Insurance Companies May Be Preventing Life Saving Precision Cancer Treatment Options

Precision medicine in cancer care has the potential to avert catastrophic consequences, but most cancer patients do not have access to precision oncology due to the limited coverage by health insurance companies. The US National Cancer Institute defines precision medicine as a form of medicine that uses information about a person's genes, proteins and environment to prevent, diagnose and treat disease, but many advances in precision medicine have not made it into standardized cancer care. Envita Medical Centers definition of precision medicine is even more expansive to include genomics, customized immunotherapy, and adjuvant integrative care options for in-depth patient care.

Insurance coverage for precision medicine, which offers hope to cancer patients, is not dependent on your type of insurance plan. Irrespective of whether you have Medicaid, Medicare, or other employer-sponsored health insurance with high premiums or deductibles, patient access to precision oncology is often limited by the National Comprehensive Cancer Network (NCCN) guidelines, followed in major cancer centers across the country. To bypass these outdated guidelines and help their employees benefit from the latest developments in cancer research and precision oncology, while reducing their own healthcare costs, several self-funded employer groups have partnered with Envita Center of Excellence (COE) as an important option for cancer treatment.

Benefits of Cost-Effective Precision Oncology

"We are starting to see self-funded employer groups add precision integrative medicine as a powerful cost-effective tool that improves patient outcomes. To further expand the reach of precision medicine and fill the gaps left by large insurance companies, we will be launching a national healthcare plan later this year," said Dr. Dino Prato, CEO and Founder, Envita Medical Centers and Envita Center of Excellence. Envita is committed to help every patient overcome the challenges of cancer denials, with the goal of facilitating better survival rates and outcomes for most types of cancers, including breast cancer, lung cancer, prostate cancer, colorectal cancer, or ovarian cancer.

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Envita has been practicing value-based precision oncology at 50% of the cost of conventional cancer treatment, as proved by a latest 3rd party actuarial response data certifying Envita's fees at 141% of Medicare rates*. In contrast, standard cancer treatments can range anywhere between 300% to 1000% of Medicare rates, depending on several factors. "In the healthcare system 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. Envita was the only healthcare provider in the cancer space that was transparent and willing to collaborate on a solution," said Dave Madden, Employee Benefits Adviser, CBIZ, who coordinated the collaborations between Envita and other self-funded employer groups.

Going Beyond Standard Cancer Treatments and Clinical Trials

With Envita's precision oncology treatments, cancer patients reported improvement in symptom score and fewer side effects, but studies show that less than 20% of cancer patients have access to precision oncology via standard insurance-based care. Health insurance companies generally approve the standard NCCN guideline treatments, which allow access to precision medicine only as follow-up intervention to failed first-line treatments. This delay in access to precision oncology may contribute to making cancer the second leading cause of death in the United States. To reduce the prevalence of cancer deaths and help every patient with a cancer diagnosis live with a better quality of life, the team of integrative physicians at Envita COE utilize advanced precision oncology options.

The Next-Level of Patient Care with Personalized Precision Oncology for All

The specially trained team at Envita COE aims to bridge this disparity in access to precision oncology, as several studies highlight the need for precision medicine to overcome the challenges of these one-size-fits-all protocols, based on the stage and type of cancer. Envita's personalized precision oncology treatments are based on a series of in-depth genetic tests for detailed genomic sequencing, and customized immunotherapy bioinformatic algorithms, to potentiate treatment results for each individual cancer patient. They test for many more parameters than just Tumor Mutation Burden (TMB), Microsatellite Instability (MSI), and genetic mutations caused due to family history. Diving deep into analyzing the cancer triggers and cancer risks of each individual patient is critical for reducing the chances of cancer recurrence and its metastatic spread.

Envita Precision Algorithm vs.
Standard Oncology Precision Testing

Envita's exhaustive tests enable their team of clinicians to develop a personalized medical blueprint for each individual cancer patient based on the N-of-1 treatment model. This approach considers each patient's individual cancer biomarkers and their latest mutations, which are proactively treated with powerful anti-cancer therapies.

Powerful Combinations for Precision-Targeted Therapies

Combining the latest developments in conventional oncology with research-based advanced natural therapies has led to several successful recoveries in patients, many of whom sought treatment at Envita after major cancer centers in the country had failed to help them. Envita's personalized precision oncology treatments go beyond the scope of check-point inhibitors and cancer vaccines, as they utilize a combination of FDA (Food and Drug Administration) approved drugs, repurposed drugs, and custom-compounded adjuvants. Their proprietary minimally invasive technologies also play a crucial role in enabling them to maintain a value-based precision oncology model.

Value-Based Precision Oncology Model

To reduce out-of-pocket costs of treatments and unnecessary financial burden on payers, Envita's value-based model shifts from the conventional fee-split model, where doctors' payments are linked directly to the number of procedures. At Envita, doctors are salaried, and patients' treatments have no bearing on their salary or income. Envita incentivizes their salaried doctors on patient outcome metrics and their patient concierge team is incentivized to ensure an exceptional experience for patients. The concierge team, which has no influence on treatment decisions, is trained to assist patients and their family members with facilitating a free case review before establishing care, helping with scheduling, and coordinating detailed precision care.

* 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 of Envita Medical Centers and Envita COE

You should never be alone in your healthcare journey, which is why Envita is launching a national healthcare plan to not only expand the reach of value-based precision oncology and provide advanced cancer prevention plans and cancer screening technologies, but to also improve patient experience during their treatment and recovery phase. 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 personalized precision oncology approach. They have been relentlessly working for over 25 years to help patients with late-stage and complicated cancers. 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.