New Mexico CO-OP Selects MCG to Help Support Members with Complex Care Needs

SEATTLE, Oct. 6, 2015 /PRNewswire/ -- New Mexico Health Connections (NMHC) has licensed interactive software and evidence-based care guidelines from MCG (part of the Hearst Health network) to help support members with complex care needs.

"With a membership projected to double over the next year, we need to manage risk across our expanding population," said Linda Reiter, NMHC senior director of quality and medical management. "We need an evidence-based solution that supports care of members with complex needs, so we chose MCG CareWebQI^® and MCG Chronic Care guidelines."

Created under the Affordable Care Act's Consumer Operated and Oriented Plan (CO-OP), NMHC offers health insurance in the retail market. The CO-OP is physician-led and clinically integrated emphasizing individual attention to members.  Its 35,000 members include many individuals new to health insurance as well as small and large employer groups.  According to Reiter, the pent-up demand for healthcare has brought to NMHC a high percentage of members with one or more chronic condition.

"We're committed to meeting members where they are," said Reiter. "Whether they have asthma, diabetes, or a combination of chronic conditions, it's crucial to have a solution that creates a coaching plan tailored to the particular member."

NMHC case and disease management teams will use CareWebQI, an interactive care management solution from MCG, to generate individualized care plans based on the Chronic Care guidelines. Chronic Care helps clinicians evaluate needs, identify goals, and support effective self-care for patients with chronic diseases or complex care needs.

"When NMHC began offering healthcare coverage in 2014, they chose to support the community and embrace medical risk instead of running away from it," said Jon Shreve, president of MCG. "Their decision to purchase MCG guidelines and solutions is a testament to the merit of that approach. The NMHC commitment to innovation makes them an excellent partner for MCG."

About New Mexico Health Connections (NMHC)
NMHC, New Mexico's nonprofit, consumer-operated and -oriented (CO-OP) health plan, focuses on the well-being of patients by making sure care is coordinated at every level. It is chartered by the Affordable Care Act to provide a nonprofit competitive health plan alternative in the New Mexico marketplace, with a focus on individuals and small businesses. As a nonprofit, member-focused plan, any profits it makes must be reinvested into expanded benefits or lower premiums for its members. NMHC prioritizes keeping people healthy, lowering premium costs, and delivering appropriate levels of care at the right time to keep its members healthy and out of unnecessary hospital stays. Community-based care management is an essential element of that commitment.  NMHC understands that its members like and trust their doctors and that a strong network of primary care providers is critical to ensuring the good health of its members.

About MCG
MCG, now part of the Hearst Health network, independently develops and produces evidence-based clinical guidelines and software used by more than 2,200 clients, including 1,300 hospitals and eight of the ten largest U.S. health plans. Updated annually by an experienced team of clinicians, the care guidelines support the care management of a majority of Americans. For more information, visit www.mcg.com.

The Hearst Health network also includes FDB (First Databank), Zynx Health, and Homecare Homebase. 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 United States, care guidance from the Hearst Health network reaches 76% of discharged patients, 133 million insured individuals, and supports 30 million home health visits, 1.88 billion retail pharmacy prescriptions, and 3.26 billion prescription claims. Extensions of the Hearst Health network include Hearst Health Ventures and the Hearst Health Innovation Lab. For more information, visit www.hearsthealth.com.

Media Contact
Nancy Narraway
MCG
Tel +1 206 389 5405
[email protected]

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SOURCE MCG

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