Study in AJMC Finds Use of Better Methods to Develop Pathways,
but Lack of Transparency Remains a Concern
(Washington, D.C., June 18, 2019)—A new peer-reviewed study found that while the use of care pathways by health care providers is continuing to increase, there is still room for improvement, especially in efforts to better engage patients. The study, “U.S. Care Pathways: Continued Focus on Oncology and Outstanding Challenges,” was conducted by the National Pharmaceutical Council and Analysis Group Inc., and published today in the American Journal of Managed Care.
Care pathways are designed to provide evidence-based treatment options for disease management, improve quality of care and reduce unnecessary variation in care. With the current movement toward value-based care and alternative payment models in the United States, care pathways are increasingly being utilized as a way to lower health care costs, particularly for chronic diseases and cancer. Providers also are becoming a driving force behind key aspects of pathway development and implementation.
“Overall, we are seeing some bright spots of improvement since we first analyzed the care pathways landscape,” said Kimberly Westrich, NPC Vice President for Health Services Research and a study co-author. “There are notable increases in process transparency, codification of standards, and prioritization of high-quality evidence. When it comes to patients, however, more transparency is needed. Patients often aren’t aware that their treatment is guided by a pathway or that their doctor may be financially incentivized to use the pathway.”
The study builds on a 2016 NPC-Analysis Group landscape assessment that focused on understanding the development, implementation, and evaluation of care pathways, and found that opportunities for more rigorous development methodologies and increased transparency remained. The 2019 study assessed changes in development, implementation, and evaluation of care pathways, and reviewed the latest evidence on integration of pathways with value-based care initiatives in the U.S.
Through a targeted literature review followed by an online survey and in-depth interviews with experts, the study authors offered five recommendations for continued focus as the influence of pathways on patient care continues to expand:
- Increase transparency
- Disclose conflicts of interest
- Engage with patients
- Effectively align care pathways with improvements in patient outcomes
- Integrate efficiently with other value-based care initiatives
“Pathways promise to improve value, however, integration with other value-based care initiatives remains limited so far,” said study co-author Anita Chawla, Managing Principal of Analysis Group. “When pathways are linked with value-based contracting and outcomes-based payments, they may result in a more efficient use of scarce resources once operational and data challenges have been addressed.”
About the National Pharmaceutical Council
The National Pharmaceutical Council is a health policy research organization dedicated to the advancement of good evidence and science, and to fostering an environment in the United States that supports medical innovation. Founded in 1953 and supported by the nation’s major research-based pharmaceutical companies, NPC focuses on research development, information dissemination, and education on the critical issues of evidence, innovation and the value of medicines for patients. For more information, visit www.npcnow.org and follow NPC on Twitter @npcnow.
About Analysis Group’s HEOR Practice
Founded in 1981, Analysis Group is one of the largest international economics consulting firms, with more than 950 professionals across 14 offices. Analysis Group’s health care experts apply analytical expertise to health economics and outcomes research, clinical research, market access and commercial strategy, and health care policy engagements, as well as drug safety-related engagements in epidemiology. Analysis Group’s internal experts, together with its network of affiliated experts from academia, industry, and government, provide our clients with exceptional breadth and depth of expertise and end-to-end consulting services globally.
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