July 23, 2016 12:32 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

Phone:

800-782-1334

Fax:

617-273-3450

Key Executives for McKesson Health Solutions LLC

Senior Vice President & General Manager, Network and Financial Management
Senior Vice President of Product Generation & Strategy
Managing Director for InterQual - U.K. & Ireland
Chief Technical Officer
Vice President of Human Resources
Compensation as of Fiscal Year 2016.

McKesson Health Solutions LLC Key Developments

McKesson Health Solutions Expands its Portfolio to Include ClarityQx Value-Based Payment Technology

McKesson Health Solutions announced that it has expanded its portfolio to include ClarityQx value-based payment technology through acquisition of HealthQX™. This technology enhances McKesson’s ability to help customers rapidly and cost-effectively transition to value-based care by automating and scaling complex payment models, such as retrospective and prospective bundled payment. Health plans use ClarityQx for analytics and for automation of retrospective bundled payment models and McKesson’s Episode Management ™ to support automation of prospective bundled payment. Pairing ClarityQx with McKesson’s Episode Management gives health plans the ability to automate retrospective bundled payment processes and move to prospective payment as they are ready. Payers and providers are under immense pressure to operationalize bundled payments. Bundled payment is projected to be 17% of medical reimbursement by 2021, making it the fast growing payment model. And the CMS is now mandating bundled payment in one out of every five metropolitan areas2 as part of its goal to make alternative payment 50% of reimbursement by 2018. Yet just half of payers and only 40% of providers are ready to implement bundles, and nearly 75% don’t have the tools they need to automate these complex models3. Now, with the addition of ClarityQx, McKesson can offer health plans a more complete portfolio that can automate their medical policy, payment policy, value-based reimbursement models, provider management, and contract management. In addition to ClarityQx, McKesson’s Network and Financial Management portfolio also includes McKesson Episode Management™prospective bundled payment automation solution, McKesson ClaimsXten™ advanced claims auditing rules engine, McKesson Reimbursement Manager ™, McKesson Contract Manager ™, McKesson Provider Manager ™, and McKesson Payer Connectivity Services ™.

3M Health Information Systems Integrates McKesson InterQual Connect into 3M ClinTrac Product Suite

McKesson Health Solutions announced that InterQual Connect™ is now being integrated with the 3M™ ClinTrac™ Suite. Now providers that use 3M ClinTrac software applications can complete the InterQual® medical review and authorization request within their current workflow, and electronically submit directly from 3M ClinTrac to every payer that has InterQual connectivity, removing the need for phone, fax, or multiple portals. Instead, they can use InterQual Connect’s secure payer connectivity to request an auth and, in most cases, automatically receive the authorization determination right away, without manual work and without leaving 3M ClinTrac. By eliminating manual work and streamlining the authorization request process, providers can drive down administrative costs, make authorizations faster, and improve the patient experience—all while ensuring appropriate care with InterQual’s evidence-based criteria.

McKesson Health Solutions and TriZetto to Integrate Claimsxten and QNXT Systems

McKesson Health Solutions and TriZetto have agreed to integrate McKesson ClaimsXten and ClaimsXten Select clinically-based claims auditing solutions with TriZetto's QNXT enterprise core claim administration system. This latest collaboration between the two market leaders underscores the companies commitment to helping payers of all sizes simplify the management of increasingly complex clinical and reimbursement policies. Health plans are under relentless regulatory and competitive pressure to innovate and scale emerging payment models for improved efficiency and customer experience. Integrating McKesson ClaimsXten and TriZetto QNXT will help payers automate payment and medical policy, simplify management of complex clinical and reimbursement rules, and digitally transform their business through strategic replacement of legacy or homegrown systems. The stringent certification process already in place for the companies previous integrations will ensure the reliability and quality of the interfaces between McKesson ClaimsXten and TriZetto QNXT systems prior to each new release.

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Recent Private Companies Transactions

Type
Date
Target
Merger/Acquisition
July 12, 2016
HealthQx, LLC
 

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