The stakes for improvement and innovation are high in American cancer care, and insurers are trying to wield some of their influence to get a return on investment for their members and their budgets.
Horizon Blue Cross Blue Shield of New Jersey is investing $3.7 million in Series A funding in COTA, a Hackensack-based oncology management company specializing in technologies for personalized medicine and value-based care.
Abbreviated for Cancer Outcomes Tracking & Analysis, COTA was founded in 2008 by Andrew Pecora, MD, a hematologist/oncologist who is also president of Regional Cancer Care Associates, a network of 26 oncology clinics in New Jersey.
Pecora started the data company anticipating that "value-based reimbursement in oncology is coming," as the company's website puts it -- with spending on cancer care and new drugs in particular growing along with an aging society.
According to COTA, its data platform lets oncologists zero-in on specific subsets of patients across factors like age, cancer stage and genetic markers, and show relevant outcomes, along with correlative analysis between clinical outcomes and spending at aggregate and individual levels.
The company cites the example of breast cancer and its many subtypes: "Obtaining certain molecular (genetic) information before therapy starts allows for value-based care by avoiding chemotherapy in some patients whose genetic signature predicts no benefit to chemotherapy for that specific patient," the company said
Horizon, as New Jersey's largest health insurer with 3.7 million members, is trying to "assist doctors in providing their patients with the most effective and efficient treatment possible" while moving away from fee-for-service-based reimbursement, said chief medical officer Glenn Pomerantz, MD, in a media release.
"In the molecular age of medicine," Pomerantz said, "the data COTA provides can give doctors a clearer picture of how to most effectively treat their patients, so we see this as an investment to further transform how health plans and doctors collaborate to improve safety and patient outcomes."
As part of Horizon's capital infusion, Pomerantz will be joining COTA's board of directors, along with Joseph Davi, CEO of another New Jersey company, Med-Metrix, and William DeRosa, DO, a board member of Regional Cancer Care Associates.