Challenges and Opportunities Associated with Value-Based Frameworks and Clinical Care Pathways in Community/Academic Oncology Practice Sites

A study described the use, challenges, and opportunities associated with the implementation of value-based frameworks (VBFs) and clinical care pathways (CCPs) in US cancer centers. The results were published as a poster at the Academy of Managed Care Pharmacy Nexus 2021.

After conducting a literature review and consulting with a team of content experts and researchers, the investigators developed a novel survey to assess the impact of VBFs and CCPs. Subsequently, they electronically disseminated this survey oncology/hematology physicians (MDs) and quality officers (QOs) from August to November 2020. Descriptive analysis was conducted. In total, 136 sites were contacted and 28 sites (15 community; 13 academic) participated, yielding a 20% response rate.

The results showed that the most common VBFs/CCPs used were from the National Comprehensive Cancer Network (85%, n=22; 79%, n=27) followed by the American Society of Clinical Oncology (ASCO) framework and vendor-developed CCPs, (31%, n=8; 41%, n=14). The results showed that a higher proportion of community respondents implemented both VBFs/CCPs (78%, n=18; 87%, n=20) compared to academic respondents (38%, n=8; 67%, n=14).

Respondents reported challenges to implementation, including incorporation of the patient experience, outcomes, and care quality into the framework (38%, n=10) and substantial costs associated with implementing a CCP program (26%, n=9). According to the researchers, the implementation of VBFs/CCPs may be hindered by lack of accessible patient-specific outcomes and lack of consensus on pathway choices at institutions (53%, n=9; 70%, n=7).

“Implementation of VBFs in practices may be limited due to resource allocation such as staffing models and potential costs assumed by practices,” the researchers concluded.

“Future VBFs should consider inclusion of patient interpreted value and translation of outputs that address patient-specific outcomes into clear, actionable guidance. For CCPs, an evidence-based development process that incorporates all relevant stakeholders, particularly physicians, and includes cost of care should be utilized.”

Source: Panchai R, et al. Challenges and Opportunities of Value-Based Frameworks and Clinical Care Pathways For Physicians Quality Officers in Community/Academic Oncology Practice Sites Via A National Prospective Survey. Poster U18. Published for AMCP Nexus 2021; October 18-21, 2021, Denver, CO.