CareCore National, headquartered in Wappingers Falls, New York, has a great deal of influence in the New York/Tri-State area as an adviser to major healthcare insurance companies such as United Health Care, Oxford, Aetna, and HIP, among others.

When it comes to which imaging facilities are recommended to perform diagnostic imaging procedures, CareCore's assessments carry a great deal of weight, though each individual insurance company can make the final determination.
CareCore's fundamental mission is to help insurance companies control costs by ensuring an accurate diagnosis is achieved the first time - thus helping to avoid repeat procedures and/or poor outcomes. The companies CareCore serves have more than 10 million insured.


The potential problem here -- which IAMERS also recently reported on -- is that if CareCore deems systems that are more than 4 or 5 years old to be "over the hill," then much of the equipment already in the used medical equipment pipeline would be difficult to sell in the greater Tri-State area and Northeast. And if CareCore's policies are adopted by other leading radiology management consulting companies nationwide, the problem will be magnified.

There is some good news, however, to report. This week, DOTmed interviewed one of CareCore's top executives who said the company was seriously considering accrediting imaging facilities on a case-by-case basis, and not applying a blanket standard based on equipment age alone. CareCore acknowledged that older systems which have been upgraded in terms of either hardware, software, or both, can continue to produce quality images that allow for accurate diagnoses. This re-evaluation of qualification standards is slated to be ready at the end of April, 2006.

IAMERS observed, also on a positive note, that Medicare has not adopted any blanket restrictions.

The bottom line is: Imaging centers should keep detailed records of all service performed on any imaging system they own. There is also the opportunity for companies that upgrade systems to pick up more business in the Northeast.

The other bright spot to note here is that there continues to be a healthy international demand for used imaging equipment - and no regulatory changes are on the horizon in this global market.

We will check back with CareCore at the end of April to see what standards are actually put in place.

More Industry Headlines