Improving Oncology Quality Through the Implementation of Evidence-based Clinical Pathways in a Payer’s Oncology Network Daniel McCrone, MD; Dudley Gill, MBA; Cecilia Tran, PharmD, BCOP; Michael Sturgill
Background: Physicians and health plans are collaboratively exploring clinical pathway strategies to improve patient outcomes, reduce treatment variation and reduce oncology cost. Studies have demonstrated that the use of pathways can lower the cost of care and that oncologist participation is a critical element for success. Objectives: New Century Health (NCH), in partnership with a leading health plan and one of its Midwestern oncology networks, had two quality goals with the implementation of a chemotherapy prior authorization system:
Conclusions: Implementation of an oncology prior authorization system that measures compendia-based adherence rates is associated with increased levels of evidence-based chemotherapy treatment plans by participating providers.