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Are you ready for the next wave of specialty care management?
Value-based pathways focus on proven, evidence-based treatments that have
a low side-effect profile relative to other therapies and are also cost-effective.
"We consider value-based pathways to be very high-value treatment options for
patients," Dr. Hertler said, describing how NCH works with payers to align health
plans, providers and patients.
But pathways alone don't guarantee high value care. Today's specialty care
management must expand to include physician education and reimbursement
models, along with tools equipped for point-of-care needs to help manage the
complex clinical decision-making environment.
NCH believes in point-of-care decision support and provides oncologists and
cardiologists with decision-making technology delivered through CarePro
SM
.
This platform is uniquely designed with specialty physician workflows in mind,
so providers receive automatic guidance on preferred treatment regimens.
The NCH pathway development process is informed by teams of independent
oncologists and cardiologists who serve on a Scientific Advisory Board reviewing
the clinical evidence supporting differing treatment options quarterly to provide
updated evidenced-based guidance.
Finally, a critical part of managing specialty care involves aligning specialty
physician reimbursement models to change behavior, "whether that be
a pathway program with financial incentives or alternative payment methods,"
Dr. Hertler noted.
ONCOLOGY QUALITY PROGRAM BRINGS
$18 MILLION IN SAVINGS
In one oncology case study outlined in the webinar, a Medicare Advantage
(MA) plan faced spiraling costs and needed to create a sustainable program
for its 40,000 members that would ensure provider engagement.
Today's specialty care management must expand
to include physician education and reimbursement
models, along with tools equipped for point-of-care
needs to help manage the complex clinical decision-
making environment.
