Are Pathways the Answer?

Right now...yes they are.  If your physician organization hasn't approached your commercial payers to develop a quality initiative with pathways then it is vital you and your physician leaders insist on a program.  Why?  Because if you don't then an external disease management company will and you will have no leverage in treatment decisions or future negotiations.

Next week, I will be talking with CHOP members at the CHOP Business Summit in Denver about pathway programs and why they are necessary in payer negotiations. 

Clinical treatment pathways are designed to provide high quality patient care through clinically proven, evidence-based treatment protocols.

A Clinical Oncology Pathways Program is intended to help patients, physicians, and payers. Physicians who elect to participate will be rewarded for a "Pay-for-Quality Initiative" for delivering the right patient care at the right time while helping to manage drug costs associated with quality oncology care.

If followed, a physician-driven pathway program can provide cost-effective care and improve the quality of healthcare delivery without comprising integrity or delivery of treatment. Pay -for-Quality Pathway Programs claim to:

• Reduce variability of care

• Optimal outcomes

• Minimizing and better management of toxicities

• Reduce errors, misuse, hospitalizations

• Allowing for a greater predictability of treatment cost

• Improve outcomes and patient quality of life

• Demonstrate success through measurement and performance reporting

• Support alignment of appropriate incentives

• Maintain viability of community based oncology to serve the patients

• Utilize technology and informatics solutions