What You Should Know
- Transcarent launched a first-of-its-kind bundled payment model for bispecific T-cell engager (BiTE) and chimeric antigen receptor (CAR) T-cell therapies delivered through community oncology providers.
- Addresses the primary cost driver for self-insured employers: the Business Group on Health’s survey found that cancer is the No. 1 condition driving employer healthcare costs for the fifth consecutive year, with 70% of employers citing it as their top cost driver.
- Breakthrough cell and immunotherapy treatments routinely cost hundreds of thousands of dollars and have historically been concentrated in major academic medical centers, requiring long travel distances and complex care navigation.
- The bundled payment structure offers employers predictable pricing and has the potential to deliver savings of up to $150,000 per case, based on Transcarent data.
- Partners with national community oncology networks, including Vantris Oncology, to deliver advanced infusions and cell therapies in accredited regional and community settings closer to patients’ homes.
Moving High-Tech Oncology Closer to Home
The program expands Transcarent’s Cancer Care Centers of Excellence (COE) model by partnering with Vantris Oncology, an organization that operationalizes value-based cancer models across community practices nationwide. The partnership allows patients to receive complex infusions and monitoring near their local support systems rather than temporarily relocating to academic hubs.
Key components of the bundled model include:
- Predictable Episode Pricing: Replaces open-ended fee-for-service billing with a single prospective bundled rate for BiTE and CAR T regimens, generating potential savings of up to $150,000 per episode for self-insured plan sponsors.
- Dedicated Nurse Navigation: Assigns each patient an American Cancer Society LION™-certified Oncology Nurse Navigator (ONN) to coordinate staging, treatment protocols, and post-infusion recovery.
- Integrated Care Ecosystem: Connects directly into Transcarent’s WayFinding platform, which provides expert second opinions (2nd.MD), virtual primary care, and pharmacy support across more than 21 million covered lives.
