Mergers and Acquisitions in Clinical Pathways

This time of year brings about holidays, time with family, and time for reflection as we move into a new calendar cycle. For those of us who work in medicine—no matter the specialty or area—it can also be a time for us to consider how best to serve our patients in the new year. New developments within the parameters of clinical pathways and value-based care offer many possibilities, and the current issue of Journal of Clinical Pathways offers a wide scope of where the field stands.

Take, for example, this month’s Conferences section (page 19), which highlights the Association of Community Cancer Centers’ National Oncology Conference. Community oncologists treat the majority of cancer patients in the United States, so they must have their finger on the pulse of trends in patient management and value-based care. Our coverage of the 2017 meeting, which occurred in Nashville last month, includes the launch of a community-focused cancer screening program through Duke University, which aims to reduce cancer disparities; how the role of lay navigators can influence the reduction of cancer costs; and what insight survivors can offer practitioners as they strive to provide better care. You will want to check it out.

This month’s issue also features two columns that address the shifting partnerships between medical management and pharmacy benefit. In his Clinical Pathways GPS column (page 36), Richard G Stefanacci, DO, MGH, MBA, AGSF, CMD, takes a look at CVS pharmacy’s attempts to purchase Aetna Health Plan, which would integrate payers and providers in a manner heretofore unforeseen. Dr Stefanacci considers what effect this will have on managed care in general, and how it might lead to new considerations in price negotiations and value-based purchasing. Elsewhere (page 38), I take a look at Express Scripts’ proposed purchase of eviCore, which could represent a new normal for the industry consolidation of clinical pathways. Many questions remain as to the viability of these partnerships, but to borrow a phrase from Dr Stefanacci, it seems that “atypical players” are here to stay.

A research report written by Ladan Golestanah, MD, MS, and colleagues (page 40) looks at chronic kidney disease (CKD) from both medical and financial perspectives. The researchers identified comorbid conditions that affect the progression of CKD, and also showed how disease progression differed among younger and older patients. They also analyzed how incremental costs of treatment increased as CKD progressed, and their findings offer ways for clinicians to not only manage their patients more effectively from a medical standpoint, but to provide value-based care for both the patient and the health care system. 

Journal of Clinical Pathways continues to provide cutting-edge research and commentary in the area of value-based care. We hope that in all the hullabaloo that comes up toward the end of the year, you can still make time for us!