Evolving Pathways: How Stakeholder Collaboration is Shaping the PCC Model
At CPC+CBEx 2025, Carole Tremonti, RN, MBA, discusses how the Predictable Cost of Care initiative evolved from expanding stakeholder engagement to advancing data transparency and real-world model testing, marking a pivotal shift toward truly data-driven clinical decision-making.
How did the goals and stakeholder engagement strategies evolve from Phase 1 to Phase 2 of the Predictable Cost of Care (PCC) model development?
Carole Tremonti, RN, MBA: It was very exciting to transition from Phase 1 to Phase 2 and to have that opportunity and excitement that built off the 2024 Clinical Pathways Cancer Business Exchange Conference. We had such fantastic feedback and ideas on how we could move the model forward. The element that was really critical for us to include was to be able to expand the membership of our advisory group and our stakeholders to expound upon multiple pharmaceutical companies.
We wanted to be sure that we were very democratic and that we were involving as many critical voices that are affected by these decisions from pathway developers as possible. Bringing together a more robust group of pathway developers and representatives from the pharmaceutical industry has strengthened the perspective of both sides of the equation, as well as brought greater insights and precision into the work we're moving forward.
Can you walk us through a pivotal learning from Phase 1 that significantly reshaped your approach in Phase 2?
Tremonti: The most important thing we learned from Phase 1 to Phase 2 that we needed to bring forward and adapt was on data availability. This is the biggest challenge—not just how the data was structured, not just the variables of the data that we needed, but how we could have open access to use data that was equitable across all end users of the model that we developed.
This has been our biggest challenge, but also our greatest opportunity. We've been able to see that there are barriers on both sides to transparency and data sharing, and that is an obstacle that we're actively working through.
What measurable impact has the PCC initiative had so far?
Tremonti: The greatest impact, and also the most exciting impact, is watching the real model take place. In our first iteration of our Predictable Cost of Care Working Group, we defined the parameters that needed to go into the model; however, defining them and building a model are two very, very big chasmic tasks.
In the Predictable Cost of Care Working Group part 2, now we have the model elements. We have now built the variables that will be relevant, and we're ready to test the model in a real-world data set.
What have been your biggest takeaways from CPC+CBEx 2025?
Tremonti: This has been a fantastic conference, and an evolution of every single year prior to this one. What we've focused on now is not just the importance of pathways, because that's always the fundamental base concept that we are all coming to this conference to discuss, but how the exterior of the world of health care are really bringing an impact.
Those are the ways in which we are having federal changes to Medicaid and Medicare; we're talking about how that will impact treatment decision-making. In addition, how does technology play a role in pathway development and in the way providers see and interpret data and treatment decisions? It's a wonderful transition for us—from going from the old way of developing and thinking through pathways to a model in which we are making clinical decisions that are data-driven.
