Detailed, evidence-based regimens for providers in cancer care. Health care professionals, learn how you can participate in the Cancer Therapy Pathways Program today.
Care providers can help enhance quality and value in cancer care, and earn rewards, through our Cancer Therapy Pathways program. Cancer Therapy Pathways are detailed, evidence-based regimens associated with better clinical outcomes that we’ve selected through rigorous evaluation for specific cancer types and states.
Explore the full list of the cancer therapy pathways and regimens
Review the eligibility and reward information. Then, submit a new prior authorization request and select the appropriate regimen. Track your participation in the Optum® Cancer Guidance Program (CGP) tool.
Submit your prior authorization requests for chemotherapy or related therapies through the CGP tool for patients who are UnitedHealthcare Community Plan, UnitedHealthcare Medicare Advantage or UnitedHealthcare commercial plan members. Providers in all states are eligible to use our Cancer Therapy Pathways.
Note: Pathway selection isn't required to receive prior authorization approval for therapy.
The rewards program is currently only available for participating commercial plans.*
We’ll pay you $1,000 cash for each pathway regimen you follow. You must achieve the following in the 6-month measurement period (January–June and July–December):
A pathway adherence of at least 75%
A minimum of 5 prior authorizations
*Excludes Hawaii, North Carolina, Puerto Rico and the U.S. Virgin Islands. Contract amendment required to receive program rewards in California, Delaware, Maryland, Massachusetts, New Jersey, New York, Pennsylvania, Rhode Island, Virginia, Washington and West Virginia. For all eligibility information, please see the Cancer Pathways Program: Terms and Conditions.
How we develop the pathways
We use a comprehensive literature review of all National Comprehensive Cancer Network (NCCN)-recommended regimens.
We select regimens by efficacy, safety/toxicity and medication drug cost, which we only review when efficacy and safety between regimens are comparable. We also use our member data to better understand the typical duration of therapy, hospitalization rates and total cost of care.
The UnitedHealthcare Oncology Advisory Committee and disease-specific expert consultants review and evaluate each therapy pathway. We select the members of this committee for their clinical expertise and diverse perspectives. The Committee includes practicing medical oncologists from academic medical centers and community oncology practices.