Oncology Ventures: Underutilized Levers in Scaling Oncology Innovation + Job Title Comedy

Investing in data start-ups to improve cancer care and research

Oncology Ventures Fund Updates

Happy June, the Friday afternoon of months, whose motto is “Let’s Circle Back in Q3”.

I am grateful to be included in this year’s 40 Under 40 in Cancer. Congratulations to the other honorees - here's to continued progress in cancer care.

Where we’ve been:

• Thank you to our partners at Atlantic Health System for hosting their annual Atlantic Venture Innovation Summit, where healthcare innovators met to talk and implement critical industry partnerships. Excited by what their ecosystem is building to drive cancer innovation.

• As a proud CancerX Champion Partner, we joined their Innovation Jam in Charlotte, NC, hosted by Advocate Health. Great to see how systems are collaborating with Oncology Ventures’ portfolio companies mPATH and Gabbi as we thoughtfully integrate much needed digital innovation around early detection for cancer.

  • CancerX Demo Day is June 24th in Boston - let us know if you want an invite

• We continue to scale what our partners have called The Oncology Ventures LP Experience. Thank you to Adria Warren and the Foley team for hosting a beautiful dinner at Jac’s on Bond in SoHo, NYC for our LPs and portfolio company CEOs. It is always fun to talk cancer innovation with leaders in the space.

  • Let us know if you want to co-host or attend our next event

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Oncology Ventures Market Pulse

At Oncology Ventures, we’re focused on high-ROI infrastructure that’s working today to improve cancer care. Here are a few cancer infrastructure opportunities that improve cancer care outcomes through underutilized reimbursement opportunities:

1. Patient Navigation and Wraparound Support

   1. We know that navigation improves outcomes for cancer patients, including 30%+ reduction in emergency room visits and 20% faster time to treatment. Yet, over 90% of cancer centers don’t effectively bill for it, leaving revenue on the table.

   2. What’s billable today through existing CPT codes:

      1. Chronic Care Management: $62–$134/month/patient

         1. For patients with 2+ chronic conditions (cancer qualifies) and can be billed by non-physicians (e.g., RNs, navigators under supervision)

      2. Principal Care Management: $62–$140/month/patient

         1. For patients with one complex condition (like metastatic cancer)

      3. Behavioral Health Integration: $48-$170 per encounter

         1. Allows billing for collaborative care models, focused on integrating mental health into oncology workflows

      4. Transitional Care Management: $203-$281 per encounter

         1. For patients discharged from inpatient care to the home, and can cover follow-up coordination by navigators or nurses

      5. Advanced Care Planning and Palliative Care: $70-100 per session

         1. Helps patients make informed decisions about future care and provides relief from the symptoms and stress of serious illness at any stage. These consults are often undocumented or under-coded

   3. And through Principal Illness Navigation (“PIN”) codes:

      1. CMS started reimbursing oncology navigation in 2024, with four new PIN codes designed for trained navigators (clinical and peer) working under physician supervision

2. Electronic Patient-Reported Outcomes (“ePROs”)

   1. Studies show ePROs can improve overall survival by 5+ months, yet less than 15% of oncology programs collect them consistently and bill for them

   2. What’s reimbursable now for remote monitoring:

      1. $20–$50/month for symptom monitoring (pain, nausea, fatigue) and $50–$140/month for adherence or wearable devices

3. G-Codes for Genomic Testing

   1. G-codes (CMS) are temporary, procedure-specific billing codes that are not yet assigned a formal CPT code

      1. Examples in cancer care include molecular pathology interpretation by a physician (G0452) and FDA-approved colorectal cancer screening tests (e.g., Cologuard - G9143)

      2. There is complexity here as a lack of a G-code can mean denials or delays in payment

4. Why are these codes missed?

   1. Most EHRs don’t flag eligibility, and finance teams default to philanthropy to support those activities

   2. These codes require documentation workflows, team alignment and often don’t have centralized digital leads to manage all of it

   3. Health systems often underestimate how billable this work is when structured correctly

5. How big of an opportunity is this?

   1. A 10-provider oncology practice with 400 eligible patients could add $300K+ in annual revenue without adding visit volume or additional FTEs, while improving care outcomes

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Comedy!

Jobs used to be simple. People used to do stuff. You were a carpenter, a shoemaker or the town drunk… who was somehow more productive than your colleague who spends most of their day saying “sorry, I was on mute.”

Now, everyone’s job title sounds like a game of Mad Libs. Yeah… I’m a senior innovation growth strategist for frictionless product experience. That’s not a job. That sounds like something ChatGPT came up with when you asked it to make you sound important.

Have you asked your friends what they actually do for work? It’s like watching someone try to explain an odd dream they had last week.

So, Bill, what do you do? Well I’m off to London on Tuesday, then back to San Francisco the following week.

Yeah, but what is your job? Ah yes… London is to meet with a few prospects and then SF is to align on Q4 OKRs with the team.

Okay… what is it you actually contribute to society? I don’t know… I meet with a lot of people named Brandon, who look kind of like me, to discuss whatever makes my boss feel like we’re executing.

In reality everyone’s just on Slack touching base for prep sync meetings to ensure cross-functional alignment. Which sounds important. Until you get on the call.

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Ask

1. We are working on something interesting…

   • If you could redesign cancer care from scratch, what would you change first? Please feel free to respond here or schedule time with us to chat

   • Is there one oncology innovation leader we should ask this (and other questions) to?