Milliman Care Guidelines Announces License Agreement with Health Care Service Corporation.SEATTLE -- Integration of Multiple Products Promotes Quality of Care with Evidence-Based Guidelines Milliman Care Guidelines, a division of Milliman, today announced the decision to license its evidence-based clinical guidelines, the Milliman Care Guideline(R) to Health Care Service Corporation (HCSC HCSC Higher Command and Staff Course (educational Course run at the Joint Services Command & Staff College, Shrivenham, UK) HCSC Here Comes Santa Claus ). The agreement gives Blue Cross Blue Shield Blue Shield A US not-for-profit health care insurer that is a reimbursement intermediary for physicians. Cf Blue Cross. of Illinois and Blue Cross Blue Shield of New Mexico New Mexico, state in the SW United States. At its northwestern corner are the so-called Four Corners, where Colorado, New Mexico, Arizona, and Utah meet at right angles; New Mexico is also bordered by Oklahoma (NE), Texas (E, S), and Mexico (S). , divisions of HCSC, access to several Care Guidelines products, some of which are fully integrated with their software systems by MEDecision. The management of healthcare in these two plans is backed by nationally recognized, evidence-based clinical guidelines. Products licensed include, Ambulatory Care ambulatory care n. Medical care provided to outpatients. ambulatory care, n the health services provided on an outpatient basis to those who can visit a health care facility and return home the same day. , Inpatient inpatient /in·pa·tient/ (in´pa-shent) a patient who comes to a hospital or other health care facility for diagnosis or treatment that requires an overnight stay. in·pa·tient n. and Surgical Care, Recovery Facility Care, Home Care and General Recovery Guidelines, which includes Long Term Acute Care and chronic care management guidelines. Also licensed are CareGuideQI(R), CarePC(R), CareWeb(TM), and a web transaction module. Milliman Care Guidelines' CareGuideQI is integrated with MEDecision's CarePlanner Advanced Medical Management for greater user efficiency, improved consistency, and variance reporting. The web transaction module is integrated with MEDecision's Transactioning and Automated Authorizations to further reduce administrative costs administrative costs, n.pl the overhead expenses incurred in the operation of a dental benefits program, excluding costs of dental services provided. for the health plan and participating facilities through automation. Chronic care management guidelines are utilized to provide sophisticated identification of high-risk enrollees that might benefit from additional intervention from the health plans. Enhancing quality of care while controlling costs to maximize premium value places difficult pressure on care management operations. The integration creates an automated process that decreases administrative costs and helps to secure patient safety. Value of Integration Several factors make each product intrinsically valuable, but when used collectively, the information derived and processes eliminated create a highly functioning organization that is informed by evidence-based guidelines. CareGuideQI creates a workflow that ensures consistent use of the Care Guidelines and provides a documentation source for patient progress and documents variance from the best practice guidelines practice guidelines Medical practice A set of recommendations for Pt management that identifies a specific or range of range of management strategies. See Peer review organization, Practice standards. Cf 'Cookbook' medicine. . Variance tracking and reporting support quality care by identifying specific areas for enhancement. When paired with MEDecision's Integrated Medical Management, the user interfaces with both products in an efficient and seamless process that reduces administrative time by eliminating duplicate data entry. Clinical Consistency Health plans demand consistency in processing and reviewing clinical cases. Integrating predictive modeling software that foresees those at high risk of needing specialized care with the consistency of Care Guidelines allows the goals of many major health plans to be met. These clinical guidelines are certified as evidence-based, ensuring that the high-risk patient identifiers are consistent with the industry's best practices. "Milliman Care Guidelines' products are respected in the healthcare industry because they are an evidence-based solution, and the integration of these products is certain to continue that trend," says Scott Harris Several notable people have the name Scott Harris, including:
More Efficiency A seamless transition from MEDecision's Integrated Medical Management to Milliman Care Guidelines' products streamlines the care management process to increase efficiency. For example, end users no longer have to switch between programs to complete a standard procedure, while the need to enter data only once before distribution cuts data entry time in half. Identifying high-risk members improves the process of care management because decisions are based on reliable best practice guidelines. The web transaction module is a tool that Blue Cross Blue Shield of Illinois and Blue Cross Blue Shield of New Mexico are making available to their network of providers. Simply stated, the implementation of this product reduces administrative time spent approving patient care by clinically adjudicating routine requests without human intervention. The web-based system eliminates telephone calls and approval wait time is reduced to mere seconds. Another of the licensed products, General Recovery Guidelines, also has a direct positive impact on quality of care. By giving organizations one set of comprehensive clinical practice guidelines clinical practice guidelines Clinical policies, practice guidelines, practice parameters, practice policies Medtalk Systematically developed statements to assist practitioner and Pt decisions about appropriate health care for specific clinical circumstances. See Psychology. , they enable more informed and consistent clinical care decisions. They are specifically designed for complex cases where existing guidelines do not apply, facilitating the coordination of care and increasing the effectiveness of every decision. About Health Care Service Corporation, a Legal Mutual Reserve Company Founded in 1936, Health Care Service Corporation (HCSC) is a non-investor-owned mutual insurance company that operates the Blue Cross and Blue Shield Plans in Illinois, Texas and New Mexico serving 9.5 million members. These Plans offer PPO PPO abbr. preferred provider organization PPO Managed care Preferred provider organization, see there Infectious disease Pleuropneumonia-like organism, see there , HMO HMO health maintenance organization. HMO n. A corporation that is financed by insurance premiums and has member physicians and professional staff who provide curative and preventive medicine within certain financial, , POS (1) See point of sale and packet over SONET. (2) "Parent over shoulder." See digispeak. POS - point of sale , traditional indemnity and Medicare Supplemental health plans. In addition, HCSC's life insurance subsidiaries, Fort Dearborn Fort Dearborn, U.S. army post on the Chicago River, NE Ill.; est. 1803 and named for Secretary of War Henry Dearborn. Threatened by the indigenous population at the start of the War of 1812, the frontier post was ordered by Gen. William Hull to evacuate. On Aug. Life Insurance Company in Illinois; Medical Life Insurance Company in Ohio; and Colorado Bankers Life Insurance Company in Colorado, operating as Preferred Financial Group, offer life insurance and financial products. Learn more at www.hcsc.net. HCSC maintains its headquarters in Chicago and has a Standard and Poor's Noun 1. Standard and Poor's - a broadly based stock market index Standard and Poor's Index "A" rating, a Moody's "A3" rating and a rating of "A" from A.M. Best Co. HCSC is an independent licensee of the Blue Cross and Blue Shield Association
About MEDecision MEDecision is a leading software and services provider of integrated care management solutions. Founded in 1988, the company specializes in linking patients, providers and payers in an information network that relies upon electronic health records to improve overall health outcomes and reduce costs. MEDecision's software products are being used by more than 50 managed care organizations to improve the quality of healthcare and reduce both administrative and unnecessary clinical costs for approximately one in every seven Americans with health insurance. For more information about MEDecision and Integrated Medical Management, please call 610-254-0202, email Marketing@MEDecision.com or visit www.MEDecision.com. About Milliman Care Guidelines Milliman Care Guidelines, located in Seattle, WA, is a division of Milliman and provides its Care Guidelines to many of the firm's clients in the hospital and insurance industries. The Care Guidelines are evidence-based tools that guide care and improve care management across the continuum of care. They reflect current best practices for the actual working environment of today's healthcare organizations. Milliman, whose corporate offices are in Seattle, serves the full spectrum of business, financial, government and union organizations. Founded in 1947 as Milliman & Robertson, the company has 32 offices in the United States United States, officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area. as well as offices in Bermuda, Hong Kong Hong Kong (hŏng kŏng), Mandarin Xianggang, special administrative region of China, formerly a British crown colony (2005 est. pop. 6,899,000), land area 422 sq mi (1,092 sq km), adjacent to Guangdong prov. , London, Madrid, Sao Paulo, Seoul and Tokyo. Milliman employs approximately 1,800 people, including a professional staff of more than 800 qualified consultants and actuaries. The firm has consulting practices in employee benefits, healthcare, life insurance/financial services, and property & casualty insurance. It is a founding member of Milliman Global, an international organization of consulting firms Noun 1. consulting firm - a firm of experts providing professional advice to an organization for a fee consulting company business firm, firm, house - the members of a business organization that owns or operates one or more establishments; "he worked for a serving insurance, employee benefits and healthcare clients worldwide. For further information, visit www.careguidelines.com or call 888.464.4746. |
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