- Evolent Health (EVH, Financial) achieved a 20.1% reduction in the usage of low-value oncology regimens from February to May 2024.
- Provider requests for these regimens decreased by 15.5% over the same period.
- A low-value lung cancer regimen costs 70 times more than its preferred alternative, at $40,000 more per quarter.
Evolent Health (EVH) has reported a significant achievement in reducing the use of low-value oncology treatment regimens by over 20% through an impactful provider education and engagement campaign. Detailed in the Journal of Clinical Pathways, this program aims to identify and limit the use of treatments that may have lower survival rates, more severe side effects, or excessive costs without additional clinical benefits.
Spanning therapies for 10 common cancer types, the initiative targets approximately 1% of all treatment requests. One notable example highlighted a low-value lung cancer regimen that was approximately 70 times more expensive—$40,000 more per quarter—than a preferred alternative, despite lacking evidence of better clinical outcomes.
From February through May 2024, the program achieved a 20.1% reduction in low-value regimen usage compared to the same period in 2023. This success is attributed to a comprehensive approach integrating provider education, technology-enabled clinical decision support, and performance incentives, resulting in a 15.5% decrease in provider requests for such regimens.
By leveraging a multi-faceted implementation strategy, Evolent Health emphasizes enhancing treatment quality while minimizing excessive financial strain, positioning itself as a leader in value-based care solutions. As cancer medications account for about 60% of Medicare oncology spending, Evolent's initiative offers a potent financial impact by reallocating resources towards more effective treatment options.
Evolent's oncology program demonstrates a valuable proposition for healthcare cost management, addressing the largest component of cancer care spending while securing meaningful improvements in clinical outcomes. This nationwide expansion with multiple health plans confirms strong market reception, indicating promising potential for recurring revenue opportunities.
