New Century Health is a leading specialty care management company that provides innovative technology and clinical solutions that help to improve the quality of patient care, reduce administrative work associated with the delivery of care, and lower therapeutic costs for payers and physicians.
Currently New Century Health provides specialty care services to 2 million covered lives managed by Medicare, Medicaid, and Commercial payers for an expanding roster of national and regional clients. With a proven track record of success, our clients can achieve significant cost savings through the implementation of our specialty care quality management solutions.
Company Background
A decade ago, New Century Health set out to make significant impact on healthcare by reducing insurers’ costs, giving physicians better quality-focused decision support tools, and accelerating the delivery of life-saving treatments to patients. We achieved these goals by taking a collaborative approach with payers and physicians to develop technology and clinical programs capable of enhancing the delivery of evidence-based medicine.
As a specialty care management organization and third-party administrator, we are able to offer a comprehensive management program that begins prior to a patient’s therapy and leverages our strong expertise in claims management and remittance processing. As a result of the breadth of our services, we have been able to envision and implement numerous ways to transform healthcare with new efficiencies in medical and pharmacy management.
What Makes Us Different
New Century Health is able to provide effective and valuable solutions for our clients through the combination of existing approaches in the market and innovative technological and clinical solutions that when integrated yield significantly better results over other specialty care management programs. Examples of what sets us apart from others in specialty care management:
| Differentiator | Why It Matters |
|---|---|
| Treatment Model |
New Century Health pioneered the “Integrated Specialty Care” model that enables a comprehensive management capability for both medical and pharmacy services concurrently:
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| Technology | Our CareProSM technology platform accesses a database of clinical pathways and compendia data to help support physicians in the selection and submission of evidence-based treatment requests that are accepted by payer protocols. |
| Prospective Therapy Adjudication | We've streamlined the cumbersome process of determining medical appropriateness through standard pre-authorization processes and enabled instant approval for selecting evidence based therapies at the point-of-care. |
| Peer to Peer Consultation | Our model supports peer review processes that enable medical specialists to speak directly with medical specialists from the same specialty to collaboratively determine the best, most cost-effective treatment option for each patient. |
| Collaboration | New Century Health has set a new standard of excellence in facilitating collaboration between payers and providers when developing a Quality Improvement Plan. Our approach has changed prescriber behavior and strengthened the delivery of evidence based care; a formula that creates a win-win-win situation for payers, providers and patients. |
| Risk Management Flexibility | New Century Health’s deep experience can meet varied client requirements for scope of service and risk management needs, allowing us the ability to provide services on a capitated, fee-for-service, or patient/case rate basis |
| Payer Focused but Physician Friendly | With over 200,000 Medicare, Medicaid and Commercial lives under capitated management for oncology and cardiology services, New Century Health has proven experience in using evidence-based medicine to drive cost effective care delivery. |
Strategic Alliances
New Century Health is teaming with leading healthcare organizations to improve healthcare quality and provider and patient satisfaction while controlling costs.
| Partner | Strategic Focus |
|---|---|
| CVS Caremark | CVS Caremark is working with New Century Health to offer a new medical benefit drug management service for the CVS Caremark’s pharmacy benefit management (PBM) and specialty pharmacy clients. The payer-centric offering will employ both prospective and retrospective drug utilization management strategies to specialty medications billed under the medical benefit, while ensuring minimal disruption to the physician’s workflow and facilitating the delivery of evidence-based care. |
| National Comprehensive Cancer Network | New Century Health is an official licensee of the NCCN Drugs & Biologics Compendium™. NCCN supports the development and widespread use of the NCCN Compendium™ and has collaborated with New Century Health for communication of this important information. |
| The Guideline Advantage™ | New Century Health is collaborating with the American Cancer Society, American Diabetes Association and American Heart Association to integrate The Guideline Advantage™ into our product offering to promote guidelines-based treatment for prevention and disease management in an outpatient setting. |
Thought Leadership
The New Century Health team stands in the forefront of leading transformative change in specialty care management. By combining our medical management expertise with our deep understanding of healthcare informatics, pharmacy management, medical management, and healthcare technology systems applications, we are able to provide unique insights that drive innovation.
New Century Health thought leaders recently presented at these conferences:
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1) NCCN Academy for Excellence & Leadership in Oncology™
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2) Mercer Client Conference, Innovation in Specialty Care Management
