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New Century Infusion Solutions, Inc. (NCIS) is a health care management organization that is the first to utilize the Integrated Single Specialty Provider (ISSP) model. The Integrated Single Specialty Provider model (Patent Pending, July 24, 2009), developed by founders Christopher Nee and Joseph M. Perez, aims to deliver cost-effective cancer care. NCIS promises clients to boost efficiency by bridging together the distinct segments of oncology care: the health plan, the oncologists, and the patients. This way, instead of having the three segments running separately (which frequently leads to multiple costly and avoidable errors), all segments are integrated to streamline health care management. With ISSP (Patent Pending, July 24, 2009), NCIS claims to root out common administrative blunders that hinder cancer patient care and therefore raise prices. Already, increasing cancer prevalence causes rising costs [1]; divided health care departments only amplify the costs of cancer drugs, which are "already among the costliest in medical care" [2]. By integrating all levels (the medical, technical, and pharmacological components) of a medical specialty—in this case the specialty being oncology—NCIS streamlines the business aspect of cancer care.

Contents

Business

Since its establishment in 2007, New Century Infusion Solutions, Inc. offers services that guarantees to successfully re-align the incentives of oncology care delivery between payers, providers, and patients. The company manages approximately 500,000 accounts divided into 100,000 Medicare, 400,000 Medicaid and Commercial (2009). It operates in Florida, California, and Texas and is expanding into Michigan, New York, and Pennsylvania [3 ]

The ISSP Model, and Cancer Care

Oncology care—or cancer care—is one industry whose “costs continue to rise” [4] "largely due to the increase in cancer prevalence and the incorporation...of novel, highly expensive drugs" [1]. Additionally, the provision of oncology care remains extremely fragmented. The medical health plans, its medical oncologists (doctors specializing in the study and treatment of cancer), radiation therapists, and pharmacies all work on separate “silos”; and instead of coordinating all parts in the continuum of cancer care, each stakeholder performs its functions in its own processes according to its own system. This fragmentation often leads to inefficient, if not wasteful, use of resources. Further causing inefficiency in oncology care is the fact that the incentives of stakeholders are often mis-aligned.

As a global oncology management company, NCIS aims to bridge the fragmented segments in the cancer care delivery system to bring cost-effective care and maintain high-quality care. NCIS is the only Integrated (meaning it incorporates all parts of a system—the cancer care system, in this case) Single Specialty (meaning it specializes in only one type of medical care—specifically cancer/oncology) Provider in the oncology care market. The key distinction for the Integrated Single Specialty Provider (ISSP) is the fact that it only focus on a single specialty. This type of concentrated focus allows NCIS to be an expert in the specialty of oncology. Contrast this with health plans and other payers who are, in essence, “generalists” since they have to manage all aspects of healthcare deliveries. As with all “generalists” in healthcare, they may or may not contain expertise in each specialty. This is why the ISSP model may revolutionize healthcare management: by being the experts in their specialty and bringing more efficiency to cancer care with their singular focus. An example of the ISSP focused expertise is demonstrated by the fact that NCIS employs oncologists, hematologists (blood specialists), and radiation therapists as medical directors to review prescriptions. Because "off-label therapy for cancer drugs is common in practice" [5], NCIS feels that having the expertise of doctors who only specialize in oncology provides better care for their oncology patients. In one particular case, an NCIS medical director—Myron “Mickey” Goldsmith, MD (and Chief Medical Officer of NCIS)—explains how once:

“…a health plan reviewer approved Avastin for a squamous-cell carcinoma (a type of lung cancer) patient because it was FDA approved for adeno lung cancer (a non-squamous cell form of lung cancer). However, Avastin is not approved for squamous-cell carcinoma—the type of lung cancer that this particular patient had. I was able to collaborate with the health plan’s medical reviewer, prescriber and patient to amend the original therapy to save the health plan thousands of dollars and the patient the need to go through a potentially ineffective or dangerous treatment...In another case, one of the health plan reviewers approved the use of Avastin for a colon cancer patient. However, that reviewer did not realize that Avastin was not approved for the particular stage of colon cancer the patient had…” (Source: Myron "Mickey" Goldsmith, Chief Medical Officer of NCIS)

Claimed benefits of NCIS

Payers and providers will allegedly realize short and long-term benefits, including:

  • Instant savings (by reduced oncology care risks)[6]
  • Long-term savings (with a halted oncology drug inflationary trend)[6]
  • Full capitation and global risk management with a full integration between pharmacy, radiation/technical, provider, and health plans[6]
  • Oncology specialists managing every facet of cancer care, leading to optimized patient care and minimized physician risks[6]
  • Faster and more-efficient claims processing and paying[6]
  • Reduced administrative burdens[6]
  • Instant referrals[6]
  • Integrated drug regimen management[6]

Products and services

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TrendStopSM

TrendStopSM is NCIS’ product that uses the ISSP model to implement full capitation on oncology costs. Clients of NCIS that use TrendStopSM will only endure inflation at their assigned capitation rate and not at the regular oncology cost inflation rate (anywhere from 10-20+ %). TrendStopSM is also a cost-management program that guarantees oncology savings.[3 ]

TrendGuardSM

TrendGuardSM is NCIS’ system that provides oncology cost management on a fee-for-service basis. TrendGuardSM is a cost-management program that uses an new kind of claims processing platform to deliver evidence-based medicine and management of oncology costs. [3 ]

Management Team

Joseph M. Perez
Founder and Co-President
Christopher Nee
Pharm. D., MBA, Founder and Co-President
Myron “Mickey” Goldsmith
MD, Chief Medical Officer
Giselle Cueto
Director of Network Operations
Paige Fretwell
Director of Operations
Dudley “Skip” Gill III
MBA, Director of Relationship Management
Rose de Ocampo
Director of Pharmacy Operations
Isaac Romero
Director of Information Technology and Chief Privacy Officer

References

External links


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