Avident Solutions for Payers

Controlling the Most Preventable Driver of Cancer Care Costs

Nonadherence in oncology is not a patient compliance problem—it is a predictable, measurable, and largely preventable cost driver that health plans can directly influence.

When members with cancer fall off their oral therapy regimens, the downstream consequences are immediate and expensive:

• Avoidable ED visits and hospitalizations surge — nonadherent patients experience 23% more hospitalizations with longer lengths of stay than their adherent counterparts.
• Disease progresses faster — patients who discontinue oral therapy early experience worse disease control, accelerating transitions to more expensive later-line treatments and supportive care.
• Total cost of care rises disproportionately — unplanned care, increased disability days, and financial strain on members compound into some of the highest per-member costs in a plan's oncology population.

Nearly half of patients starting oral anticancer therapy become nonadherent within six months. For commercial plans, Medicare Advantage organizations, and Medicaid programs, this is not a clinical abstraction — it is a predictable utilization pattern that compounds spending quarter over quarter.

MyNavigator: A Validated, Evidence-Based Platform

Avident Health's MyNavigator Platform has been evaluated in peer-reviewed research and presented at ASCO — giving health plan partners a credible, evidence-based intervention rather than an unproven wellness add-on.

Ongoing initiatives with organizations such as MedStar Health, Wichita Urology, Unite for Her, and Pfizer Advanced Solutions are generating real-world evidence on adherence, utilization, and outcomes across cancer types including:

• Breast cancer
• Advanced prostate cancer
• Additional solid and hematologic oncology indications

Current research addresses questions that map directly to payer priorities:

• Does proactive symptom monitoring reduce unplanned ED visits and inpatient admissions?
• Does including informal caregivers improve medication adherence and early symptom identification — preventing costly escalations?
• Can AI-enabled education and triage redirect low-acuity concerns away from the ED and toward appropriate ambulatory care?

These data streams support value-based contract design, quality metric performance, and total cost-of-care reduction strategies across your oncology population.

Partnership Model for Payers

Avident Health partners with health plans to deploy adherence solutions that are:

• Population-targeted – Deployed to your highest-risk oncology members based on claims signals, hospitalization history, and adherence predictors.
• ROI-accountable – Structured to generate measurable data on utilization reduction, adherence improvement, and member experience outcomes aligned with your reporting needs.
• Plan-customizable – Configurable to your formulary, care management programs, and preferred provider relationships — whether commercial, Medicare Advantage, or Medicaid.

The MyNavigator Platform:

• Integrates seamlessly with existing care management and utilization management programs, amplifying the impact of your oncology case managers.
• Can be deployed across multiple provider networks and cancer centers in your plan footprint, supporting consistent member engagement at scale.
• Creates a closed loop between members, caregivers, clinical teams, and plan care management — reducing gaps that lead to avoidable utilization.

Next Step: Explore a Partnership

By partnering with Avident Health, health plans can:

• Reduce avoidable hospitalizations and ED visits among their highest-cost oncology members
• Lower total cost of care by keeping members adherent and on the most clinically appropriate therapy longer
• Generate robust utilization and adherence data that supports Star Ratings performance, quality reporting, and value-based contract negotiations

To schedule a demonstration or discuss a partnership, click below.