What question did this study set out to answer?

To determine the extent of compliance with payer-led oncology clinical pathways and identify patient-, physician-, and practice-level characteristics associated with adherence.

May 9, 2023JAMA Network OpenOpen Access

Association of Patient, Physician, and Practice-Level Factors with Uptake of Payer-Led Oncology Clinical Pathways

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Authors

SMSamyukta MullangiOpen Society XCXiaoxue ChenSun Yat-sen University TPTimothy PhamAugusta University

Discussion

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Implication

Cohort study reveals 64.0% compliance with payer-led oncology clinical pathways in adults with metastatic cancer, highlighting practice- and physician-level influences on adherence.

Key Points

To determine the extent of compliance with payer-led oncology clinical pathways and identify patient-, physician-, and practice-level characteristics associated with adherence.
Cohort study analyzing administrative claims data from a national insurer and clinical pathways vendor from July 1, 2018, to October 31, 2021.
Included 17,293 adult patients receiving first-line systemic therapy for metastatic breast, lung, colorectal, pancreatic, melanoma, kidney, bladder, gastric, or uterine cancer with 6 months continuous prior insurance coverage.
Evaluated pathway compliance using multivariable stepwise logistic regression to identify independent predictors of on-pathway prescribing.
Overall pathway compliance was 64.0% (11,071 of 17,293 patients on-pathway vs 6,222 [36.0%] off-pathway), with compliance rates trending downward after 2018.
Increased pathway compliance was associated with baseline inpatient visits (aOR, 1.32; 95% CI, 1.22-1.43; P < .001), insurer-specific patient volume per physician (aOR, 1.12; 95% CI, 1.04-1.20; P = .002), and Oncology Care Model participation (aOR, 1.13; 95% CI, 1.04-1.23; P = .004).
Higher baseline medical costs were significantly associated with decreased pathway compliance (mean [SD], $55,990 [$69,706] vs $65,955 [$74,678]; aOR, 0.86; 95% CI, 0.83-0.88; P < .001).

Cite This Study

Mullangi et al. (2023) studied this question.

synapsesocial.com/papers/6a894f8bb1e5d05ea8ec69b4 https://doi.org/10.1001/jamanetworkopen.2023.12461

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Implication

Cohort study reveals 64.0% compliance with payer-led oncology clinical pathways in adults with metastatic cancer, highlighting practice- and physician-level influences on adherence.

Association of Patient, Physician, and Practice-Level Factors with Uptake of Payer-Led Oncology Clinical Pathways

Discussion

Member takes

Implication

Key Points

Cite This Study

Association of Patient, Physician, and Practice-Level Factors with Uptake of Payer-Led Oncology Clinical Pathways

Discussion

Member takes

Implication

Key Points

Cite This Study

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