We all saw that [MedInsight] Guideline Analytics was a simple and clear presentation of clinical services that we could quickly take action upon to inform the right utilization.
Seattle, WA (PRWEB) January 11, 2017
The teams from MCG Health and Milliman MedInsight have collaborated to create an innovative analytic software designed to identify inefficiencies in the way that care is delivered at a population level. MedInsight Guideline Analytics (GA) enables organizations to easily aggregate claims data to help improve performance and care within a given population.
This product collaboration was formed from a common heritage—MCG Health, now part of the Hearst Health Network, was previously part of Milliman alongside MedInsight, which is Milliman’s healthcare analytic software platform. By combining the strong risk assessment and data science legacy of Milliman with the gold-standard care guidelines of MCG, the two healthcare leaders offer health plan payers and providers information that will not only help control costs, but also ensure appropriate levels of treatment for patients in the U.S.
Guideline Analytics is an ideal analytic resource to support care management by enabling healthcare entities to easily evaluate their performance against industry benchmarks. It also provides benchmarks against peer healthcare organizations to identify opportunities for quality improvement. As a population health tool, Guideline Analytics provides crucial data for provider profiling, care management reporting, and marketing the value of an organization’s medical management initiatives. When asked about the importance of Guideline Analytics, Jon Shreve, President and CEO of MCG stated, “In our experience, organizations that have implemented effective, informed care strategies have focused on areas with significant unwarranted variations in care. By organizing clinical services into the clinically coherent categories that MCG uses, customers have the feedback mechanism that they can use to both define their goals and track their progress towards those goals.”
Some of the specific benchmarks inside the tool that have been developed include: length of stay (LOS) in a hospital setting, readmission rates for over 300 medical and surgical procedures, 79 potential ambulatory procedures, and subacute stays (including Rehab and SNF analysis). Leveraging these analytics provides additional insights when auditing and evaluating auto authorization workflows as well as retrospective and concurrent care management review.
“MedInsight Guideline Analytics (GA) is a tool we chose to implement in partnership with the key providers in our alternative payment programs (Accountable Cost & Quality Arrangement or ACQA),” said Jeremy Donath, Director of Health Informatics at Excellus BlueCross BlueShield. “Our provider partners sat down to review the pros/cons of the analytic package they received from us, and we all saw that GA was a simple and clear presentation of clinical services that we could quickly take action upon to inform the right utilization in the ACQA environment. We are very excited about the opportunities that GA will provide our ACQAs.”
MCG and MedInsight intend to further introduce Guideline Analytics to the market, with plans to host webinars and demos, and formally showcase the tool at MCG’s Client Forum this spring.
Milliman is among the world's largest providers of actuarial and related products and services. The firm has consulting practices in healthcare, property & casualty insurance, life insurance and financial services, and employee benefits. Founded in 1947, Milliman is an independent firm with offices in major cities around the globe. For further information, visit http://www.milliman.com.
About MCG Health
MCG, part of the Hearst Health Network, helps healthcare organizations implement informed care strategies that proactively and efficiently move patients toward health. MCG’s transparent assessment of the latest research and scholarly articles, along with our own data analysis, gives patients, providers and payers the vetted information they need to feel confident in every care decision, in every moment. For more information, visit http://www.mcg.com or follow MCG on Twitter at @MCG_Health.
About Hearst Health
The Hearst Health network includes FDB (First Databank), Zynx Health, MCG, Homecare Homebase, MedHOK, Hearst Health International, Hearst Health Ventures and the Hearst Health Innovation Lab (http://www.hearsthealth.com). The mission of the Hearst Health network is to help guide the most important care moments by delivering vital information into the hands of everyone who touches a person's health journey. Each year in the U.S., care guidance from the Hearst Health network reaches 84 percent of discharged patients, 177 million insured individuals, 47 million home health visits, and 4 billion prescriptions.