McKesson InterQual® Introduces Clinical Decision Support For Autism Spectrum Disorders

McKesson InterQual® Introduces Clinical Decision Support for Autism Spectrum Disorders

  • January 20, 2015

Today we announced the release of Applied Behavior Analysis (ABA) criteria for autism spectrum disorders in our Behavioral Health InterQual® solution. Demand for autism treatment is growing, as are associated treatment costs. In 2014, the CDC reported 1 in 68 U.S. children were identified with autism spectrum disorder, a 30% increase over their 2012 estimate. And JAMA Pediatrics estimates the average lifetime cost for an autism spectrum disorder is $2.4 million. Part of the increase in demand can be attributed to Federal and state healthcare reforms that mandate greater access to treatment, coupled with more Americans now having health insurance as a result of the ACA. Read the…

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True Fax Facts In Healthcare Reimbursement

True Fax Facts in Healthcare Reimbursement

  • January 14, 2015

If you’re laughing, you know it’s true. And, in fact, this cartoon is based on a true story we overheard at a trade show. Obsolete practically everywhere else, the fax machine is alive and well in healthcare reimbursement. It’s emblematic of why many organizations struggle with costly, burdensome, error-prone administrative work when processing authorization requests or claims. Fortunately, payers and providers can reduce administrative costs with cloud-based utilization management and coverage solutions that support medical appropriateness reviews at the time of decision, such as Clear Coverage. Our clients can fully automate up to 40% or more of their prior authorizations.…

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It’s Time For A New Value-Based Utilization Management Model

It’s Time For A New Value-Based Utilization Management Model

  • January 12, 2015

Today The Morning Consult featured Matthew Zubiller's description of a next-generation UM model that helps payers and providers collaboratively measure, manage, and refine high-quality care delivery while reducing administrative costs. Read how Zubiller's UM model works while helping balance stakeholders’ concerns

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Why You Need To Start ICD-10 Testing Right Now

Why You Need to Start ICD-10 Testing Right Now

  • December 18, 2014

In the latest edition of ICD-10 Watch,  Joshua Berman, Director of Analytics and ICD-10 at RelayHealth Financial, discusses what payers and providers should do now to ensure they're ready for ICD-10 tomorrow. He advocates end-to-end testing and transparency from payers, so providers who are not being tested can learn from those that are. He also discusses forming partnerships to optimize testing results, and advises providers on what they should be testing. Read the whole column

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A Tale Of Two Communities: How A Payer And A Provider Each Experienced The “Best Of Times” With MHS

A Tale of Two Communities: How a Payer and a Provider Each Experienced the “Best of Times” with MHS

  • December 16, 2014

How a national general acute care hospital and a national managed health care company each saw the “best of times” with McKesson   Community Health Solutions (payer) and Community Healthcare System (provider) each shared a struggle on how to bring more transparency and information to their care and payment workflows. Automated and robust solutions from McKesson helped them improve the quality and cost of healthcare their organizations provide.  The Payer Community Health Solutions: Improving care quality, cost with more robust clinical standards Without a stricter tie to evidence-based guidelines while making medical necessity decisions, payers face potential inconsistency in the…

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ICD-10 Readiness: Countdown Considerations

ICD-10 Readiness: Countdown Considerations

  • November 4, 2014

ICD-10 Watch's Carl Natale invited Josh Berman, Director of Analytics and ICD-10 at RelayHealth Financial, to write a series on the ICD-10 transition and what payers and providers need to do starting now. In this first installment, Berman reviews the three key areas: testing, training and key performance indicators. Look for his piece on the perils of procrastinating coming soon. Read his full story here

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Reimbursement Coding For Molecular Diagnostics

Reimbursement Coding for Molecular Diagnostics

  • October 28, 2014

In Advance for Laboratory, McKesson medical director Douglas Moeller, MD, explains what Z-Code Identifiers are and why they're needed to identify molecular diagnostic tests. Dr. Moeller also explains how they can work alongside CPT codes to uniquely identify tests, help labs bring their tests to market, and help speed reimbursement. Read the full article here

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A Healthcare IT Halloween

A Healthcare IT Halloween

  • October 26, 2014

There are lots of scary issues that payers and providers face in healthcare IT every day. Payment reform, ICD-10, uncontrolled molecular diagnostic spends, maintaining legacy systems running in a rapidly changing world -- there's no shortage of costly technical challenges to keep us up at night. But with Halloween approaching, we thought it was time to take a lighter look at "what’s scary about healthcare IT." To do that, and to celebrate McKesson Health Solutions 27th annual customer forum taking place this Halloween week in Baltimore, we commissioned some B2B cartoons around a Halloween theme. Here they are! Feel free to share them with your colleagues in email or…

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