In its third annual State of Cancer Care in America report, the American Society of Clinical Oncology (ASCO) described a number of the advances and remaining challenges concerning cancer care—including the sudden ubiquity of clinical pathways.
ASCO reported that advances in treatments have generated exciting progress for patients, families, and physicians. While these advances have resulted in lower mortality rates and a growing number of survivors, physicians are increasingly concerns about the volatile practice environment, increasingly unsustainable costs, and newly emerging practice models.
Recently, clinical pathways have proliferated at health care institutions. In the 2015 ASCO trends survey, 117 oncology practices (62%) reported adhering to clinical pathways, with almost a third (31%) saying they adhere to more than one pathway program.
However, while some studies have reported cost savings through pathway use, they are still causing confusion and administrative burden for practices. In some instances, different payers are specifying different pathways for the same clinical scenario, with incentives based on adherence to each. In response to this growing problem, ASCO released its policy statement to improve the development of oncology pathways and processes to ensure they promote evidence-based, high-value care.
While not yet universally implemented, pathways, other alternative payment models, and value-based initiatives are expected to become more integrated into daily care activities as time passes. When surveyed, representatives from academic, physician-owned, and hospital or health systems reported alternative payment models (including clinical pathways), electronic medical records (EHRs), and the cost of care as the areas of greatest concern to them. The new payment and care models causing most concern were accountable care organizations, bundled payments or episodes of care, clinical pathways, and patient-centered medical homes.
To help facilitate the transition to these new models and initiatives aimed at improving the costs of cancer care, ASCO provided four recommendations to key national stakeholders:
- Ensure all publicly funded insurance programs offer consistent and appropriate benefits and services for patients with cancer.
- Test multiple innovative payment and care delivery models to identify feasible solutions that promote high-quality, high-value cancer care.
- Advance health information technology that supports efficient, coordinated care across the cancer care continuum.
- Recognize and address the unsustainable trend in the cost of cancer care.
