BLUFFTON, S.C. & PITTSBUGH--(BUSINESS WIRE)-- To improve quality and contain rising costs in cancer care, CareCore National and D3, an affiliate of UPMC, have formed a new company to accelerate implementation of cancer care pathways.
PathForward Oncology, the new company, will offer cancer care pathways developed at UPMC to health insurers and their oncology networks nationwide. Pathways are evidence-based clinical algorithms that standardize best practices for chemotherapy-based treatment and related services.
CareCore, one of the nation’s leading specialty benefits management companies with proven care-management systems expertise, will enable oncologists to access the pathways at the point of patient care via an online care management platform. This software delivers pathways decision support to the physician’s desk and opens the door to fully integrated digital data exchange, enabling the physician to consider available clinical and cost information when making care decisions.
“With the experience and expertise that CareCore brings through its 15-year history of working with health insurers, we expect to greatly enhance the scope and speed of implementing the cancer care pathways,” said Kathy Lokay, senior vice president of commercial oncology services at UPMC and president of D3, a for-profit company in which UPMC holds a minority interest. “Partnering with CareCore increases our ability to bring payers and providers to the table to work together on a new model for improving the quality and value of cancer care.”
“Cancer care requires a different approach to cost and quality management than the models typically used in health care. The path to continuing quality improvement and sustainable cost control in cancer care is to change the patient care process at the point of care,” said Richard Weininger, M.D., medical director for oncology services at CareCore. “UPMC’s pathways have been proven to reduce unwarranted variability in care at UPMC Cancer Centers and the other oncology groups that have adopted them. They fit perfectly with the CareCore approach to evaluating, supporting and managing episodes of care as distinct from individual services.”
UPMC’s cancer care pathways were developed over the past five years by UPMC and are regularly updated by oncologists who have adopted them in Pennsylvania, Texas, Florida and New Jersey. Sixteen disease-specific committees of academic and community-based physicians review and update the pathways on a quarterly basis, based on their evaluation of the latest clinical literature. Through this effort, a single, best treatment is identified for approximately 80 percent of patient presentations. These treatments are based upon reviewing the research first for the most effective, then the least toxic and, finally, all other factors being equal, the most cost-effective option.
“By standardizing care and driving to the best, evidence-based treatments, we’ve been able to demonstrate not only better care, but also a reduction in the total cost of care compared to practices without the pathways,” noted Peter Ellis, M.D., medical director for the UPMC pathways program and a practicing medical oncologist at UPMC Cancer Centers.
PathForward Oncology is expected to begin operations in the first quarter of 2011.
About CareCore National
CareCore National, LLC (www.carecorenational.com) is the nation’s largest specialty benefits management company. It has been in business since 1994, at which time it began to offer services for radiology benefit management only. Since that time it has developed programs and management specific technology in cardiology, medical oncology, radiation oncology, pain management, sleep apnea, lab services, and, in 2011, musculoskeletal services. CareCore currently contracts with more than 25 health plans with over 50 million insureds. The company is headquartered in Bluffton, SC and has more than 1000 employees.
UPMC is an $8 billion global health enterprise with almost 50,000 employees headquartered in Pittsburgh, Pa., and is transforming health care by integrating 20 hospitals, 400 doctors’ offices and outpatient sites, a health insurance services division, and international and commercial services. Affiliated with the University of Pittsburgh Schools of the Health Sciences, UPMC is redefining health care by using innovative science, technology and medicine to invent new models of accountable, cost-efficient and patient-centered care. For more information on how UPMC is taking medicine from where it is to where it needs to be, go to www.upmc.com.
D3 has been a trusted source of innovative products, technical expertise and industry knowledge in oncology since 2001. The Via Oncology division of D3 offers Radiation and Medical Oncology Pathways to oncology practices across the globe through its proprietary Pathways Portal, allowing programs to prove their quality and value in the marketplace and be leaders in healthcare reform. The D3 Radiation Oncology Solutions division offers unmatched expertise in support of advanced radiation oncology from flexible options for equipment commissioning, treatment planning and hands-on clinical training as well as quality assurance and peer reviews to prepare programs for accreditation. For more information, please access D3’s websites at www.d3rad.com and www.viaoncology.com or call (412) 365-0710.
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