February 12, 2026
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The headlines are ugly.
The 2026 CMS coding and reimbursement changes were among the biggest our industry has seen in years. Community oncology providers, especially independent and freestanding radiation oncology practices, are under intense pressure. Some centers are already feeling the financial strain. Others are asking an uncomfortable question:
Is this the end for freestanding cancer centers?
The answer is no. But it is a defining moment.
For years, independent cancer centers have operated on razor‑thin margins. Rising operating costs, staffing shortages, payer denials, and administrative burdens have created a fragile environment. The coding changes didn’t create these problems; they exposed them.
Because while access to care is threatened, this moment is not an inevitable collapse. It is an opportunity to adapt, collaborate, and protect community‑based cancer care.
We have seen firsthand that organizational structure matters.
Centers aligned within nonprofit models where resources, expertise, and governance are shared have greater resilience during periods of disruption. Nonprofit oncology foundations are often better positioned to reinvest surplus into clinical operations, spread administrative costs, and buffer short‑term reimbursement volatility without compromising patient access.
That belief is what led our team to help build nonprofit entities like Aurora Integrated Oncology Foundation and Anoma Cancer Collective—not as an exit strategy for cancer care, but as a way to preserve it.
These models are not immune to policy changes. But they are designed to reduce single‑center vulnerability by:
They are one example (but not the only one!) of how collaboration can strengthen freestanding cancer centers in an increasingly complex environment.
One of the most encouraging developments right now is the oncology industry’s newfound unity. Providers, administrators, advocacy organizations, and partners are aligned in ways we haven’t seen before.
That unity creates leverage.
Organizations like ASTRO, ACRO, COA and others are advocating for fair reimbursement policies, but lawmakers also need to hear directly from the cancer centers serving their constituents. When access to local cancer care is clearly at risk, policymakers listen.
This moment requires action—not retreat. There are clear, practical steps cancer centers can take today:
Contact legislators. Share specific, real‑world examples of how reimbursement changes impact patient access in your community. Personal stories drive awareness far more effectively than abstract policy arguments.
Unwarranted denials and underpayments cannot be treated as unavoidable. Appeal consistently. Request peer‑to‑peer reviews. Push back when claims are inappropriately reduced. Every challenged denial strengthens the system.
Patients, employers, civic leaders, and local media likely have no idea how fragile their access to cancer care has become. When communities understand what’s at stake, they speak up, and their voices matter.
This challenge extends beyond freestanding cancer centers. Hospital‑based programs, rural clinics, and large systems are all affected by the same underlying pressures. Hospitals may absorb financial strain more easily today, but access erosion eventually reaches everyone.
Vendors, manufacturers, and industry partners also have a stake here. Cancer care is an interconnected ecosystem. When community cancer centers disappear, the impact doesn’t stop at one organization.
The sky is not falling.
But standing still is not an option.
The centers that will endure are the ones willing to collaborate, modernize their operating models, and rethink how independence and sustainability can coexist. Shared strength, not isolation, is how freestanding cancer centers continue serving patients close to home.
This window of opportunity will not remain open forever.
Our patients fight for their lives every day. The responsibility to protect access to their care belongs to all of us—and it is a fight worth having, together.
If your cancer center is facing instability due to the 2026 coding changes, call us. We can provide personalized recommendations on actions you can take to mitigate risk and get involved in the movement.
Let’s not let this window of opportunity close.
