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February 08, 2016 2:51 PM ET

Health Care Technology

Company Overview of McKesson Health Solutions LLC

Company Overview

McKesson Health Solutions LLC develops software solutions for integrated care management that enable payers, providers, and patients to transform the business and process of care. The company’s medical management solutions include InterQual, an evidence-based clinical decision support application; CareEnhance Care Management Workflow Software, a workflow solution for allocating resources, coordinating care, integrating data, and planning interventions; care management services; nurse advise services; Clear Coverage, a point-of-care utilization management, coverage determination, and network compliance platform; Clear Orders, an application that aggregates orders and performs required medical...

275 Grove Street

Suite 1-110

Newton, MA 02466

United States

Founded in 2000

Key Executives for McKesson Health Solutions LLC

Senior Vice President & General Manager, Network and Financial Management
Senior Vice President of Product Generation & Strategy
Senior Vice President and General Manager for Decision Management
Managing Director for InterQual - U.K. & Ireland
Chief Technical Officer
Compensation as of Fiscal Year 2015.

McKesson Health Solutions LLC Key Developments

Rachel Sharp Joins McKesson Health Solutions as Managing Director for InterQual in U.K. and Ireland

Rachel Sharp, a registered clinician with over 20 years of experience in health and social care in the United Kingdom, has joined McKesson Health Solutions as Managing Director for InterQual in the U.K. and Ireland. In her new role, Mrs. Sharp will define regional sales, marketing, and business development strategies for InterQual, McKessons market-leading clinical criteria. She will also help define international third-party distribution, local service support plans, and strategies that expand access to InterQuals product portfolio by provisioners of care in the region. Most recently, as Managing Director at Rachel Sharp Ltd., she provided expert executive counsel on transformation and improving clinical quality and efficiency for a range of health and social care services organizations.

KEPRO Extends Use of InterQual to Support Clinical Excellence in Utilization and Quality Reviews

KEPRO has signed a long-term agreement to continue its use of InterQual® for utilization and quality review across its state Medicaid contracts, Medicare reviews, and other commercial lines. Specifically, KEPRO has renewed its license for all of the InterQual Level of Care, Behavioral Health, and Care Planning Criteria. KEPRO will utilize InterQual evidence-based clinical criteria exclusively for review of two-midnight short stays on behalf of the Centers for Medicare & Medicaid Services (CMS). KEPRO is one of only two Beneficiary and Family Centered Care Quality Improvement Organizations (BFCC-QIOs) charged by CMS to audit short stay claims. KEPRO is the BFCC-QIO for the more than 30 states within CMS Areas 2, 3 and 4. In all its service areas, KEPRO helps identify and coordinate the appropriate care for clients and their members and beneficiaries with acute, chronic and complex conditions across the healthcare continuum. KEPRO is URAC-accredited in case management, health utilization management, and disease management.

McKesson Health Solutions Unveils McKesson ClaimsXten 6.0 and ClaimsXten Select 2.0, its New Solutions in Claims Editing Technology Portfolio

McKesson Health Solutions has unveiled two next-generation solutions in its claims editing technology portfolio: McKesson ClaimsXten 6.0 and ClaimsXten Select 2.0. Designed for payers navigating the transition to value-based models, both ClaimsXten solutions streamline payment and reimbursement policy management to help reduce the cost and complexity of scaling mixed fee-for-service and value-based models. For large health plans, ClaimsXten 6.0 is an enterprise-class solution that automates payment and medical policy and helps simplify management of increasingly complex clinical and reimbursement rules for value-based reimbursement models, with extensive customization abilities and services. ClaimsXten Select 2.0 adapts ClaimsXten's essentials for the unique needs of small to midsize health plans. ClaimsXten Select is available both as SaaS (Software as a Service) or as an on-premise offering. ClaimsXten 6.0 and ClaimsXten Select 2.0 are available immediately. ClaimsXten is integrated with the McKesson Reimbursement Manager pricer and the McKesson Episode Management™ bundled payment solution, as part of a portfolio that supports end-to-end value-based reimbursement.

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