North Dakota Health Care Review, Inc. QIO Uses Milliman Care Guidelines® for Medicare and Medicaid Reviews

SEATTLE, Oct. 27 /PRNewswire/ -- North Dakota Health Care Review, Inc., (NDHCRI) the Quality Improvement Organization (QIO) for North Dakota, has signed a five-year licensing agreement with Milliman Care Guidelines LLC, A Milliman Company, to use the Care Guidelines for Medicare and Medicaid utilization and quality reviews in North Dakota.  

NDHCRI is using all Care Guidelines products -- Ambulatory Care, Inpatient and Surgical Care, General Recovery Guidelines, Recovery Facility Care, Home Care, Chronic Care Guidelines and Behavioral Health Guidelines – through Web software to support appropriate quality of care reviews.

The Centers for Medicare & Medicaid Services (CMS) contracts with QIOs in each state to conduct Medicare reviews and quality initiatives across a variety of healthcare settings.  It does not mandate or endorse the use of any specific criteria set by QIOs.

The Care Guidelines promote quality care by providing healthcare professionals with access to best practice based on annually updated evidence.  The Care Guidelines also display Quality Measures used by CMS, and each inpatient topic includes care planning information -- highlighting interventions that help lead to improved outcomes. Designed for prospective, concurrent, and retrospective reviews, the Care Guidelines enable informed and consistent clinical care decisions, and support the best possible care management using the most current evidence-based medicine.

"We are very pleased with the Care Guidelines," said Julie Thraikill, NDHCRI Director of Review.  "They are valuable because they are disease specific and continuously updated by a panel of health care professionals.  We have found them to be easy to use, comprehensive in their scope, and a useful tool for assisting us with our quality of care and utilization reviews."

"The Care Guidelines incorporate Hospital Quality Alliance quality measures," said Bill McKinley, Milliman Care Guidelines Vice President of Sales.  "Access to evidence-based clinical tools that improve quality of care enables QIOs to effectively manage their review processes and quality initiatives."

About North Dakota Health Care Review, Inc. (NDHCRI)

NDHCRI is a non-profit company that provides quality improvement expertise and services through contracts with federal and state governments, research and granting entities, foundation and corporate grants, and other payors. Through a contract with the Centers for Medicare & Medicaid Services, NDHCRI serves as North Dakota's Medicare Quality Improvement Organization (QIO).  For more information, visit www.ndhcri.org.

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 used by more than 1,800 clients, including more than 1,000 hospitals, seven of the eight largest US health plans, and 25 CMS audit contractors.  Covering the continuum of care, the seven-product Care Guidelines series is updated annually by an experienced team of clinicians and is used to support the care management of a majority of Americans.  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 53 offices in key locations worldwide.  Milliman employs more than 2,400 people.  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 more information, visit www.milliman.com.

SOURCE Milliman Care Guidelines