Advancing Value-Based Oncology With the Predictable Cost of Care Working Group: Part 2
In this episode of Oncology Innovations, experts discuss the Predictable Cost of Care Working Group’s efforts to develop a standardized model for assessing oncology treatment costs, highlighting insights from phase I, the goals of phase II, and the importance of incorporating broader industry and patient perspectives (Figure). The following is an edited excerpt from the interview for clarity and brevity.
Gordon Kuntz: Welcome to Oncology Innovations, a Journal of Clinical Pathways podcast, focusing on candid discussions with innovators dedicated to enhancing quality, value, and the role of clinical pathways in the evolving cancer care ecosystem. I’m your host, Gordon Kuntz. I’m a consultant with 20 years of experience in oncology clinical pathways and the business of oncology.
I’ve worked with oncology practices, pharma, payers, group purchasing organizations (GPOs), and pathway developers— basically, every aspect of the oncology ecosystem. I’m really looking forward to today’s conversation.
We’re joined today by Carole Tremonti, senior director of customer success and provider partnerships at ConcertAI. While this is a new role for Carole, it is not a surprising move by any means. Carole is a pathways expert and longtime innovator in oncology care. I’ve had the pleasure of working with Carole for several years, and over the past couple of years, collaborated with her on several projects. Today, we’re going to be talking about the Predictable Cost of Care Working Group that she and I comoderated in 2024 and focusing on the work we’re starting in phase II in 2025.
Carole, the results of phase I are just being published in the Journal of Clinical Pathways. While we didn’t accomplish everything we might have hoped, what we did was actually quite significant for the world of oncology pathways. Can you describe how the work from phase I can be used?
Carole Tremonti, RN, MBA: I completely agree with you, and I am so proud of what we were able to accomplish for the broader oncology pathway community.
We tackled a problem that people have been talking about for years but that everyone thought was too complicated to even approach. Given that there were so many variables that could or should be included in the model—which was the difficult part—one of the things we decided to use to make this process more objective was a Delphi round-robin method to define those variables in the model in a way that was unbiased. In doing so, it wasn’t just the representatives in the working group making the decisions; rather, it was the voices from the broader oncology community—providers from different domains—that shaped and ultimately defined the variables we chose to use in this model.
From what was created in our phase I work, we can now begin the work of constructing the models, beginning with metastatic non–small cell lung cancer, and then test them in real-world settings to see whether they work and whether they are applicable. We do believe we’ve created an approach that is flexible enough to be applicable to other solid tumor disease states, but we need to test that theory.
Kuntz: Absolutely. Again, the goal of the work here in phase I and again in phase II—where, as Carole described, phase I was to find the model, and phase II is actually building the prototype and what will eventually be the model itself for use in the future—is to have an industry-wide solution.
The phase of definition was really critical, and I feel like we did a very good job with that. As you mentioned, the Delphi method broadened that set of perspectives to, I believe, 25 people voting on various aspects of the model in addition to the number of people we had in regular discussions. As we broaden the number of pharma participants that are involved, we are able to get some new voices in there as well. I think we really have something that we can absolutely say is built for the industry, not just for a particular specific use case.
Tremonti: I agree. As you recall, we presented the outcome of this work—where we were going with it—last year at the Clinical Pathways Congress and Cancer Care Business Exchange, and the response from the oncology community was wonderful, overwhelming, and a little unexpected. Everyone really embraced it. Additionally, during our question-and-answer session, so many unique perspectives and thought processes came to bear, and the opportunity to invite those different perspectives in to solve the problem is the beauty of the Delphi method. We knew we needed a broader perspective, and people really stepped up to the plate for that, which we were thrilled about.
Kuntz: I had at least half a dozen people find me after the conversation on stage and ask how they could help and get involved. It was truly wonderful. To that end, we’re actually starting phase II very soon. We’re recording this in early February, and I think we’re going to get started in March sometime. Things are just being scheduled right now. What kind of things do we want to tackle in 2025, and how will this be different than our first time around?
Tremonti: The number 1 lesson learned, as I mentioned, is to be sure we have a broader and more comprehensive perspective in the group itself. Number 2 was to test the model. We had hoped we could get that far in phase I, but it wasn’t realistic. We bit off quite a bit. In phase II, we want to test the model and do a complete analysis to see whether it is useful in the decision-making setting—because that’s the intention—and specifically what decisions this information was useful for.
Again, we’ve got different perspectives, use cases, and needs, and we’re trying to meet all of them—or at least get to 80% of their needs, if possible. The third thing we’re going to accomplish is applying the model to 1 or 2 different disease states to really understand the applicability and scalability of this. We have the variables for one, but if it doesn’t work when you pick it up and apply it to breast cancer or prostate cancer, then it’s not very helpful in the long run.
Watch the full video here.
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