American Oncology Network (AON) is a physician-led management services organization (MSO) that manages the non-clinical operations of community-based oncology practices across the U.S. As of year-end 2024, AON's network spans 37 practices across 20 states and Washington D.C., treating adult and senior cancer patients with medical oncology services, chemotherapy infusions, and clinical trial access — all in community settings rather than hospital systems. AON operates under a Management Services Agreement structure, where AON manages all non-clinical functions (billing, drug procurement, IT, staffing) for physician-owned entities in exchange for a management fee with fixed and variable components. For accounting purposes, AON consolidates these entities, so its financials reflect full practice revenue rather than just the management fee. The largest cost is drug and medical supplies; Medicare reimburses oncology drugs at average sales price (ASP) plus a fixed percentage, and AON's ability to procure drugs below ASP creates a key margin spread. AON also runs ancillary services — a centralized specialty pharmacy, clinical lab, and in-house pathology — that capture more of the oncology care value chain and improve margins. AON has grown primarily by acquiring independent community oncology practices, targeting a fragmented market where smaller practices face rising administrative burdens and hospital competition. AON's pitch to practices is back-office scale combined with physician autonomy over clinical decisions.