CMS Audit Contractor and Health Plan Clients Also Increase

SEATTLE, Nov. 12 /PRNewswire/ -- The number of hospitals using the Milliman Care Guidelines® has grown eight-fold from 116 in 2002 to more than 950 in 2009 thanks to client-driven innovations and enhancements in all Care Guidelines products and software.

These enhancements include improved care pathway tables, expanded patient education materials and integrated quality measures, plus enhanced search, documentation and customization features in CareWebQI® interactive software.

Evidence-based clinical guidelines and software from Milliman Care Guidelines are used by a wide range of healthcare organizations. Updated annually, the seven-product Care Guidelines series covers the continuum of care. By enabling informed and consistent clinical decisions, the Care Guidelines can support the best patient outcomes possible.

Significant Growth Among All Clients

The overall number of healthcare organizations using the Care Guidelines has grown significantly, from fewer than 200 clients in 2002 to more than 1,700 now.

Hundreds of payors including seven of the country's eight largest health plans use Care Guidelines products and software to support the care of nearly two-thirds of all US health plan members. More than 20 audit contractors for Centers for Medicare & Medicaid Services (CMS), such as Quality Improvement Organizations (QIOs), Recovery Audit Contractors (RACs) and Zone Program Integrity Contractors (ZPICs), use the Care Guidelines to review the quality of healthcare delivered across the country.

While CMS contractors audit healthcare quality and effectiveness in many settings, the agency itself does not mandate or endorse any specific criteria. Contractors may select any nationally recognized guidelines for audits, and a growing number of them select the Care Guidelines.

"We are gratified by this growth, and proud that the Care Guidelines products and software are fast becoming the standard among healthcare professionals, particularly in hospitals," said Scott Harris, Milliman Care Guidelines Senior Vice President of Sales and Marketing. "This strong response supports our core belief that evidence-based medicine, presented in easily used software, can help deliver the right care, in the right place and at the right time to provide optimal healthcare."

Improving Care through Evidence-Based Medicine

Developed in the 1990s, the Care Guidelines were the first clinical guidelines to offer a proactive, "look-ahead," approach to most conditions, allowing clinicians to see the entire continuum of care for a patient, and to identify milestones along the road to recovery. Today, Care Guidelines products Ambulatory Care, Inpatient and Surgical Care, General Recovery Guidelines, Recovery Facility Care, Home Care, Chronic Care Guidelines and Behavioral Health Guidelines and their supporting software are licensed by clients delivering optimal care to patients and members.

Interactive Software Available

A growing number of clients access the Care Guidelines through CareWebQI interactive software, which provides robust medical management tools and features to ease clients' care management and patient-tracking workload, making it one of the most useful patient episode management applications available. This flexible software allows Care Guidelines clients to capture and report on real-time clinical data to measure their own performance against national quality standards; track variances from best-practice; identify inappropriate care; and detect physician, facility and resource delays.

About Milliman Care Guidelines

Milliman Care Guidelines LLC, A Milliman Company, is located in Seattle, and independently develops and produces evidence-based clinical guidelines and software widely used by hospitals, health plans, and government contractors. Covering the continuum of care, the seven-product Care Guidelines series is updated annually by an experienced full-time team of clinicians. For more information, visit www.careguidelines.com.

About Milliman

Milliman Care Guidelines is a wholly owned subsidiary of Milliman, Inc., which is among the world's largest independent actuarial and consulting firms. Founded in Seattle in 1947 as Milliman & Robertson, the company now has 51 offices in key locations worldwide. Milliman employs more than 2,300 people, with a professional staff of more than 1,100 qualified consultants and actuaries, including specialists ranging from clinicians to economists. The firm has consulting practices in healthcare, employee benefits, property and casualty insurance, life insurance, and financial services. Milliman serves the full spectrum of business, financial, government, union, education, and nonprofit organizations. For further information, visit www.milliman.com.

SOURCE Milliman Care Guidelines LLC

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