The ongoing journey toward value-based care has led to innovations in care delivery and reimbursement. Many new concepts and strategies have evolved from concept to reality. We now have gathered enough long-term data to assess how effective these new innovations are. We will be able to assess if they are truly adding value to care through improved health outcomes and learn how we may be able to enhance the results. While this is an exciting time, it is important to step back to stay grounded to our original goals. Stakeholders and decision-makers, in the pursuit of value, need to ensure that lines of communication are open, so that goals and strategies are clearly defined and, ideally, synergistic with one another.
The American Society of Clinical Oncology (ASCO) previously published statements regarding clinical pathways, proposing guidance and standards for effective clinical pathway development and implementation. As programs evolve from concept to real-world practice, seldom does the perception of the end user, the provider, match the intent of the developer. To determine how health care decision-makers define and perceive their own clinical pathways programs, Amy Schroeder, RPh, and her team conducted proprietary surveys and interviews directly with oncology providers, payers, and other stakeholders to compile direct feedback (page 45). Findings show ways in which stakeholders may better communicate and work together in future.
The Pharma Insights column focuses on decision-makers’ need for transparency and collaboration when it comes to how value is calculated and how individual assumptions affect the final result of the value equation (page 37). Mark T Linthicum, MPP, and coauthors describe how open-source approaches to software development may provide an answer as these models are available in the public domain, including source code, detailed documentation, public feedback, and plans for revision—this iterative development process remains fully transparent while facilitating collaboration.
In the spirit of open dialogue and communication, two Journal of Clinical Pathways (JCP) readers submitted Letters to the Editor for this issue, both in response to the May 2018 JCP Pharma Insights column on value-based contracting. In his letter, Ira Klein, MD, MBA, FACP, provides a reminder of the clinical significance of value-based contracting and why it is good for patients (page 15). Barbara Naydeck, MPH, also responds to this topic, drawing from her past experience as a predictive modeler and analyst to help coordinate care with shared savings to provider groups (page 17).