Advancing Community Oncology in an Era of Uncertainty With Matthew Hadfield, DO, and Jason Hammonds

The Paradox of Progress: Innovation vs Complexity

Mr. Hammonds characterized the current era as both exhilarating and demanding for oncology teams. “In some ways, it’s one of the most exciting times as we’re seeing advancements in care more than ever before,” he said. “But with that comes more complexity that more providers and care teams are having to keep up with.”

This complexity extends beyond therapeutics to an evolving and often opaque policy environment. Legislative and regulatory actions on drug pricing aim to reduce patient costs, but Mr. Hammonds cautioned that while these efforts “have good intent in terms of lowering overall patient costs,” they frequently carry “unintended consequences when you get into some of the details and how they’re rolled out.”

For clinicians, this means increasing administrative burden and financial uncertainty layered onto rapidly changing standards of care. Yet the clinical benefits are undeniable. Mr. Hammonds pointed out that “patient outcomes are improving. We have roughly 18 million Americans living with cancer today, many with better survival rates than ever before,” driven by “the advancement of personalized medicines.” He sees technology as essential to sustaining this trajectory: “That’s why the advancement of AI and technology is so exciting, because it’s coming at an opportune time to help accelerate the progress we’re seeing.”

Scaling Precision Medicine in Community Settings

Dr. Hadfield emphasized that most US cancer care happens outside academic centers, and equity in access to innovation is a core concern. “The vast majority of patients in the US are treated at community oncology centers or private practices outside large academic medical centers,” he noted, adding, “If we can’t give new therapies to everyone in the country or make them accessible, what are we really accomplishing?” He pointed to NGS as a particularly challenging area: every week seems to bring “a new FDA approval for drugs that require different immunohistochemistry (IHC) testing and different molecular markers,” yet uptake of molecular testing in community settings remains lower.

Part of the barrier is information overload. Dr. Hadfield described what many community oncologists report when ordering third party NGS: “Sometimes it’s a PDF that includes 17 pages of information; it’s incredibly complex,” with targetable alterations, variants of unknown significance, and carrier findings mixed together. “I’ve spoken to several oncologists who have said they don’t order NGS testing because it’s just too overwhelming,” he said.

Mr. Hammonds explained that McKesson is addressing this problem by building precision workflows that fit the realities of practice. “We’ve now automated certain items where practices can seamlessly order molecular tests and maybe get reminders for when it’s a good time to order,” he said, stressing that success hinges on integrating tools into daily workflows. On the back end, they focus on actionable data: “Rather than hunting through large PDF files, they can get the most relevant information directly back into the electronic medical record (EMR), so they can then make the right decisions at the right time for those patients.” By structuring molecular data within the EMR, the aim is to make NGS both feasible and clinically useful for busy community oncologists.

Technology, Trials, and Keeping Care Close to Home

Both speakers underscored that preserving local access to high-quality care and clinical research is central to patient outcomes and quality of life. Mr. Hammonds described McKesson’s oncology businesses—including The US Oncology Network, Provider Solutions, Ontada, and Sarah Cannon Research Institute—as “focused on helping to preserve and empower community oncology, empowering state-of-the-art care close to home so patients can receive great care close to home, regardless of their location.”

Clinical trials are a key part of that mission. He highlighted McKesson’s acquisition of Genospace as “a clinical trial matching tool which helps to mine data in real time so that practices can identify patients who may be good clinical trial candidates,” addressing the challenge of finding increasingly narrow, biomarker-defined populations.

Dr. Hadfield offered a personal lens on the importance of proximity. Growing up two hours north of Syracuse in Northern New York, he saw that access to specialized care was very limited, and that for many patients, “driving two or three hours to centers to try and undergo treatment creates financial strain, and it’s emotional and physical burden that is very, very hard.” He noted that the National Cancer Institute regards clinical trials as preferred when available, since “clinical trials offer the best options to patients for long-term survival and benefit.” For that reason, he argued, “we need to bring those closer to home so people can actually participate and be a part of that.”

The Main Challenge Ahead: Ensuring Public Policy Supports Community Care

Looking toward 2026, Mr. Hammonds identified regulatory and reimbursement uncertainty as the most significant risk to patient access. “Anything that doesn’t protect access or doesn’t align with the appropriate reimbursement needs for providers and patients, I think, is a concern.” While “community oncology over the years has been incredibly resilient and fought off a lot of key challenges,” he warned that adverse policy changes can quickly impact patients: “Any time that community oncology is under pressure, that’s always going to translate into patients having the risk of losing their care.”

To counter this, McKesson is pairing operational support with active advocacy. “We’ve been very focused on providing a platform that is focused on empowering community oncology and making sure they have everything they need to provide quality care close to home,” Mr. Hammonds said, including tools for clinical research and complex care delivery. Simultaneously, the company is “very active in helping to advocate for appropriate public policy measures that support community providers and their patients.”

Key Takeaways

• Innovation is outpacing infrastructure. Biomarker-driven therapies and trials are growing rapidly, while data systems, workflows, and regulations struggle to keep up.
• Community oncology is central—and vulnerable. Most cancer care occurs in community settings; policy missteps and consolidation can directly erode local access.
• NGS must be made more usable. Structured EMR integration, clinical decision support, and standardized workflows are essential to move beyond overwhelming PDF reports and underuse of molecular testing.
• Technology can narrow access gaps. Trial-matching platforms, integrated EMRs, and community-based research partnerships can bring cutting-edge care and clinical trials closer to patients’ homes.
• Clinician engagement in policy is critical. Oncology providers play a key role in shaping legislation and payment models that sustain community practices and protect patient access.

About the Speakers

Matthew Hadfield, DO, is a Medical Oncologist and Assistant Professor of Medicine at Brown University/Legorreta Cancer Center. He recently completed his Hematology/Oncology Fellowship at Brown University. Dr. Hadfield’s clinical and research interests are in phase 1 clinical trials and developmental therapeutics, as well as treatment of cutaneous malignancies and management of immunotherapy-related adverse events.

Jason Hammonds is the President of Oncology and Multispecialty at McKesson. Previously, he served as President of The US Oncology Network. He has held leadership roles at McKesson and The US Oncology Network for over 17 years, and he is passionate about empowering physicians and oncology practices to provide the highest quality of value-based care to the patients they serve.