Employers Partner with Center of Excellence for Value-Based Precision Oncology

The increasing costs of oncology care and the uncertainties of navigating a life-threatening disease, not only affect cancer patients and their families, but employers are also hugely impacted by the incidence of cancer in their workforce.

An initiative by the Northeast Business Group on Health (NEBGH) highlights the total cancer-related costs for employers in 2010 were $264 billion, with $125 billion spent in direct medical costs and $139 billion accrued in indirect costs, resulting from lost productivity. To counter such losses and provide high-quality cancer care with value-based pricing, several self-insured employers are partnering with Centers of Excellence (COE) in precision oncology, which offer optimal healthcare options as well as reduce employers' healthcare costs.

With a COE in place, employees receive care from world-class physicians focused on delivering comprehensive, evidence-based specialized treatment options, meaning patients benefit from the latest research on cancer care. By utilizing the latest developments in precision medicine, the integrative physicians at Envita Center of Excellence aim to help every cancer patient respond to care and recover holistically, while reducing their employers' cost of care.

Value-Based Care Providers in Precision Oncology

A recent 3rd party actuarial response data certified Envita Medical Centers' fees at 141% of Medicare rates*, while typical oncology service fees in the standard health care system can range from 300% - 1000% of Medicare. “In healthcare there is often no direct relation between cost and quality of care, as Americans are largely dependent on their employer's health insurance, and these insurance companies choose providers based on favorable rate negotiations,” said Dave Madden, Employee Benefits Adviser, CBIZ, who coordinated the collaborations between Envita Center of Excellence and other self-funded employer groups.

Explaining how such partnerships are beneficial for employers and their employees, he added, “Envita was the only provider in the cancer space that was transparent on cost and willing to collaborate on a solution.” The COE aims to improve patient outcomes while avoiding wasteful expenditures, which may be caused due to lack of access to precision oncology through standard insurance-based care.

Going Beyond Standard Oncology Treatments and Clinical Trials

“Our cost-effective treatment plans break away from the one-size-fits-all standard protocols to include the latest developments in cancer clinical research, which are customized to precision-target the unique set of cancer drivers of each individual patient. These personalized precision oncology treatments have proved beneficial for our patients, many of whom had failed to experience results with standard oncology treatments,” said Dr. Dino Prato, CEO and Founder, Envita Medical Centers and Envita Center of Excellence.

Precision oncology includes extensive genomic testing to identify disease biomarkers in each individual patient, which is crucial for developing a comprehensive treatment plan with proactive interventions. The goal of precision medicine is simply to deliver the right cancer treatment to the right patient at the right dose and the right time, which is what the team of integrative physicians at Envita aim to accomplish through their patient-centered precision plans. However, through standard insurance-based care, less than 20% of cancer patients get access to precision oncology, as the NCCN (National Comprehensive Cancer Network) guidelines which determine standard of care protocols, do not promote precision oncology as the first line of treatment. This delay in access to precision may contribute to increasing cancer deaths.

To overcome this disparity in access to precision oncology caused by the NCCN guidelines and followed in all NCI (National Cancer Institute) designated comprehensive cancer centers across the country, employer groups are partnering with Envita COE for more targeted solutions. Their value-based precision care delivery approach is designed to go beyond the scope of standard oncology treatments and clinical trials to optimize results for patients while reducing the financial burden of employers, who are the payers in these self-insured health plans.

Envita Precision Algorithm vs.
Standard Oncology Precision Testing

At Envita COE, every patient goes through detailed diagnostics for an in-depth genomic analysis, which enables the team to custom-develop a treatment plan based on the n-of-1 clinical trial model. This single-subject treatment model determines the optimal or best intervention for an individual patient using objective data-driven criteria, potentially helping in overcoming the challenges of large sample clinical trials, which should be approached with caution.

Advanced Immunotherapy to Improve Patient Experience and Response

Envita's patient-centered treatment plans are designed to improve quality of life, increase longevity, and reduce toxicities which cause side-effects to treatment. To precision-target the cancerous cells without greatly impacting the surrounding healthy cells, the team at Envita COE relies on innovative immunotherapies for every cancer patient. Their personalized immunotherapies go beyond the standard checkpoint inhibitors or car-t therapies, to include a powerful combination of FDA (Food and Drug Administration) approved drugs, repurposed drugs, and custom-compounded adjuvants. These personalized combinations are determined through advanced precision algorithms based on detailed bioinformatic data analytics.

Cost-Effective Payment Model to Benefit Stakeholders

To be fair to all stakeholders, including patients, their employers, and the treating doctors, Envita COE offers transparent pricing for their value-based precision oncology. “We offer precision treatments at a cost-effective rate through our value-based payment model, which is in direct contrast to the conventional fee-split model, where doctors' pay is linked to the number of procedures and appointments they perform. Instead, Envita's doctors are salaried, and patients' treatments have no bearing on their salary or income, rather the salaried doctors receive incentives based on the outcome metrics of their patients,” said Craig Perkins, Vice President, Envita Medical Centers and Envita COE.

With their value-based precision oncology model, Envita COE aims to reach out to as many cancer patients as possible and help them experience the benefits of the most recent developments in cancer research from around the world.

* The 3rd party actuarial response data is based on an analysis of 87 out of 129 patients that participated in Envita's Treatment Program in 2020. 42 patients were removed from the cohort due to the patients' inability to start or complete Envita's prescribed treatment for a variety of reasons, including advanced disease state, disease progression or inability to travel.

Take a Tour and Learn More About Envita Medical Centers and Envita COE

To make their advanced precision treatments available for a wider population base, Envita is launching a national healthcare plan, covering oncology care, and all other specialties, including primary care as well. Envita's healthcare plan aims to revolutionize the health and wellness industry, as it covers both integrative and conventional in-person consultations along with advanced telehealth services, offering the latest in digital health to all their members. This plan is designed by doctors who have been treating patients with late-stage and complicated cancers at Envita Medical Centers for over 25 years. The expert team at Envita includes certified oncologists, interventional radiologists, researchers, and pharmacists, who undergo intensive training of over 1,500 hours to adapt to Envita's personalized precision oncology approach. If you or your loved ones have any questions regarding cancer and the financial aspect of treatment, please feel free to call us at 866-830-4576.