Supercharging care navigation
August 8, 2025The combination of patient engagement and clinical decision support can unlock value across the cancer journey.
By Dr. Von Nguyen
This spring, a health plan member undergoing cancer treatment was struggling. Several rounds of chemotherapy and radiation had taken a toll on his appetite and digestive system. He was having trouble finding foods he wanted to eat and that his body could tolerate. The result: low energy, weight loss and slower healing. He was failing to thrive.
Clicking into an app called Careology, he entered his symptoms — and within minutes received a call from an Evolent care navigator. The navigator assessed him immediately and offered guidance — what to eat and how often, what to avoid, and how to conserve his energy. She then sent resources to him through the app, including recipes tailored for people recovering from treatment. Within two weeks, when he checked in with his oncology team, his weight had stabilized.
This episode is a small but potent example of how we’re seeking to transform the cancer journey. We remain focused on guiding providers on the high-stakes decisions surrounding care — what tests and treatments offer their patients the best possible outcomes. With the introduction of our care navigation program, we’re also helping members at other key inflection points, like when they don’t know what to do about concerning symptoms and side effects. Given that more than half of ED visits and nearly a quarter of hospitalizations related to cancer are potentially avoidable, rapidly responding to these situations is key.
The care navigation concept has been around for decades. It helps patients understand their condition, prepare for what’s next, tap into community resources, and focus on their health and well-being rather than wandering the maze that is U.S. healthcare.
Yet, traditional care navigation has limitations — for example, it’s resource intensive and difficult to scale. And navigators often don’t learn about members’ changing conditions in time to respond to it.
Our new program aims to supercharge navigation for greater impact. Through our partnership with Careology, any member with cancer has an always-on digital resource to track their vitals and symptoms, keep tabs on their medications, get answers to common questions, and more. While members benefit directly from the app, their activity there helps navigators follow their trajectory and respond to issues as they arise.
We also believe that integrating this advanced care navigation program with our clinical decision support and provider engagement capabilities can be a force multiplier, unlocking more value than if these capabilities were siloed.
For example, using risk stratification algorithms built on claims, authorizations, patient-reported outcomes and other data, we can identify highly impactable members who are most likely to benefit from care navigation.
Later, after they enroll in the program, their navigation experience offers key insights for utilization-related issues. For example, if the member’s goals of care evolve with cancer progression, Evolent will work to ensure that treatment intensity aligns with the member’s advanced care plan.
Members, providers and plans all want a high-quality, connected experience from the time of diagnosis through survivorship or end of life. Yet it’s hard to achieve that vision of connectedness when you’re working in a fragmented system. By bringing together a model that encompasses all three groups, I believe we’re creating the conditions for comprehensive condition management and better decisions at every step.
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