The final speaker, Blase N Polite, MD, MPP, The University of Chicago, introduced himself by saying, “My job is to convince you that pathways can fix things you don’t even know are a problem yet.”
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Dr Polite talked about the importance of clinical pathways within the overall shift towards alternative payment models. Interestingly, Dr Polite argued that drugs should not be included in alternative payment models as a performance metric, because providers have a limited ability to control drug price and also a limited ability to control drug volume if they are strictly giving the right drug to the right patient at the right time. Therefore, providers should not be penalized for the amount spent on drugs.
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Current models, he said, place too great an emphasis on drugs and hospitalizations in general. This requires providers to focus on reducing costs associated with chemotherapy. The solution to this problem is value-based clinical pathways. Clinical pathways, unlike guidelines, require making the hard choices by ranking different options. This allows drug use to be evaluated not by dollars spent but as a quality metric reflecting the appropriateness of treatment. Such quality measurements can also ensure that savings are not the result of under-treatment.
