McKesson Total Payment 5.1 Helps Payers Manage the Complexity of Value-Based Reimbursement

  McKesson Total Payment 5.1 Helps Payers Manage the Complexity of Value-Based

Latest Release Paves the Way for Innovative Payment Strategies While
Supporting Waste, Abuse and Fraud Detection

Business Wire

NEWTON, Mass -- June 25, 2013

McKesson has debuted the latest version of its claims payment optimization
technology, the McKesson Total Payment™ platform, as part of its ongoing
commitment to helping payers and providers navigate the complexities of
healthcare reform. Enhancements in version 5.1 help payers more easily
collaborate with providers in the transition to value-based reimbursement
strategies, such as bundled payments for episodes of care. The latest version
also extends a payer’s ability to identify and prevent waste, abuse and fraud.

“Payers are looking for flexible solutions that allow them to test and scale
new reimbursement methods consistent with healthcare reform initiatives. At
the same time, they understand that fee-for-service payment will continue to
be part of the reimbursement equation for the foreseeable future,” said Mike
Flanagan, associate vice president, Product Management, McKesson Health
Solutions. “Through some key integrations with synergistic products in our
portfolio, McKesson Total Payment can help health plans efficiently and
accurately automate combinations of reimbursement methods, no matter how
multifaceted and complex their policies and contractual arrangements might be.
Doing so will help improve provider satisfaction and lower medical and
administrative costs.”

The McKesson Total Payment platform provides the technical foundation for two
of the company’s Financial Management solutions: ClaimsXten™, which provides
clinically based claims auditing for payment accuracy, and McKesson Episode
Management™, which supports full-scaled bundled payment programs. New
integrations help ClaimsXten and McKesson Episode Management combine to
enhance the capabilities of core claims processing systems, enabling them to
automate payment to providers for different risk-sharing arrangements and
complex benefit designs.

The McKesson Total Payment platform’s advanced technology framework and
intelligent rules engine can process both fee-for-service and bundled payment
claims simultaneously — including correct pricing via McKesson Reimbursement
Manager™. Edited claims can then pass through McKesson’s predictive analytics
engine in InvestiClaim^®, an enterprise-level waste, abuse and fraud
management system, to identify aberrant billing activity. The result is more
accurate and automated claims payment, no matter how complex the payment and
medical policies and provider contract terms.

Key enhancements in the new version include the following:

  *Bundled payment program. McKesson Episode Management capabilities have
    been expanded to fully support an automated approach to bundled payment
    programs. This release helps automate claim operations by identifying,
    reconciling and paying claims that are part of a bundled payment
    arrangement. In addition, interactive dashboards allow plans to manage an
    overall bundled payment program and share actionable information with
    providers participating in the program.
  *Improved payment integrity. As payment complexity increases and the
    industry transitions to ICD-10, payers are not only challenged to pay
    claims correctly but also to detect waste, abuse and fraud. This is adding
    administrative stress to already overburdened organizations, and
    potentially exacerbating adversarial relations between payers and
    providers. Integration of the McKesson Total Payment platform with
    InvestiClaim can help users address this intensifying challenge.
    InvestiClaim partners pre-pay clinical editing rules and pre- and post-pay
    predictive analytics to help avoid a higher volume of wasteful and abusive
    claims up front and make fraud recovery efforts more efficient on the back

For more information on McKesson Health Solutions, please visit our Web site,
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About McKesson Corporation

McKesson Corporation, currently ranked 14th on the FORTUNE 500, is a
healthcare services and information technology company dedicated to making the
business of healthcare run better. We partner with payers, hospitals,
physician offices, pharmacies, pharmaceutical companies and others across the
spectrum of care to build healthier organizations that deliver better care to
patients in every setting. McKesson helps its customers improve their
financial, operational, and clinical performance with solutions that include
pharmaceutical and medical-surgical supply management, healthcare information
technology, and business and clinical services. For more information, visit us


McKesson Health Solutions
Cara Wood, 617-273-2859
Public Relations
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