Segment 4: Reimbursement and Clinical Pathways

This segment of the panel discussion takes a closer look at the episode of cost for a patient going to a hospital versus a private office setting. Panelists agree that the cost of hospital care is not that much greater than in the office. “The drug price difference swamps some of the higher charges or fees for the related services,” said Dr. Chernew.

When asked how often UnitedHealthcare revisits its clinical pathways, Dr. Newcomer stated that the National Comprehensive Cancer Network sets them, and United’s policy is to add a recommendation for any major announcement. “It is not a perfect system, but I think as a general rule, they have been quite responsive,” said Dr. Newcomer; “they have anticipated FDA approvals very well, and get those changes made very quickly.”