July 28, 2017 9:54 AM 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
Managing Director for InterQual - U.K. & Ireland
Chief Technical Officer
Vice President of Human Resources
Compensation as of Fiscal Year 2017.

McKesson Health Solutions LLC Key Developments

McKesson Health Solutions unveils ClaimsXten™ Policy Management

McKesson Health Solutions unveiled ClaimsXten™ Policy Management, an exciting new clinical and payment management solution that helps payers cut costs and improve first pass payment accuracy by streamlining and automating advanced policy rules and clinically sourced edits. ClaimsXten’s Policy Management Module (PMM) is a single-rule framework that can be layered into a multitude of policies, providing an enterprise foundation for streamlining the creation, deployment and maintenance of a wide variety of policies and edits. Payers can use PMM to address edits as early as possible in the adjudication cycle, and they can enable advanced policy designs not just medical policies including compliance and payment policies, special investigation requirements, and more. As the industry transforms to value-based reimbursement (VBR), health plans are under tremendous pressure to innovate faster, comply with new regulations quickly, and ensure accurate payment to providers. In just two years, payers expect 47% of providers to be in value-based payment arrangements, rising to 60% in five years. But as payers try to scale VBR, they are finding existing systems aren’t nimble enough to keep up with this intense pace of change. ClaimsXten’s PMM facilitates the move to VBR by helping health plans swiftly respond to market and regulatory changes. Complex policy changes that used to take four to six months to implement can now be created, deployed, and updated in just weeks. Finally, health plans can respond with the dexterity needed to compete in today’s dynamic healthcare marketplace, while lowering administrative overhead and medical costs. Most important, ClaimsXten’s PMM helps promote fast, accurate payment on the “first pass,” dramatically reducing the potential for retrospective recovery, third-party audits, and appeals—not to mention helping foster more collaborative relationships with providers. ClaimsXten’s PMM is available now.

McKesson Health Solutions Unveils McKesson Intelligence Hub, a New Technology Platform

McKesson Health Solutions (MHS) unveiled the McKesson Intelligence Hub, a new technology platform for enabling interoperability and sharing business intelligence among healthcare applications. The result of a multi-year development program, the Intelligence Hub is designed to connect MHS's portfolio of automated reimbursement solutions and help streamline payment by making interoperability easy for customers, partners, and vendors across the healthcare ecosystem. McKesson's strategic investment in the Intelligence Hub, a contemporary platform built on open standards, makes it easy for solutions to work together, as well as with customers' systems and third-party solutions. The Intelligence Hub is thoughtfully designed to help payers and providers extend the life and enhance the value of their existing core system investments, while helping customers innovate faster to achieve their strategic goals. Engineered using open industry communication standards such as HL7 FHIR, the Intelligence Hub makes it easy to connect applications, services, and systems quickly to meet strategic business objectives. Several McKesson solutions are already connected through the Intelligence Hub, where they simplify and automate payment through smart shared services that exchange information and unify business processes across payer, provider, and technical boundaries. Moreover, the Intelligence Hub can help customers integrate across McKesson's application and services portfolio, as well as in and across third-party and vendor environments. In fact, a number of McKesson customers are now using the Intelligence Hub to connect corporate applications with McKesson services. For IT leaders, the technical muscle behind the Intelligence Hub is McKesson's core foundational technology for cloud services. The Intelligence Hub provides consistent API management, identity and access management, and application service orchestration within a PaaS (Platform as a Service) engineered around an Enterprise Service Bus (ESB). This open framework fosters integration between McKesson's applications and, equally important, near plug-and-play component and services integration between McKesson's solutions and customers' applications. The result: healthcare interoperability with little to no custom coding required. The Intelligence Hub will also be capable of providing real-time analytics to help IT teams know how their applications are working and using shared services, so systems can be optimized for the higher cost efficiency and performance.

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 ™.

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