RadCARE™ Program Manages the Rising Cost of Radiation Therapy

Bluffton, SC (October 27, 2008) – In 2008, over 900,000 cancer patients will undergo radiation therapy in the U.S.  Oncology spending is projected to grow to over $55 billion in 2009.  New and emerging technologies for radiation therapy provide more treatment options, but comprehensive clinical oversight is needed to ensure patients receive safe care that is clinically appropriate and cost effective. Due to the complexity of cancer treatment, health plans are looking for a comprehensive oncology solution to manage both medical and radiation treatments. CareCore National, a specialty benefit management company, has announced an expansion to its oncology line designed to specifically manage radiation therapy treatment. RadCARE^TM is a comprehensive radiation therapy management program that addresses a patient’s specific disease state, stage and treatment goals, while allowing payors to reduce inappropriate medical expenditures associated with radiation therapy.

The growth in the use of treatments such as intensity-modulated radiation therapy (IMRT), IGRT, Gamma Knife®, and Cyber Knife® and the emergence of new technologies such as proton beam therapy and Rapid Arc® has provided more options to treat cancer.  However, while providers are expeditious in adopting these new and emerging technologies, issues related to the use of the appropriate level of technology, its application, safety and overall costs have become major concerns for health insurers.

RadCARE^TM pathways allow the treating radiation oncologist to make use of his or her treatment plan to provide information used to determine the appropriate level of care and reimbursement for radiation therapy services.  The RadCARE^TM Program offers clinicians the necessary flexibility to render appropriate quality care in a timely manner.  It ensures safety by requiring technologies used in radiation therapy to conform to appropriate standards established by a national board of recognized radiation oncologists.

RadCARE^TM builds on CareCore National’s experience in oncology management, through its subsidiary CareCore Oncology, by adopting evidence-based treatment and reimbursement pathways for the administration and billing of radiation therapy services. It is an expansion of CareCore Oncology programs, which assist health plans to develop appropriate drug reimbursement strategies and utilization management programs that are cost-effective and meet national guidelines for appropriate quality oncology care.

For more information on RadCARE^TM, please contact Michael Joslin at 800-918-8924 extension 25030 or Kathleen Oelschlager at 800-918-8921 extension 10114.

About CareCore National, LLC 
CareCore National is a specialty benefit management company that delivers quality and utilization management solutions for radiology, cardiology and oncology services.  Our innovative and quality-driven approach has made us one of the country’s fastest-growing specialty benefits management companies.

Founded in 1994, CareCore National has taken its industry-leading expertise in managing both quality and utilization of outpatient diagnostic studies and added first-in-marketplace management of cardiac imaging, implantable devices, radiation therapy and high cost injectible drugs primarily related to cancer care.  Through our robust product offerings, CareCore National works with health plan clients to improve utilization and enhance quality.  Our expert staff of medical directors and nurses administers the dynamic clinical protocols and innovative approaches needed to deliver first-class specialty benefits management. CareCore National is URAC accredited in Health Utilization Management and certified by NCQA in Utilization Management. For more information, visit www.carecorenational.com.