Most people with cancer are treated in their own communities. Most CAR-T is not delivered there. Closing that gap starts inside your organization, with a small group of champions who can show leadership that the clinical case, the operational plan and the numbers work.
Community practices see most people with cancer, and only a small share of CAR-T is delivered there, which leaves real room to grow.
25%
Only about 25% of patients who are clinically eligible for CAR-T ultimately receive it.
Simmons, Cross & Pittos, Front Oncol 2026;16:1712533;
<15%
Nearly 85% of people with cancer are managed in community settings
Simmons, Cross & Pittos, Front Oncol 2026;16:1712533;
6.2%
Every additional 10 miles from nearest treatment center lowers an eligible patient's likelihood of receiving CAR-T by 6.2%.
Chung et al., Blood Adv 2025;9(18):4727–4735
The first step in your journey to building your case and identifying your team is to understand the steps in the Care Coordination Pathway.
Traceability
Owns clinical protocols, patient selection criteria and the toxicity management plan.
Carries the patient relationship from referral through long-term follow-up.
Sponsors the program, clears organizational barriers and approves the investment.
Turns the clinical plan into budget, space, staffing and a launch timeline.
Tests the financial model and sets the threshold the program has to meet.
Builds coding, billing and prior-authorization workflows before the first patient.
Owns product receipt, storage, chain of custody and dispensing.
Coordinates scheduling, shipping and receiving, and keeps the launch plan moving.
Owns SOPs, documentation, overall readiness and regulatory compliance.
Alliance for Regenerative Medicine
Care model adapted from published multidisciplinary CAR-T management frameworks. For illustrative purposes; individual center workflows may vary.
What leadership will ask: referrals leaving your practice, capability you already have, and what closing the gap takes.
Reach Out for Guidance
ACCC's on-demand session on budgeting for CAR-T covers the resources required to stand up services in a community setting.
Watch the ACCC session
Practice profiles and peer-reviewed reports from centers that have already built CAR-T programs outside academic settings.
Browse the case studiesName the roles before you name the budget
A CAR-T program runs on a defined team, not on added duties. Published community programs describe physicians, pharmacists, nurses and advanced practitioners, a pharmacy quality manager, billing specialists and administrative staff working to shared SOPs. Decide who holds each role, and how much of their time the program gets.
Build on what you already have
Most community programs start from existing capability rather than new construction. Leverage what you already have, and treat the remainder as a build-or-partner decision. That build-or-partner decision may change over time and with greater experience. There are many resources to assist with apheresis, cryostorage, infusion, monitoring, emergency events, logistics and case management. Treat the remainder as a build-or-partner decision.
Payer readiness is the rate-limiting step
Coverage, not clinical capability, is where community programs report the most friction. Put revenue and managed care specialists on prior authorization, coding, billing and single-case agreements with commercial payers before the first referral. Outcomes-based and milestone-based contracts are emerging.
Not just paperwork
Building Quality into each step of your process will ensure smooth operations and reliable delivery to your patients. It’s worth involving your quality unit early and often to think about how to implement best practices. Accreditation can be one tool used to execute a high-quality program.
Decide what to contract out
Contracting is how a community program moves faster without building everything itself. The playbook identifies agreements with product developers and third-party providers covering product handling, cold chain, inventory, scheduling, logistics and contingency planning. Apheresis collection can be contracted to qualified providers, and even infusion and adverse-event admissions, once treated as in-house functions, can be covered by agreement. Define roles and timelines in writing before launch.
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