Leading publisher of unbiased, evidence-based clinical guidance incorporates changes to support CMS-4201-F compliance
SEATTLE, Feb. 27, 2024 /PRNewswire-PRWeb/ -- MCG Health, part of the Hearst Health network and an industry leader in technology-enabled evidence-based guidance, announces the release of its 28th edition of the MCG care guidelines. Many new changes to the industry-leading guidelines were made to help payers and providers support compliance with the 2024 Medicare Advantage and Part D Final Rule (CMS-4201-F) which was announced by the Centers for Medicare & Medicaid Services (CMS) in April 2023.
MCG care guidelines are among the most widely used clinical guidelines in the healthcare industry. They are currently licensed by a majority of U.S. health plans, over 3,100 hospitals, and several state and federal agencies. For the 28th edition, MCG clinical editors reviewed 217,640 scientific articles leading to a total of 48,137 unique citations in the MCG evidence base (including 5,565 brand new citations).
For the 28th edition, clinical experts enhanced MCG Inpatient & Surgical Care, Multiple Condition Management, Ambulatory Care, General Recovery Care, and Recovery Facility Care guidelines with Supplemental Medicare Criteria and new evidence summaries. The updates were designed to help payers and providers support compliance with the 2024 Medicare Advantage and Part D Final Rule (CMS-4201-F). For its software solution suites, Cite and Indicia, MCG made parallel updates to support visibility of the criteria and evidence summaries. In addition, MCG Cite for Guideline Transparency includes new enhancements that will allow Medicare Advantage payers to share the evidence supporting their coverage decisions more efficiently with providers and current (or prospective) health plan members.
Additional updates in the 28th edition include:
- New observation care guidelines for pediatric patients and substance-related disorders within MCG Inpatient & Surgical Care
- Language supporting a "whole person care" approach for care coordination has been added to MCG Behavioral Health Care. Additional substance use disorder content was updated to align with the recently released ASAM (American Society of Addiction Medicine) Criteria (Fourth Edition)
- A new Social Vulnerability Index Dashboard was added to MCG Benchmarks and Data to present information on socioeconomic status, household characteristics, racial & ethnic minority status, and housing type & transportation for U.S. populations (including Puerto Rico) by zip code, county, and state
- MCG Home Care now contains a statistical companion that includes data on the average number of home care visits by MCG care guideline, visit type, days from start of care, and average minutes per day by visit type (for both commercial and Medicare populations)
Regarding the 28th edition, MCG President and CEO, Jon Shreve, said, "This past year has seen some extraordinary work by the MCG clinical and technology teams as they help our payer and provider clients adapt to a rapidly changing regulatory landscape. I am confident that these new updates will help our customers meet compliance with CMS rules while continuing to drive healthcare decisions with the best available scientific evidence."
MCG clients will learn more about the new updates in the 28th edition through training webinars available on the MCG website at: https://www.mcg.com/client-resources/education-training/escholar-webinar-training/. In addition, MCG will hold several educational sessions related to the 28th edition at their annual Client Forum in Phoenix, Arizona (April 22-24).
About MCG Health
MCG, part of the Hearst Health network, provides unbiased clinical guidance that gives healthcare organizations confidence in delivering patient-centered care. MCG's artificial intelligence and technology, infused with clinical expertise, enable its clients to prioritize and simplify their work. MCG's world-class customer service ensures that its clients maximize the benefits of licensing MCG solutions – demonstrating improved clinical and financial outcomes. For more information visit http://www.mcg.com..
About Hearst Health
The mission of Hearst Health 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. Care guidance from Hearst Health reaches the majority of people in the U.S. The Hearst Health network includes FDB (First Databank), Zynx Health, MCG, Homecare Homebase, and MHK (formerly MedHOK). Hearst also holds a minority interest in the precision medicine and oncology analytics company Aster Insights. Follow Hearst Health on X @HearstHealth and LinkedIn @Hearst-Health.
Media Contact
Arri, Burgess, (206) 389-5405, [email protected], https://www.mcg.com/
SOURCE MCG Health
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