The Pathways Guys

Journal of Clinical Pathways is proud to introduce The Pathways Guys podcast, hosted by Gordon Kuntz and Bryan Loy—a new podcast series exploring the real-world impact of clinical pathways on oncology policy, payment, and practice.

In the launch episode, Gordon and Bryan examine:

• Why payers develop and depend on pathway programs
• How pathways align cost management, quality, and innovation
• The connection between clinical pathways, medical policy, and formularies
• What “quality care” truly means from a payer perspective

Why it matters:

• Pharma market access teams: Understand the framework shaping access and coverage decisions
• Oncology practices: Gain insight into the payer perspective on pathway adoption
• MSLs and product leaders: Strengthen stakeholder conversations with payer-informed context
• Pathway developers: Learn how payers evaluate value and make pathway decisions

Prior auths are almost always approved—but they still create delays, costs, and frustration for oncology practices and patients. In this episode, Bryan Loy and Gordon Kuntz unpack why payers rely on prior authorizations, what they’re really trying to learn that claims can’t show, and where the current system breaks down. As Gordon puts it: “If you ask 100 oncologists about prior authorization… 130 to 150 of them would say they hated it.” They also explore what it would take to reduce burden without losing accountability—especially as value-based care expands.

Oncology is moving steadily toward value-based care—but “total cost of care” is one of the most challenging (and misunderstood) concepts in these arrangements. In this episode of The Pathways Guys, host Gordon Kuntz (provider pathways veteran) and Bryan Loy (payer-side leader) unpack what total cost of care really means, why defining boundaries is so difficult, and how attribution can create unintended consequences.

They explore:

• What to include vs. exclude when measuring “total cost of care”
• Concentric rings of accountability (services billed, ordered, referred, and beyond)
• The tension between utilization vs. unit cost—and lack of provider visibility into pricing
• Care fragmentation risks when incentives aren’t aligned
• Why analytics, trust, and better measurement systems matter
• The patient perspective—and the real fear of “remission and bankruptcy” happening at the same time

Listen now, and subscribe for more conversations at the intersection of pathways, payers, and value-based oncology.