#USA #Washington #Cancer Treatments #Evolent Health #oncology regimens

Evolent Health's Remarkable 20% Reduction in Low-Value Oncology Regimens

In a remarkable effort to enhance cancer care, Evolent Health, a leader in specialized healthcare solutions, has successfully reduced the utilization of low-value oncology regimens by over 20%. The initiative aims to not only improve patient outcomes but also manage the rising costs of cancer treatments that have put a financial strain on healthcare systems and patients alike.

The Challenge of Low-Value Regimens

When treating cancer patients, oncologists have a wide array of FDA-approved treatment regimens at their disposal. Unfortunately, among these choices, some regimens have been identified as low-value due to their high costs relative to clinical benefits. These low-value options can lead to lower survival rates and more severe side effects without any added therapeutic advantages.

Evolent's program, as documented in the Journal of Clinical Pathways by its oncology experts, aims to change this narrative. The team undertook a thorough analysis to identify these low-value regimens, which consist of therapies across ten common cancer types. Despite representing merely 1% of all regimen requests, these options disproportionately impact the overall quality and affordability of cancer care.

Identifying Low-Value Options

Evolent's clinical experts conducted extensive research into the medical literature and analyzed real-world outcomes to pinpoint these low-value regimens. With insights from the Oncology Scientific Advisory Board, comprised of leading oncologists, the program was formed to address this critical issue. One striking example highlighted by Dr. Andrew Hertler, Evolent's CMO Emeritus, is that one low-value regimen for lung cancer costs approximately $40,000 more per quarter compared to a clinically equivalent and preferred alternative. Yet, evidence shows that it does not yield any better clinical results.

Implementing Effective Strategies

In early 2023, Evolent partnered with a national health plan to embark on a multifaceted campaign aimed at reducing the use of identified low-value regimens across multiple markets. Central to this effort was the engagement of healthcare providers through various initiatives. Evolent deployed accomplished oncology pharmacists to facilitate in-person and virtual forums, educating clinicians on the evidence for preferred regimens versus low-value alternatives.

Furthermore, Evolent utilized advanced technology within its clinical decision support system to flag these low-value options. Should a provider submit a request for any low-value regimen, the system initiated an outreach protocol where an Evolent clinical reviewer would engage with them, evaluate the specifics of the case, and suggest alternative, higher-value therapies.

In conjunction with these educational tactics, Evolent implemented pay-for-performance systems that collaborate with healthcare providers to encourage the selection of preferred regimens. This approach was complemented by the inclusion of low-value regimen usage as a key metric on specialist scorecards distributed to oncology practices and referring providers.

Positive Outcomes from the Initiative

Data collected from February to May 2024 indicate a substantial shift in the usage of low-value regimens—evidence shows a 20.1% decrease compared to the same timeframe in 2023. This positive trend reflects a significant reformation in the ordering habits of healthcare providers, with requests for low-value regimens dropping by 15.5%.

Dr. Von Nguyen, Evolent's Chief Medical Officer, emphasized the power of the provider engagement model in driving these positive changes. Building awareness among healthcare providers about low-value oncology regimens constitutes just a part of the equation; ongoing technological support, performance tracking, and structured incentives are crucial to maintain this progress.

Moving forward, Evolent's initiative is set to impact health plans nationwide, setting a precedent for similar strategies that prioritize high-value care in oncology. With an established presence in the healthcare sector, Evolent Health is dedicated to transforming treatment paradigms, ensuring that both patients and healthcare systems benefit from improved outcomes and reduced financial burdens.

For more detailed information on Evolent's groundbreaking program and its implications for the future of oncology care, visit Evolent Health's website.