A new outcomes analysis across 2,344 cancer patients reveals how much avoidable acute care utilization is actually preventable — and what it takes to change the pattern.
For a patient on active cancer treatment, a fever at 11pm shouldn’t mean a trip to the emergency department. But without around-the-clock clinical support, the ED becomes the default — not because it’s the right setting, but because it’s the only one available. That’s not a failure of patient judgment. It’s a gap in how care is designed.
The data has always suggested this problem is large. What’s been harder to demonstrate is whether it’s systematically solvable. A new outcomes analysis from Reimagine Care, conducted in partnership with actuarial firm Accorded across 2,344 patients, offers the clearest evidence yet that it is.
Across Every Patient Segment, the Reductions Hold
Reimagine Care benchmarked its patient population against national claims data — the CMS Limited Data Set and MarketScan commercial benchmarks — over a 180-day enrollment window. The avoidable ED metric followed the CMS OP-35 subset, targeting symptom categories manageable outside the ED (pain, nausea, vomiting, fever, diarrhea) while excluding complex acute presentations like sepsis and neutropenia.
The results were consistent across every patient segment analyzed:
- 68.6% reduction in avoidable ED visits overall at 180 days
- 77.1% reduction among Medicare patients — the population at highest risk for complications from emergency care
- 59.2% reduction among high-risk patients with metastatic disease, advanced age, and high comorbidity burden
- 45.7% reduction in ED-originated short-stay hospitalizations overall
That last figure matters. When cancer patients go to the ED, they are frequently admitted — often for short stays of two days or fewer that represent the direct downstream consequence of a visit that could have been managed at home. Preventing the ED visit prevents the hospitalization.
Engagement Is a Clinical Variable, Not a Satisfaction Metric
One of the most significant findings in this analysis isn’t the overall reduction — it’s the engagement gap. Patients with consistent, high-frequency interaction across both Remi (Reimagine Care’s AI-powered virtual assistant) and the Virtual Care Center showed a 79.6% reduction in avoidable ED visits at 180 days, compared to 68.6% for the overall population.
That 11-point spread has a direct implication for program design: engagement is not a downstream outcome of good care. It is an intervention lever — one that oncology programs can actively design, measure, and optimize. Patients who use the system more get better outcomes. Building in the structures that drive consistent engagement isn’t an amenity; it’s clinical infrastructure.
What This Means for Oncology Programs
As Reimagine Care Medical Director Pallav Mehta, MD, put it: “Fewer middle-of-the-night emergency room visits, fewer multiday hospitalizations from symptoms that were manageable at home, and more patients who feel like someone has their back. That’s what a 68% reduction in avoidable ED visits actually looks like for a family dealing with cancer.”
The clinical case for virtual oncology support is no longer theoretical. For programs operating under value-based arrangements — including the CMS Enhancing Oncology Model — the downstream implications are meaningful. Each avoidable ED visit prevented represents a disruption avoided for a patient in treatment, a hospitalization likely avoided, and a measurable reduction in cost of care.
The full report, including methodology, segment-level breakdowns, and engagement analysis, is available now.
Download the full ED Avoidance Report →
This analysis was conducted in partnership with Accorded. Patient cohort: 2,344. Minimum enrollment: 6 months. Benchmarks: CMS Limited Data Set + MarketScan.