Segment 2 - Development of Pathway Guidelines

The panelists discussed and shared examples of how payers and providers are collaborating to develop pathway guidelines.

The panelists discussed and shared examples of how payers and providers are collaborating to develop pathway guidelines.

Dr Tischler shared his experience of working with The US Oncology Network, one of the country’s largest networks of community-based oncology practices. While limited, he thinks there is a variety of strong anecdotal experience with pathway implementation within organizations such as US Oncology. These include both stories of success, and those that come with challenges.

Dr Nabhan, shared his personal experience and suggested that current guidelines fail to address the cost factor in pathways. He argued there are no clear defined steps to developing effective pathways. He commented that US Oncology is 1 organization that has begun to approach successful pathway programs.

Dr Malin added that WellPoint is in the early stages of launching its own pathways program. WellPoint recently announced that it would begin to offer oncologists a financial incentive for each patient who receives treatment for breast, colorectal, or lung cancer as specified by 1 of the insurer's recommended regimens. The program will rollout in a handful of states beginning on July 1, 2014, and is expected to be implemented in other states throughout 2015. The pathways selected by WellPoint intend to eliminate unnecessary medical interventions and to promote only the most cost-effective treatments in cancer care.