NCH Management Systems, Inc., D/B/A New Century Health (NCH), a NCQA-accredited national leader in specialty care management, announced that 2020 was the largest membership growth year in the 19-year history of the company. In addition to driving significant quality improvement and financial savings for its partners, the year was defined by continued clinical, operational and technology innovation to support health plans and providers amidst the COVID-19 pandemic.
In total, NCH’s oncology and cardiology management programs saw a 43% increase in health plan membership in 2020. Through several new health plan partnerships, including Florida Blue Medicare, Molina and Neighborhood Health Plan of Rhode Island, and population and product expansions within existing partners, NCH significantly increased its impact across millions of new lives across the country.
“We are proud of our record growth in a year defined by countless challenges and see it as a testament to the differentiated value we provide to our partners in addressing their most pressing of clinical needs. We look forward to building on our success in 2020 to continue to provide high-quality care across the patient journey and deepen our already strong relationships with specialty practices in 2021,” said Dan McCarthy, Chief Executive Officer of NCH.
NCH is continuing to adapt to the changing health care landscape and is looking towards the future of care delivery.
Adapting to the Pandemic
In response to COVID-19, NCH adjusted its operations to help payers and providers balance the risks posed by the pandemic against the need to continue high-value treatment for patients with cancer and cardiovascular disease.
These strategies, which focused on maintaining high-quality care while minimizing unnecessary face-to-face patient visits, included the following:
- Taking full advantage of telehealth for oncology and cardiology patients where appropriate, including surveillance visits, post-treatment follow-up and toxicity checks.
- Refining oncology clinical guidelines to promote chemotherapy treatment plans that required fewer trips to the clinic and/or used oral agents that could be taken at home.
- Promoting radiation therapy treatments that used a smaller number of treatments (and hence fewer trips to the radiation therapy center) while maintaining effectiveness.
- Introducing phone screening tools to help practices efficiently and remotely triage patients and provide the most appropriate intervention and site of care.
In 2020, NCH continued offering its industry-leading high-value clinical pathways solution, while introducing several new services to improve outcomes and reduce costs across the patient journey.
NCH expanded its clinical scope in 2020 beyond medical oncology, radiation oncology, advanced imaging, and cardiology to include genomic testing and CAR-T reviews. It also broadened its focus to include not only adult, but also pediatric populations. Finally, NCH continued its innovation around total cost of care risk models through partnering with practices on the Oncology Care Model and the Bundled Payments for Care Improvement Advanced.
Additionally, NCH launched new services for payers to help them ensure accurate payments (leveraging NCH’s deep specialty-specific claims logic), optimize their drug policies, and reduce medication waste. For instance, NCH initiated a dose-rounding program designed to reduce drug waste with one health plan partner. Relying on guidance from the Hematology/Oncology Pharmacy Association, NCH is encouraging and enabling providers to adjust requested doses to match the nearest vial size within 10% of the standard recommended dose.
NCH also continued to evolve its support in maximizing appropriate use of palliative care programs, which aim to improve cancer patients’ quality of life—and sometimes even extend survival—while avoiding overly aggressive treatments. Using clinical data obtained by its CarePro decision support tool, NCH can identify patients who will benefit from palliative care and coordinate referrals to a palliative care specialist, all while continuing treatment.
“Palliative care significantly impacts not only quality of life and patient satisfaction, but also reduces hospitalizations and saves long-term costs during treatment. However, logistical hurdles often make it difficult for patients to receive this important aspect of care,” said Dr. Andrew Hertler, Chief Medical Officer of NCH. “It is our goal to help providers overcome these obstacles, and we are excited to continue working with our health plan partners to develop palliative care offerings that meet their needs in 2021 and beyond.”
To better engage providers and counter perverse incentives to prescribe more expensive therapies that offer little to no improvement in outcomes, NCH expanded its use of alternative payment models, which now cover more than 1,600 provider practices. In combination with ongoing education and dedicated support from its specialty-specific network team, these services lead providers to choose NCH’s value-based clinical pathways more than 80% of the time. Overall, nearly three-quarters of oncology and cardiology teams surveyed prefer NCH to similar products and services.
Moving forward, NCH has developed a robust innovation agenda focused across the entire patient lifecycle, from pre-treatment to post-treatment, and is maintaining its focus on deepening engagement with providers and reducing their administrative burden.
In 2021, NCH pathways will become even more personalized, by considering an expanded list of factors when determining the best treatment regiment for an individual. A new collaboration with a leading precision medicine company will harness the power of sophisticated next-generation sequencing. New pathways for cell and gene therapy are also planned, reflecting the importance of managing this growing class of therapy, and a pilot palliative care program will launch later this year. Finally, NCH has begun a year-long initiative to evaluate potential racial and ethnic disparities in clinical pathway selection to establish an underlying fact base to inform action planning with our partners, as applicable.
NCH is also launching several new initiatives that seek to identify, promote and reward exceptional provider performance. These include release of a proprietary physician performance index that incorporates multiple dimensions of performance—operational, clinical and financial—and piloting a dedicated practice performance improvement team to work with specialty practices. NCH also aims to streamline the administrative burden for providers through electronic medical record integration and new features that reduces data entry for subsequent authorizations.
NCH anticipates that 2021 will be another banner year for growth, having already completed six implementations with many more slated for the remainder of the year.
"At New Century Health, our mission is to drive radical improvements in the quality and cost of care for patients with cancer and heart disease. Our mission has always deeply mattered but it will take on heightened importance going forward given the likely downstream impact of COVID-19 from delayed screening and forgone preventive care. We feel privileged to live our our mission on a broader scale this year given our growth and look forward to continue leading the way in value-based care in oncology and cardiology in collaboration with our health plan and provider partners," McCarthy said.
About New Century Health
New Century Health is the nation's leading specialty care management company, with special focus on cancer and cardiology patients. 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.