Downstream revenue (DSR) and value-based care are both excellent ways to boost revenue potential. For oncology practices, these boosts can be realized by adding three specialists: a cancer genetic counselor, a nurse navigator, and a cancer dietician.

In a JCO Oncology Practice paper, the benefits of enhanced cancer risk reduction measures for patients with hereditary predispositions to certain cancers were shown to bring in substantial DSR. Among 425 patients who met with a genetics counselor at a Texas cancer center, the DSR totaled almost $33 million after such encounters, with these patients collectively generating almost 74,000 work-relative value units. The study investigators noted that substantial DSR was also generated by institution-naïve and other unaffected patients who opted to continue receiving care at the institution.

Nurse navigator specialists, in conjunction with cancer care navigation programs, can help reduce healthcare costs and generate additional revenue opportunities for hospitals, according to an observational study published in JAMA Oncology. The study found that use of cancer care navigation programs directly correlated with declines in healthcare use and costs, with three notable results. First, there was an improved return on investment of 1:10, which came from a reduction in costs per patient per quarter versus nonnavigated patients. Second, there was a decrease in resource use, with fewer ED visits, hospitalizations, and ICU admissions. Finally, there was increased patient activation, because barriers to care were overcome and patients were equipped to stay connected within the community.

Nutrition is well known to play a crucial role in cancer prevention, treatment, and survivorship, making a registered dietitian nutritionist (RDN) a crucial member of the interdisciplinary care team. An article published by the Association of Community Cancer Centers (ACCC) makes a business case for hiring an RDN, noting that medical nutrition therapy (MNT) is an evidence-based intervention that can prevent, delay, or manage diseases and conditions, with nutrition education and counseling provided by an RDN being reimbursable.

The ACCC article recommends that providers who add an RDN to their practice also build nutrition outcomes measures into their programs. By observing outcomes that are meaningful to patients, clinicians, and payers, practices can be reassured that they have made a solid return on their investment in MNT.