to care
• Program depth and breadth
• Best-practices medicine
• Patient- and family-oriented programs and services
• Patient volumes
• Treatment planning and coordination
• High-quality clinical research
• Patient safety

The results

• 50,000+ members supported since 2001⁹
• Plans save on average $14,000 each time they use an Optum COE⁹