May 17, 2020

Evolent Health is set to acquire New Century Health for $217mn.

M&A
USA
M&A
USA
Catherine Sturman
3 min
Evolent Health, Inc., NCIS Holdings, Inc. and New Century Health have entered into an agreement for Evolent to acquire New Century Health’s business f...

Evolent Health, Inc., NCIS Holdings, Inc. and New Century Health have entered into an agreement for Evolent to acquire New Century Health’s business for up to $217mn.

Founded in 2011, Evolent supports providers in moving to a population health model of care delivery and successfully manage performance-based payment arrangements. Headquartered in Massachusetts, New Century Health is a technology-enabled, specialty care management company focused primarily on cancer and cardiac care.

The combination brings together two innovative companies that support provider organisations and health plans with clinical management and operational capabilities.

Utilising its proprietary technology platform, New Century Health brings together clinical capabilities, pharmacy management and physician engagement to assist its customers in managing the large and complex specialties of cancer and cardiac care.

New Century Health manages approximately 462,000 Medicare Advantage lives under performance-based arrangements and provides administrative services (ASO) to several partner organisations. The company serves 12 long-term operating partners across multiple states; partners include at-risk provider organisations, as well as national and regional health plans.

“Since day one, Evolent has been focused on delivering improved and differentiated clinical outcomes for its provider partners; the addition of New Century Health will enhance our clinical capabilities and enable us to offer a more integrated set of MSO services to our current provider partners,” said Evolent Health President Seth Blackley.

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“The acquisition will also expand access to the payer market directly and allow us to facilitate collaboration between payers and providers. New Century Health has a proven, 15-year track record of delivering significant cost savings through its specialty care management model, deep clinical expertise and technology-driven approach."

"We have consistently focused on aligning with organisations that can help us enhance our capabilities and grow our clinical impact and footprint, so I’m excited for New Century Health to take this next step with Evolent Health and have the opportunity to serve even more patients across the US,” added New Century Health Chief Executive Officer Dr Atul Dhir.

Together, the organisations will be able to offer comprehensive specialty care management services and technology across Medicare Advantage, Medicaid and commercial populations in support of both New Century Health and Evolent’s clients. Upon closing this transaction, the duo will serve more than 3.5mn lives across more than 40 long-term operating partners.

"The addition of the New Century Health business is a strong strategic fit for Evolent, as we work to deliver demonstrable improvements in clinical and financial outcomes for providers and payers," commented Evolent Health Chief Executive Officer Frank Williams.

"We believe this transaction furthers our differentiation and position as the leader in a high-growth market well into the future."

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Jun 21, 2021

How health plans can reduce healthcare inequalities

healthcareinequalities
COVID19
healthplan
sdoh
4 min
Jim Clement from Inovalon on the role of health plans in improving access to healthcare

The COVID-19 pandemic has put inequalities accessing the healthcare system in the spotlight. Jim Clement, Vice President of Product & Services at cloud provider Inovalon, tells us that health plans play the most integral role in advancing the health equity movement.

Why did it a global pandemic to highlight the issue of healthcare inequities? 

Health inequity in the US has been well understood by healthcare professionals for many years, but it has become more evident due to the COVID-19 pandemic. It wasn’t until the racial and ethnic differential seen in response to COVID-19 related infections, deaths and vaccinations that many Americans became acutely aware of the health inequity due to sociodemographic factors such as race, geography, education and income.

Fortunately, there’s now a growing health equity movement afoot in America which aims to improve public health and achieve equity in health status for all people by ensuring opportunities are available to attain the highest level of health. While the entire healthcare ecosystem is important to this transformation, it is health plans that arguably play the most integral role.

How can health plans help? 

Achieving health equity means obstacles to health must be removed, including poverty, discrimination, powerlessness, and lack of access to the basics like physicians, hospitals, medicine, technology, and health education. This is not only a social justice initiative, but also a clear call to action for health plan organisations that are bearing the economic brunt of the costs due to health disparities. 

Health plan organisations that recognise the alignment between efforts to improve health equity and broader member engagement initiatives will be in the best position to move the needle. Plans must also understand that the provision of medical services within hospital walls, physician offices and other health services providers is necessary, but not sufficient. 

By recognising that health inequity also includes non-medical factors such as employment, income, housing, transportation, childcare, and more, plans will be better equipped to ensure their members are set up for success. 

What do healthcare providers need to do generally to address inequities? 

Outreach by both health plans and providers is critical to ensuring people have knowledge of available services, the reason those services are critical to their health, and options to access those services based on their unique circumstances. With both stakeholders beating the same drum, progress can be made quickly.

Given the impact of social determinants of health (SDOH), should healthcare providers take a more active role in addressing these, or other agencies? 

While communicating with patients is critically important, what is truly required to address inequalities is helping patients take medical  actions – like regular PCP visits, monitoring A1C and accepting health coaching – that are necessary to maximise their health, along with non-medical actions –like availing themselves of community resources that address homelessness, food insecurity and employment services. 

The most progressive providers and payers have or are putting in place programs to address these non-medical issues.  In addition, non-medical tools such as transportation services can certainly help drive the effectiveness of medical services. 

How important is it to educate patients about their health and how can this be done? 

Education is a social determinant of health and a key lever to be used to drive health equity.  Patients who do not understand their medical conditions or the consequences of non-compliance with their treatment plans are prone to poor outcomes. 

For health plans, understanding member needs is one of the biggest drivers of quality care. A continuous cycle of engagement through feedback and appropriate responses will provide health plans with an opportunity to uncover, discuss, and resolve problems faster. 

Improving member outreach and engagement can be made easier with a programmatic approach involving four stages of intentional outreach: Getting to know your members, educating members, seeking feedback from members and gaining member loyalty. Each stage not only contributes to a better member experience but also to improved outcomes and higher satisfaction scores.

Now that the issue has come to the fore, what do you think things will look like in 5 years or so?

I predict that health plans that get member engagement, education and equity right will achieve better health and greater value, faster. Those who get it wrong or delay will suffer the consequences of competitive disadvantage and pay a larger share of the rising costs associated with health inequity.

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