The Season of Support: Why the Holidays Expose Gaps in Cancer Care, and How Value-Based Care Helps Close Them

When Seasonal Strain Reveals Structural Weakness

As we close out the year, many oncology practices are doing more than reflecting on performance metrics or year-end results. They are thinking about patients and families spending the holidays in the middle of treatment and about clinicians and staff covering nights, weekends and on-call schedules.

And they are thinking about where care coordination still breaks down when resources are stretched thin.

The holiday season reliably exposes stress points in oncology care delivery that remain partially obscured during the rest of the year. Staff shortages intensify. Care coordination becomes more fragile. Patients face increased logistical, financial, and emotional burdens at precisely the moment continuity matters most. These pressures are not anomalies; they reveal underlying gaps that exist year-round but become harder to manage when capacity is constrained.

Value-based and clinical quality oncology care models did not emerge to solve seasonal challenges, but their core design principles directly address many of the gaps that holidays make more visible. The question is not whether value-based and clinical quality care is philosophically aligned with patient support, but whether its operational practices meaningfully close gaps in access, coordination and experience when systems are under strain.

Acknowledging those who Close the Gaps

As this year draws to a close, it is also appropriate to recognize the clinicians, nurses, pharmacists, care coordinators, social workers, administrators, and support staff who continue to deliver oncology care through holidays and weekends. Their work often compensates for structural limitations that no individual effort alone can resolve.

Why Holiday-Exposed Gaps Matter Operationally

During the holidays, oncology practices experience predictable disruptions. Staff take well-earned time off, referral pathways slow and patients often delay reporting symptoms or attending appointments due to travel, family obligations, or financial pressure. For patients undergoing active treatment, even short delays or missed touchpoints can increase risk.

Operationally, these disruptions surface four persistent gaps.

First, care coordination becomes more fragile when informal workarounds disappear. Practices that rely heavily on individual heroics rather than standardized processes feel the strain immediately.

Second, symptom management and patient communication are more vulnerable to breakdowns. Expanded hours need to increase while coverage thins, raising the likelihood of avoidable emergency department utilization.

Third, social and logistical barriers intensify. Transportation challenges, medication access, caregiver availability, and financial stress all become more acute, directly affecting adherence and patient experience.

Fourth, scheduled practice closings during the holidays such as Christmas or New Years Day reduce normal visit availability and increase visit “compression” immediately before and after the holiday.

Value-based and clinical quality oncology models are structured to anticipate these pressures because they assume variability, not ideal conditions. Programs that invest in proactive outreach, navigation and monitoring are better positioned to absorb seasonal disruption without compromising care quality.

Where Common Interpretations Fall Short

Discussions of holiday care gaps often frame the issue as temporary inconvenience rather than structural vulnerability. This framing minimizes the operational implications and obscures why some practices perform more consistently than others.

Another common oversimplification is the assumption that value-based and quality care primarily affects cost. In practice, the most consequential impact during periods of strain is clinical and operational. Care models designed around longitudinal accountability, rather than episodic encounters, are inherently more resilient when schedules compress and staffing fluctuate.

Finally, there is a tendency to equate support services with optional add-ons. During the holidays, it becomes clear that navigation, symptom triage and social support are not ancillary. They are core infrastructure for maintaining continuity and safety.

A More Useful Framing of Value-Based Care and Seasonal Gaps

A more precise way to evaluate value-based and clinical quality oncology during the holidays is to examine how its practices address three categories of exposure.

Continuity of clinical oversight.

Value-based and clinical quality models emphasize proactive monitoring and defined accountability for patient populations. This reduces reliance on ad hoc follow-up when schedules tighten and helps ensure that symptom escalation pathways remain functional despite reduced staffing.

Patient navigation and support.

Navigation services embedded within value-based programs become particularly critical during the holidays. They help patients manage appointments, medications, transportation and communication at a time when external support networks may be less available.

Alignment of incentives with prevention.

Fee-for-service environments often struggle to justify investments in outreach and coordination that do not generate immediate billable activity. Value-based arrangements explicitly reward avoidance of preventable complications, making it operationally rational to maintain support services even during low-volume periods.

These mechanisms do not eliminate holiday strain, but they narrow the gap between ideal and actual care delivery.

Implications for Physician Leaders and Practice Administrators

For physician leadership, the holiday season offers a practical stress test. Where care depends on individual effort rather than system design, risks increase. Value-based and clinical quality care frameworks provide tools to formalize accountability and ensure that patient support does not degrade when capacity tightens.

For practice administrators, the operational lesson is that resilience must be planned, not improvised. Staffing models, triage protocols and patient communication strategies should be designed with predictable seasonal disruption in mind. Practices engaged in value-based oncology are often better positioned because these elements are already required for performance success.

For both groups, closing seasonal gaps is not about doing more work during the holidays. It is about building care models that require fewer heroic interventions to maintain quality and patient trust.

Areas of Legitimate Debate and Evidence Gaps

Reasonable clinicians and administrators may differ on how much incremental benefit value-based models provide during short seasonal periods versus across longer horizons. Measurement challenges persist, particularly in isolating holiday-specific effects from broader utilization patterns.

More granular data linking navigation intensity, symptom monitoring and patient experience during high-strain periods would strengthen the evidence base. Until then, conclusions rely in part on observed operational behavior across diverse practice settings rather than controlled comparisons.

Closing Perspective

The holidays illuminate what oncology care systems depend on when conditions are less forgiving. They reveal whether patient support is embedded in the care model or supplied through individual effort. Value-based oncology care does not remove seasonal challenges, but it provides a framework for closing gaps that otherwise widen under strain.

My work (see Svobodaconsulting.com/about) in oncology strategy, value-based care design, operational assessment and clinical quality measurement consistently reflects this reality. Practices that align care delivery, incentives and support infrastructure are more resilient not only in December, but throughout the entire year.