inVentiv Medical Management

Comprehensive Oncology Care Management


The National Institute of Health estimates that more than 1.5 million new cancer cases have been diagnosed over the past year, with the cost of cancer-related care in the $366.6 billion range. On average, cancer care costs $110,000 per patient treated each year. These costs are double that of 20 years ago and are expected to continue to rise by at least 27% in the next 10 years as new targeted therapies come to market. Studies have shown that 30% to 75% of care (depending on site of service, line of therapy, and tumor type) is not evidence-based, which contributes to unnecessary costs with questionable benefit to the patient.

Comprehensive Oncology Care Management, an Accountable Care Solution powered by inVentiv Medical Management™ provides a clinically accountable solution focused on promoting cost-effective, evidence-based and integrated care management for patients living with cancer.

The Comprehensive Oncology Care Management team is a multidisciplinary team that includes:

  • In-house Hematologist/Oncologist, Radiation Oncologist and Consulting Surgical Oncologists
  • Pharmacologist
  • Oncology Nurses, RN, Oncology Certfied Nurse
  • Registered Dietitian
  • Advanced Illness Counselor
  • Case Managers, RN, Certified Case Manager
  • Licensed Medical Social Worker
  • Oncology Billing, Coding and Negotiation Professionals

In conjunction with the prospective clinical review, claims are monitored to ensure adherence to evidence-based treatment, identify billing and coding errors and opportunities for cost negotiation. Case management is provided to support the patient and caregiver psychosocial needs through all phases of therapy, identify and mitigate factors impacting quality of care, and coordinate additional resources such as dietary for cancer-related nutritional challenges and social work for financial and emotional support. Advanced illness counselors are available to help patients with progressing disease become more active in communicating their preferences and in decision making processes. This becomes very important as decisions must be made around types of therapy options-chemotherapy, radiation, or surgery. Ultimately, the patient is empowered to own their health outcome. Regular reporting is provided to the client and reflects the coordination of care and impact on care utilization. Comprehensive Oncology Care Management combines our deep in-house clinical strength in oncology with the gold standard in evidence-based cancer care and research-NCCN Guidelines®. This approach ensures we promote adherence to the latest evidence-based medicine and personalized care in the medical home.

 

Some specialty review work is accomplished through business relationships with Health Utilization Management and Independent Review Organizations.

For pre-authorization of treatment, please contact us at 877-494-2403.