Zoadigm
The operating system for value resolution in specialty medicine
The platform that turns MASON’s payment design into something a practice can run and a health plan can settle — making two-sided accountability workable in oncology for the first time.
MASON 3.0 — Making Accountable Sustainable Oncology Networks — is Barbara McAneny, MD’s model. Zoadigm’s Open Value Health Network operationalizes it.
What this serves
Barbara McAneny, MD is building a nationwide network of independent community oncologists, and the ONCare Alliance exists to make that network durable. The value is the network’s: practices that stay independent, better outcomes for patients, and lower total cost of care — with the savings flowing back to the practices, not out of them. Everything below is the engine beneath that value. The Zoadigm model is what makes a sustainable, accountable independent network economically real — so it can grow without surrendering to consolidation.
The problem it solves
For two decades, independent practices funded the unbilled work of cancer care — triage, navigation, symptom management, coordination, prior authorization — out of the margin between what a drug cost and what it reimbursed. The Inflation Reduction Act compresses that margin, pushing practices to cut services, sell to a hospital system, or close. As care migrates to hospital outpatient departments, the plan pays materially more in facility fees and drug markups. High-performing community oncology becomes a medical-cost question for the payor, not just a provider-relations one.
The two ideas at the core
Separate the risk a practice can control — Transactional Performance Risk (pathway adherence, avoidable ED visits, drug waste, referral choices) — from the risk it cannot: Medical Volatility Risk (a multi-million-dollar therapy, a rare severe complication). Practices are held to the first; the second transfers to reinsurance. That split is what makes two-sided accountability tenable for a practice for the first time.
A shared, real-time event log and durable execution of network workflows. When a triage call needs follow-up or a prior authorization is opened, the platform guarantees the workflow completes — even across different organizations’ systems. This is what removes the “coordination tax,” the uncompensated burden that today turns small symptoms into expensive emergencies.
The platform — OVHN
The Open Value Health Network is the shared, immutable record of clinical and financial events that the practice, the plan, and the reinsurer all settle against. It ingests data in real time from the EMR, unadjudicated claims, pharmacy, and labs, normalizes it to a common standard, and runs the model on top.
The money
MASON replaces the opaque drug-margin subsidy with a payment structure that makes the true cost of good care visible — and therefore priceable.
High-cost drugs are decoupled from practice operations and reimbursed at a transparent rate (e.g. ASP + 2%). The physician neither gains nor loses on which drug they choose — so selection follows the evidence, not the margin.
A clinically nuanced, risk-adjusted budget per regimen — from staging, biomarkers, comorbidity, and SDOH — as the fair benchmark a practice’s controllable costs are measured against.
The previously unpaid work — triage, navigation, coordination, financial counseling — is funded explicitly, with margin built in for the practice to grow and keep its staff.
Oncology Payment Categories are disease- and state-specific mini-bundles — Diagnosis → Active Treatment → Maintenance → Surveillance — that isolate why an episode costs what it does, not just that it was expensive.
How it meets a health plan
Rather than ask a plan to change reimbursement on day one, the model proves itself on the plan’s own data first. The plan keeps paying under its current arrangements while a shadow OPC model is built from its claims and the practice’s clinical data — a side-by-side read of today’s oncology cost picture against an OPC-based view of the same patients. It reconciles to the plan’s existing grouper rather than replacing it.
What the validation answers, before any pilot:
The plan is asked only for claims access, committed actuarial and operations staff time, and a nominal commitment — a seriousness signal, not a vendor engagement. At week 16 it decides: proceed to a small, bounded pilot, refine, or stop. Either way it leaves with a claims-grounded read on its oncology cost and site-of-service exposure.
Where it goes
High-performing ONCare practices run MASON’s payment logic live through a captive vehicle — real actuarial evidence without waiting on payor approval.
Armed with evidence of lower total cost of care, the model is offered to commercial plans as a turnkey, de-risked option.
The same framework — isolate volatility, fund coordination, settle in real time — extends to cardiology, rheumatology, and neurology.
The thesis is that Zoadigm is not an oncology company but a specialty risk-management company — oncology is simply the hardest specialty to prove it in.
Where Forward Health Group sits
Zoadigm operationalizes the care. Forward Health Group measures the outcome. FHG works alongside this model, not inside it — reading the savings on the plan’s own claims and showing where the network should grow. FHG is paid transparently by the plans, never by ONCare and never by the network’s physicians: no draw on the alliance pool, no tax on the practices.