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New Century Health Partner Cancer Care Specialists of Illinois Earns $3.6 Million from Medicare through Federal Oncology Care Model
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New Century Health (NCH) reported that its partner, Cancer Care Specialists (CCSI) of Illinois, earned nearly $3.6 million from Medicare through the Oncology Care Model (OCM). This payment reflects CCSI's success in reducing care costs while achieving quality targets for Medicare beneficiaries. Per-beneficiary costs were 8% below Medicare's benchmark, with high scores in patient experience and lower hospital utilization rates. NCH aims to improve patient outcomes and reduce expenses through effective oncology management and a focus on value-based care.
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CCSI earned nearly $3.6 million from Medicare for outperforming OCM cost and quality targets.
CCSI achieved high performance in quality measures including pain management and patient experience.
Lower rates of ICU stays and hospitalizations indicate improved patient outcomes.
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NCH’s high-value clinical oncology pathways, patient triage programs and provider engagement strategies help community practice to succeed in value-based payment program.
BREA, Calif.--(BUSINESS WIRE)--
NCH Management Systems, Inc., D/B/A New Century Health (NCH), a NCQA-accredited national leader in specialty care management, announced that its partner Cancer Care Specialists of Illinois (CCSI) earned nearly $3.6 million from Medicare in the most recent reporting period of the Oncology Care Model (OCM). This payment rewarded CCSI for outperforming cost and quality targets in the care of Medicare beneficiaries whose episodes of care began in the first half of 2020.
Developed by the Center for Medicare & Medicaid Innovation, OCM is a payment and delivery model that seeks to provide higher quality, more coordinated care of cancer patients at the same or lower cost to Medicare. Physician practices participating in OCM enter arrangements that include financial and performance accountability for episodes of care surrounding chemotherapy administration. They also provide enhanced services to beneficiaries in areas such as care coordination.
Across nearly 1,100 Medicare beneficiaries treated by CCSI providers in the reporting period, per-beneficiary expenditures were 8% below the benchmark set by Medicare. CCSI also achieved high performance on quality measures related to improving pain management, enhancing the patient experience, preventing avoidable emergency department visits, and more.
“Our results in the Oncology Care Model reaffirm the commitment we made several years ago to be at the front of the movement to value-based cancer care,” said Dr. James Wade, founder of CCSI. “While achieving the best possible patient outcomes has always been paramount for our providers, New Century Health’s expertise in the cost and effectiveness of oncology regimens has helped us to maintain that high quality of care without putting undue financial burdens on patients or exposing them to avoidable hospital stays.”
In addition to surpassing Medicare’s targets, CCSI outperformed other practices participating in OCM in 2020 in several areas, according to CMS data:
Spending. Per-beneficiary monthly spending for the practice was $530 below the OCM median—a difference of 8.4%. Expenditures for inpatient admissions and prescription drugs were 17% and 3.5% below the OCM median, respectively.
Patient Experience. CCSI scored between the 81st and 90th percentile on patients’ overall ratings of their care experience in CMS surveys.
End of life. Compared to other OCM practices whose patients had similar disease severity, CCSI’s patients had 15% lower rates of intensive care unit stays and 8% lower rates of hospital use in their final 30 days. Meanwhile, the practices’ patients spent 10% more days in hospice in their final 90 days—an indicator that they were more likely to receive palliative comfort care and be surrounded by friends and family before they passed away.
Since 2017, New Century Health has teamed with CCSI to improve outcomes for patients with cancer while managing costs. NCH’s high-value clinical oncology pathways help the practice’s providers determine the most effective, least toxic treatments for each patient, while prioritizing the lower cost option among equivalent regimens. Additionally, NCH clinical experts and CCSI physicians meet biweekly to review the practice’s utilization trends, discuss the efficacy and costs of different drugs, and highlight improvement opportunities. To prevent unnecessary hospital and emergency department visits, NCH also introduced a triage program that helps the practice direct patients to the most appropriate intervention and site of care when they experience side effects.
“CCSI’s results represent more than just cost savings, they represent a reduction in avoidable trips to the hospital as well as effective drug cost management,” said Dr. Andrew Hertler, Chief Medical Officer for New Century Health. “This recent performance further supports our track record of success in partnering with providers to improve care throughout the patient journey.”
About New Century Health
New Century Health is a national leader in specialty care management, with special focus on oncology and cardiology. New Century Health partners with specialty providers and health plans to provide them with clinical decision and population health management tools to ensure that cancer and cardiology patients receive the highest quality, most affordable care. New Century Health has been URAC-accredited in Health Utilization Management since 2011 and received NCQA accreditation in Utilization Management in June 2020. New Century Health is a wholly owned subsidiary of Evolent Health. To learn more about New Century Health, please visit newcenturyhealth.com.
About Cancer Care Specialists of Illinois
Cancer Care Specialists of Illinois is the largest interdisciplinary oncology hematology practice in Illinois outside of Chicago. CCSI—and its more than 20 board-certified physicians—is nationally recognized as an outstanding cancer care practice and recipient of Quality Oncology Practice Initiative Certification from the American Society of Clinical Oncology. For more, visit cancercarespecialists.org.
What recent financial achievement did Evolent Health's partner Cancer Care Specialists report?
Cancer Care Specialists earned nearly $3.6 million from Medicare for exceeding cost and quality targets in the Oncology Care Model.
How did Cancer Care Specialists perform on per-beneficiary expenditures compared to Medicare benchmarks?
They reported expenditures that were 8% below the Medicare benchmark during the reporting period.
What quality measures did Cancer Care Specialists excel in?
They achieved high scores in pain management, patient experience, and lower hospital utilization rates.
How does New Century Health contribute to Cancer Care Specialists' success?
New Century Health provides clinical expertise and pathways to optimize treatment efficiency and cost-effectiveness.
What is the Oncology Care Model?
Developed by the Center for Medicare & Medicaid Innovation, it aims to provide higher quality and coordinated care for cancer patients while controlling costs.
