2025 Could Be The Year In-home Cancer Care Finally Takes Off

With the breakthrough of hospital-at-home came greater acceptance of higher acuity care in the community setting. With this in mind, experts are wondering if 2025 is the year that in-home cancer care takes off.

This question is especially relevant, as the number of new cancer cases is expected to rise. By 2040, new cases annually are projected to reach 29.9 million, and the number of cancer-related deaths to 15.3 million, according to data from National Cancer Institute.

Currently, organizations like the Mayo Clinic, Synergy HomeCare and Reimagine Care are all taking different approaches to delivering in-home cancer care.

On its end, the Mayo Clinic has a Cancer CARE (Connected Access and Remote Expertise) Beyond Walls (CCBW) program. Dr. Roxana S. Dronca — a hematologist and oncologist and site director of Mayo Clinic Comprehensive Cancer Center in Jacksonville — calls the program the answer to the shifting oncology landscape.

Specifically, Mayo Clinic’s CCBW program is focused on being patient-centered, while also addressing health disparities.

“We know that patients who live far away from medical centers have inferior outcomes, and a big part of this is because they do not have access to care,” Dronca told Home Health Care News. “We know that a lot of the underserved populations, for instance, people living in rural areas, in distant communities, people who have limited ability to travel … as well as ethnic and racial minorities have difficulty accessing care. That coupled with the fact that the number of cancer patients is significantly increasing, we see more and more new cancer diagnoses.”

Nonprofit Mayo Clinic is widely considered one of the top medical group practices in the country. Its CCBW program first launched in 2023 with 10 patients. To date, the program has over 200 patients.

The program is a cancer care delivery model that brings cancer care to patient’s homes by using a distributed vendor network and virtual command center. The command center is staffed by chemotherapy trained nurses, advanced practice providers, as well as medical oncologists. The command center oversees care in the home that is delivered by a home health nurse, who provides both in-person and virtual care.

Some patients in the program have access to remote patient monitoring. Patients also have a tablet that enables them to contact the command center at all times and a bluetooth-enabled blood pressure cuff, pulse oximeter, thermometer and more. There’s also the ability to do labs in the home.

“It’s a very coherent system and model,” Dronca said. “Patients receive treatments in the home. The way we’ve chosen these treatments are medications that have low reaction ability and that are stable during transport. This is not a system where all the treatments are moved in the home, but mainly the lower acuity treatments are moved in the home while we reserve the treatments in the clinic for patients who are on regimens that are more complex and cannot be administered that home.”

One of the challenges of delivering in-home cancer care is a lack of reimbursement for cancer medications being administered in the home.

For now, the Mayo Clinic Cancer Center fully funds one of the program’s clinical trials, while Bristol Myers Squibb funds another.

Dronca said she hopes that the clinical trials that are being conducted through the program will help lead to more permanent reimbursement for in-home cancer care.

“We think that this will show lower health care utilization, and therefore lower cost of care, as well as improved patient quality of life,” she said “Once we have this objective data, we are in active conversation with payers to explore the reimbursement models. The main challenge right now is the fact that it is difficult to expand this program outside of clinical trials until we have a reimbursement model.”

Dronca also said she believes that staffing could present a potential challenge for providers.

“The way we are dealing with staffing challenges is by partnering with home health agencies, and by training some of those nurses to be able to provide cancer care in the home, with oversight from our chemotherapy nurses,” she said.

On-demand and non-medical cancer care

World-class institutions like the Mayo Clinic aren’t the only organizations working to innovate cancer care.

Reimagine Care — an at-home on-demand cancer care provider — has steadily become more visible in the movement to shift this type of care into the home. The Nashville-based company provides technology-enabled services to health systems and oncologists to help them deliver at-home, value-based cancer care.

“We’re able to support patients for the 98% of their cancer journey that happens outside of the clinic,” Dan Nardi, CEO of Reimagine Care, told HHCN.

Since its inception, Reimagine Care has formed partnerships with companies like the University of Colorado Anschutz Medical Campus, DispatchHealth and Memorial Hermann Health System.

The company has also received a strategic investment from Oncology Ventures, a cancer-focused venture capital fund, at the start of 2024.

Nardi believes that the drastic increase in the demand for cancer is opening the door for in-home cancer care companies like Reimagine Care and others.

“We already have a shortage of oncologists,” he said. “We know burnout is happening for the existing care teams. RNs are leaving the workforce. You have a decrease in supply, so we need to be able to use technology and innovative platforms and programs to bridge that gap and support patients.”

In-home cancer care isn’t just the domain of health systems and health care technology companies, last year home care franchise company Synergy launched a specialized care program for individuals living with cancer.

“We designed the program because we really wanted to help ease the burden of cancer patients, and their families, by providing in-home assistance throughout a person’s cancer journey,” Rich Paul, chief partnership officer at Synergy, told HHCN.

Synergy is a Gilbert, Arizona-based non-medical home care franchise that operates more than 220 franchise locations nationwide. The company offers companionship services, in addition to personal assistance, housekeeping, live-in care and 24-hour home care services. Synergy was also recently acquired by Levine Leichtman Capital Partners.

Synergy’s program zeros-in on helping prepare families for how chemo, radiation and other treatments may impact the patient. Things like avoiding fall risks, addressing mobility concerns and nutritional needs, as well as transportation to and from appointments are areas the program focuses on. Offering respite care to family caregivers is also part of the program.

“One of the messages that we’re trying to convey to individuals is that, as they’re starting to put together their care team following a diagnosis of cancer, that we want home care to be part of that care team,” Paul said.

Ultimately, Dronca thinks there’s a possibility that in-home cancer care could follow in the footsteps of hospital-at-home, a care model that was once considered niche in the U.S.

“We’re coming on the heels of the hospital at home,” she said. “I think it will follow the same path. There are models of cancer care in the home, internationally. There are many studies done [internationally] showing an overwhelming patient preference for care in the home to financial and financial sustainability in single payer models.”

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