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October 10, 2015 7:16 AM ET

Health Care Technology

Company Overview of McKesson Health Solutions LLC

Company Overview

McKesson Health Solutions LLC provides 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 necessit...

275 Grove Street

Suite 1-110

Newton, MA 02466

United States

Founded in 2000

Key Executives for McKesson Health Solutions LLC

Age: 53
Chief Financial Officer
Senior Vice President of Products Division
Senior Vice President of Product Generation & Strategy
Senior Vice President and General Manager for Decision Management
Compensation as of Fiscal Year 2015.

McKesson Health Solutions LLC Key Developments

McKesson Health Solutions Announces Quality Health Associates of North Dakota Signs Long-Term Agreement

McKesson Health Solutions announced that Quality Health Associates of North Dakota has signed its first long-term agreement to use InterQual for all Medicaid utilization and quality reviews in North Dakota. Quality Health Associates has licensed all of the InterQual Level of Care Criteria and Behavioral Health Criteria, as well as InterQual Procedures, Imaging, DME, and Molecular Diagnostics Care Planning Criteria. Quality Health Associates also invested in InterQual training, a program taught by McKesson's clinical educational consultants, all of whom are Registered Nurses with experience in case management and utilization management. McKesson noted that InterQual evidence-based criteria help improve clinical decision-making across the medical and behavioral health continuums of care. The InterQual clinical development team synthesizes the most current, best evidence into a fully referenced decision support tool that is reviewed and updated annually. InterQual's development process, honed over nearly 40 years, is founded on rigorous review of the literature, and includes extensive peer review by practicing clinical experts across the United States.

Centers for Medicare & Medicaid Services Extends Contract with McKesson Health Solutions

McKesson Health Solutions reported that the Centers for Medicare & Medicaid Services (CMS) renewed its agreement to use InterQual Criteria for its Medicare services auditing programs, an extension of a 15-year relationship. Buccaneer, a part of General Dynamics Information Technology, administers the contract on behalf of CMS. Through the renewed agreement, CMS can access the entire spectrum of InterQual Criteria products to support quality oversight, utilization review and appeals decisions. According to a release, Quality Improvement Organizations (QIOs), Medicare Fiscal Intermediaries, Medicare Administrative Contractors (MACs), Administrative Law Judges and various CMS departments are using the InterQual 2015 release, the latest edition of the company's decision support solution. A key enhancement for 2015 includes the industry's first admissions criteria to include assessment of comorbidity, as well as the addition of 55 new and enhanced evidence-based clinical content areas--to help ensure payers and providers have the most current, best evidence for improved decisions across the continuum of care. The InterQual Criteria is delivered to CMS and its contractors via InterQual Online Anonymous Review, a McKesson-hosted solution that allows users to input and save reviews without exposing patient-identifying information.

McKesson Health Solutions' New McKesson Benchmark Analytics Service Gives Payers Actionable Insights into Claims Performance

McKesson Health Solutions introduced McKesson Benchmark Analytics(TM), a new service that helps health plans compare their performance to industry peers and use outlier analysis to discover ways to optimize performance. Payers can see how their performance compares to peers with respect to provider outliers, facility-based spend and service cost. The breadth and reach of the data allows plans to discover insights beyond their own claims data that might otherwise be missed. The McKesson Benchmark Analytics' dataset is updated every quarter and is HIPAA and HITECH compliant. It includes multiple claim types (professional, outpatient and inpatient facility) and aggregates statistically significant data sampling distributions across all four regions of the United States, as well as across commercial, Medicare and Medicaid lines of business. Payers can choose any one or all of three available benchmarking packages: Provider Outlier Analytics(TM), Facility Outlier Analytics(TM) and Service Outlier Analytics(TM). Every package includes analysis from McKesson experts and dashboard-style reports on a regular basis (quarterly or annual) as needed. McKesson Benchmark Analytics are available to all health plans regardless of whether or not they license McKesson payment integrity software solutions such as ClaimCheck(R) or ClaimsXten(TM).

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