In the ongoing shift from volume to value in US health care, primary care value-based alternative payment models (APMs), such as accountable care organizations, have dominated the landscape when compared to specialty care APMs. Interviews with hundreds of payers and clinicians across various specialties signal that there are ongoing challenges with investing in, designing, and scaling specialty APMs, especially for populations covered by commercial insurers. Several critical gaps complicate specialty APMs’ business case for these stakeholders, including uncertain returns on investment, lack of understanding around optimal outcome and performance measures, and data silos. Given the persistence of these challenges, which require collaboration between payers and providers on research, transparency, and technical assistance to address, philanthropic support may be a helpful and overlooked resource to support a better enabling environment for specialty APMs.
{"title":"Creating an Enabling Environment for Specialty Alternative Payment Models: A Potential Role for Philanthropy","authors":"Elizabeth Shaughnessy, L. Goh, Joel Ang","doi":"10.25270/jcp.2023.03.03","DOIUrl":"https://doi.org/10.25270/jcp.2023.03.03","url":null,"abstract":"In the ongoing shift from volume to value in US health care, primary care value-based alternative payment models (APMs), such as accountable care organizations, have dominated the landscape when compared to specialty care APMs. Interviews with hundreds of payers and clinicians across various specialties signal that there are ongoing challenges with investing in, designing, and scaling specialty APMs, especially for populations covered by commercial insurers. Several critical gaps complicate specialty APMs’ business case for these stakeholders, including uncertain returns on investment, lack of understanding around optimal outcome and performance measures, and data silos. Given the persistence of these challenges, which require collaboration between payers and providers on research, transparency, and technical assistance to address, philanthropic support may be a helpful and overlooked resource to support a better enabling environment for specialty APMs.","PeriodicalId":73670,"journal":{"name":"Journal of clinical pathways : the foundation of value-based care","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78800049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marjorie Petty, C. Chernecky, Irina Shishkina, Nita J. Maihle, Jean D. Pawl, J. Waller, L. Young, J. Zadinsky
The African American (AA) population has a higher incidence and inferior outcomes in most hematologic malignancies when compared to the non- Hispanic White population. The AA population remains grossly underrepresented in clinical trials, yet few studies have evaluated the underrepresentation in the context of belief in research and willingness to participate in clinical trials. The objectives of this study were to determine if a relationship exists between belief in research and willingness to participate, and to assess the feasibility of recruiting AA patients with hematologic malignancies for cancer clinical trials. The study recruited 31 patients with acute leukemia, lymphoma, myelodysplastic syndrome, and multiple myeloma. Questionnaires were used to assess belief in research, religious coping, and willingness to participate. An oncology nurse navigator assisted with recruitment, obtaining consent, and data collection. Study results showed that 63% of participants believed in clinical trials and were willing to participate, and 74% were not informed of clinical trials. A significant association between education and belief in research (P = .01) was observed, yet no relationship was found between belief in research and willingness to participate. Further studies are warranted to investigate the obstacles to clinical trial participation among this population.
{"title":"Belief in Research, Religious Coping, and Willingness to Participate in Clinical Trials Among African American Patients With Hematologic Malignancies: A Pilot Study","authors":"Marjorie Petty, C. Chernecky, Irina Shishkina, Nita J. Maihle, Jean D. Pawl, J. Waller, L. Young, J. Zadinsky","doi":"10.25270/jcp.2023.01.01","DOIUrl":"https://doi.org/10.25270/jcp.2023.01.01","url":null,"abstract":"The African American (AA) population has a higher incidence and inferior outcomes in most hematologic malignancies when compared to the non- Hispanic White population. The AA population remains grossly underrepresented in clinical trials, yet few studies have evaluated the underrepresentation in the context of belief in research and willingness to participate in clinical trials. The objectives of this study were to determine if a relationship exists between belief in research and willingness to participate, and to assess the feasibility of recruiting AA patients with hematologic malignancies for cancer clinical trials. The study recruited 31 patients with acute leukemia, lymphoma, myelodysplastic syndrome, and multiple myeloma. Questionnaires were used to assess belief in research, religious coping, and willingness to participate. An oncology nurse navigator assisted with recruitment, obtaining consent, and data collection. Study results showed that 63% of participants believed in clinical trials and were willing to participate, and 74% were not informed of clinical trials. A significant association between education and belief in research (P = .01) was observed, yet no relationship was found between belief in research and willingness to participate. Further studies are warranted to investigate the obstacles to clinical trial participation among this population.","PeriodicalId":73670,"journal":{"name":"Journal of clinical pathways : the foundation of value-based care","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85241900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Claudia L Campos, Cristina Nguyen, Kristina Crothers, Omar Awan, Francis J Miller, Courtney Sedillo, Johnson Vachachira, Carrie B May, Allison M Gustavson, Jacob B Lindheimer
The Department of Veterans Health Affairs (VHA) has launched 22 multispecialty post-COVID-19 clinics across the US for the growing number of veterans experiencing long-term sequelae after acute COVID-19 infection. While evidence-based treatments for this syndrome are under investigation, there is a critical need to establish and disseminate clinical pathways (CPWs) based on knowledge and experience gained in those clinics. This VHA CPW is intended to guide primary care clinicians who care for patients experiencing dyspnea and/or cough during post-COVID-19 syndrome (PCS), which includes symptoms and abnormalities persisting or present beyond 12 weeks of the onset of acute COVID-19. This effort will help guide and standardize the care of veterans across the VHA, improve health outcomes, and effectively utilize health care resources. This article summarizes our stepwise diagnostic approach for patients presenting with PCS dyspnea and/or cough in primary care; it also highlights teleconsultation and telerehabilitation as opportunities to reach those in rural areas or with transportation barriers and improve reach for specialized services.
{"title":"Post-COVID-19 Syndrome Clinical Pathway for the US Veterans Health Administration.","authors":"Claudia L Campos, Cristina Nguyen, Kristina Crothers, Omar Awan, Francis J Miller, Courtney Sedillo, Johnson Vachachira, Carrie B May, Allison M Gustavson, Jacob B Lindheimer","doi":"10.25270/jcp.2023.01.02","DOIUrl":"10.25270/jcp.2023.01.02","url":null,"abstract":"<p><p>The Department of Veterans Health Affairs (VHA) has launched 22 multispecialty post-COVID-19 clinics across the US for the growing number of veterans experiencing long-term sequelae after acute COVID-19 infection. While evidence-based treatments for this syndrome are under investigation, there is a critical need to establish and disseminate clinical pathways (CPWs) based on knowledge and experience gained in those clinics. This VHA CPW is intended to guide primary care clinicians who care for patients experiencing dyspnea and/or cough during post-COVID-19 syndrome (PCS), which includes symptoms and abnormalities persisting or present beyond 12 weeks of the onset of acute COVID-19. This effort will help guide and standardize the care of veterans across the VHA, improve health outcomes, and effectively utilize health care resources. This article summarizes our stepwise diagnostic approach for patients presenting with PCS dyspnea and/or cough in primary care; it also highlights teleconsultation and telerehabilitation as opportunities to reach those in rural areas or with transportation barriers and improve reach for specialized services.</p>","PeriodicalId":73670,"journal":{"name":"Journal of clinical pathways : the foundation of value-based care","volume":"9 1","pages":"22-28"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10288636/pdf/nihms-1889898.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9712503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stephen Hamilton, Kathryn C. Christensen, Margaret Rausa, N. Andrews, T. Dollear, Christopher Linkimer, Eric J. Gratias
{"title":"Improving Biosimilar Adoption Rates and Affordability With Oncology Pathways","authors":"Stephen Hamilton, Kathryn C. Christensen, Margaret Rausa, N. Andrews, T. Dollear, Christopher Linkimer, Eric J. Gratias","doi":"10.25270/jcp.2022.09.2","DOIUrl":"https://doi.org/10.25270/jcp.2022.09.2","url":null,"abstract":"","PeriodicalId":73670,"journal":{"name":"Journal of clinical pathways : the foundation of value-based care","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77281316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Gill, J. Baumgartner, Jesse A. Gygi, Mckenzie Bell, L. Petersen, B. Crawford, Zoya Sandhu, B. Barney, J. Tward
{"title":"Incidence and Cost of Radical Prostatectomy and Radiotherapy for NCCN Low-risk Prostate Cancer in Utah","authors":"D. Gill, J. Baumgartner, Jesse A. Gygi, Mckenzie Bell, L. Petersen, B. Crawford, Zoya Sandhu, B. Barney, J. Tward","doi":"10.25270/jcp.2022.03.4","DOIUrl":"https://doi.org/10.25270/jcp.2022.03.4","url":null,"abstract":"","PeriodicalId":73670,"journal":{"name":"Journal of clinical pathways : the foundation of value-based care","volume":"120 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77888886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yasmine Anouty, Ila M. Saunders, Shanna Block, Katherine Medley, Rabia S. Atayee, Megan Wall, Alison Wall, C. Mulroney, Janine G Martino
{"title":"Factors Associated With Poor Outcomes in Patients who Receive Cancer Directed Therapy at the End of Life","authors":"Yasmine Anouty, Ila M. Saunders, Shanna Block, Katherine Medley, Rabia S. Atayee, Megan Wall, Alison Wall, C. Mulroney, Janine G Martino","doi":"10.25270/jcp.2022.02.2","DOIUrl":"https://doi.org/10.25270/jcp.2022.02.2","url":null,"abstract":"","PeriodicalId":73670,"journal":{"name":"Journal of clinical pathways : the foundation of value-based care","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80499913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniel Mettman, Michael Goodman, Joseph R. Modzelewski, L. Verkruyse, Susie Willis, Janet Barrett, R. Hoyt, Maryam Abdo, Hanan S. Elsarraj, S. Mathur
{"title":"Streamlining Institutional Pathway Processes: The Development and Implementation of a Pathology Molecular Consult to Facilitate Convenient and Efficient Ordering, Fulfillment, and Reporting for Tissue Molecular Tests","authors":"Daniel Mettman, Michael Goodman, Joseph R. Modzelewski, L. Verkruyse, Susie Willis, Janet Barrett, R. Hoyt, Maryam Abdo, Hanan S. Elsarraj, S. Mathur","doi":"10.25270/jcp.2022.02.1","DOIUrl":"https://doi.org/10.25270/jcp.2022.02.1","url":null,"abstract":"","PeriodicalId":73670,"journal":{"name":"Journal of clinical pathways : the foundation of value-based care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89834858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elizabeth Oyekan, M. Hennessey, D. Galante, Cynthia Miller, Jorge Font
{"title":"Bringing Social Determinants of Health to Life to Optimize Health Outcomes in Patients With Chronic Conditions","authors":"Elizabeth Oyekan, M. Hennessey, D. Galante, Cynthia Miller, Jorge Font","doi":"10.25270/jcp.2022.02.3","DOIUrl":"https://doi.org/10.25270/jcp.2022.02.3","url":null,"abstract":"","PeriodicalId":73670,"journal":{"name":"Journal of clinical pathways : the foundation of value-based care","volume":"749 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76858832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-15DOI: 10.25270/jcp.2021.0708.2
Allison Kupsh, L. Alwan, E. Segal, Kate Trieselmann, Evan T. Hall
{"title":"Anticipated Cost Savings with Alternate Dosing Schema of Nivolumab/Ipilimumab for the Treatment of Metastatic Melanoma","authors":"Allison Kupsh, L. Alwan, E. Segal, Kate Trieselmann, Evan T. Hall","doi":"10.25270/jcp.2021.0708.2","DOIUrl":"https://doi.org/10.25270/jcp.2021.0708.2","url":null,"abstract":"","PeriodicalId":73670,"journal":{"name":"Journal of clinical pathways : the foundation of value-based care","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73747970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-15DOI: 10.25270/jcp.2021.0708.1
A. Feu, Q. Cai, E. Brouwer, C. Pericone, K. Woodruff
{"title":"Treatment and Outcomes Among Hospitalized COVID-19 Patients With Immune-mediated Inflammatory Diseases: An Electronic Health Record Database Cohort Study","authors":"A. Feu, Q. Cai, E. Brouwer, C. Pericone, K. Woodruff","doi":"10.25270/jcp.2021.0708.1","DOIUrl":"https://doi.org/10.25270/jcp.2021.0708.1","url":null,"abstract":"","PeriodicalId":73670,"journal":{"name":"Journal of clinical pathways : the foundation of value-based care","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85619691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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