With multiple pathways and stakeholders involved, there needs to be an arbiter who decides what is the highest quality and highest value care in oncology, said Lucy Langer, MD, MSHS, national medical director, oncology and genomics, UnitedHealthcare.
With multiple pathways and stakeholders involved, there needs to be an arbiter who decides what is the highest quality and highest value care in oncology, said Lucy Langer, MD, MSHS, national medical director, oncology and genomics, UnitedHealthcare.
Transcript
When looking at value-based care, who should decide what value really is?
One of the things I'm going to talk about this evening is drug pathways. There are many drug pathways out there. There are provider pathways, there are payer pathways, and then there's the NCCN [National Comprehensive Cancer Network] preferred pathways. And they're all different.
They do have areas of overlap, but they're all different. And when 3 major players in the health system and in oncology can't agree on pathways, at some point, you have to decide who's the ultimate arbiter of the pathways and decide: are we going to go with that group's pathways to help promote highest quality, highest value care? We're going to talk about that a little bit. I think it raises more questions than answers.
My personal philosophy is that the practicing oncologist should be the one who determines what's best for the patient. For groups like Rocky Mountain Cancer Centers, who are hosting tonight's event, I have no qualms whatsoever about them being the arbiter of what's best. But in my role at UnitedHealthcare—having been in this seat now for a year—I can say the variability in quality and integrity in selection of regimens is vast across the United States.
While here in Colorado, we may not have so much of an issue, from a national perspective, we're trying to thread that needle and figure out how do we best promote highest quality care for value contracting.
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