CPC + CBEx 2024: Influence and Impact of Oncology Pathways

At the 2024 Clinical Pathways Congress + Cancer Care Business Exchange, Lee Blansett, MBA, executive vice president at HMP Market Access Insights (MAI), and Cindy Chen, MBA, head of analytics HMP MAI, shared highlights from MAI’s research on the impact of pathway programs on treatment selections. The research ispart of MAI’s multiyear studies of oncology providers and payers.

Previous MAI research found that many provider organizations have adopted some form of clinical pathway programs, but they are used mostly in the largest and most centralized organizations. This includes highly integrated delivery networks (IDNs) and community oncology groups that are members of the US Oncology and OneOncology networks.

For the impact study, 130 oncologists who had experience working with clinical pathways were divided into 2 groups: those who mainly follow provider-initiated pathways and those who mainly follow payer-led pathways. The researchers used a multipronged methodology and tested a range of oncologists’ treatment selection behavior, focusing on 4 tumor types: liquid tumor 1, liquid tumor 2, solid tumor 1, and solid tumor 2.  

The presenters noted 3 main factors that would drive the oncologists to engage with pathways and adhere to the pathway recommendations. The first factor is the ease of access to the pathways and the recommendation—the “clickability” factor.

“For the oncologists, what they really wanted to see was pathways integrated into their electronic medical record (EMR) and into their daily workflow, so when they are treating their patients, they would have it at the fingertips,” said Chen.

The second factor is a thorough understanding of how recommendations are selected, including transparency of the data that is being used in the selection, the selection process, and the criteria for which these recommendations are finally included in the pathways.

The third factor is the availability and possibility of providing personal or institutional input on pathway recommendations, improving reliability.

In terms of understanding the impact of the pathways on decision-making, the researchers looked at 4 key attributes: treatment regimen, pathway status (on-pathway or off-pathway), incentive for pathway adherence, and monitoring for pathway adherence. The treatment regimen was found to be the most important attribute. The pathway status of a treatment regimen was the second most important attribute but only in provider organizations, according to the presenters.

Overall, the study found that pathways have a noticeable impact on treatment selection. However, payer pathways have less of an impact due to a mix of lack of convenient access, incentives, and low oncologists’ clinical confidence. Future MAI research intends to expand on this data further and incorporate more tumor types and brands.

Reference

Blansett L, Chen C. Influence and Impact of Oncology Pathways. Presented at the Clinical Pathways Congress; September 6, 2024; Boston, MA.