Actionable Content: A Framework For Better Decision Making

Actionable Content: A Framework for Better Decision Making

  • December 20, 2017

By Nilo Mehrabian and Steve Silverstein Driven by healthcare reform and other changing market dynamics, stakeholders are at last getting down to the business of effecting true transformation. Actionable content—usable information that is understood, adopted, and embedded into workflow—is a critical tool to enable that change. Clinical information or content brings consistency, collaboration, efficiency, and quality to both the delivery of healthcare services and the business of healthcare. In its fully realized form, content is truly intelligent or “actionable.” In other words, it recognizes the context in which it is invoked and automatically delivers specific and relevant guidance to the…

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Montana-Based Quality Improvement And Utilization Review Organization Expands Use Of InterQual Evidence-Based Criteria With Behavioral Health

Montana-Based Quality Improvement and Utilization Review Organization Expands Use of InterQual Evidence-Based Criteria With Behavioral Health

  • November 14, 2017

Mountain-Pacific Quality Health (Mountain-Pacific) has been a long-time user of InterQual® Criteria, including the Level of Care and Care Planning Criteria suites. Now, in a move to expand its offerings, the Montana-based organization has added InterQual Behavioral Health Criteria for Medicaid utilization reviews. For more than two decades, Mountain-Pacific clinicians have combined clinical knowledge and experience, documented clinical evidence, and utilized InterQual Criteria to make appropriate medical necessity and utilization decisions for hospital admissions. The addition of Behavioral Health will enable them to widen their offerings even further, as Mountain-Pacific uses InterQual inpatient behavioral health criteria for the utilization review…

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The High Cost Of Unneeded Procedures

The High Cost of Unneeded Procedures

  • November 2, 2017

Suresh Yarlagadda, Change Healthcare Medical Director, Clinical Strategy, has a feature piece on Healthcare Informatics about unnecessary medical care. In it, he examines a recent survey on the issue and looks at what’s behind medical decisions. Read the article

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State Rep. Kay Khan Visits Change Healthcare Newton Office

State Rep. Kay Khan Visits Change Healthcare Newton Office

  • October 27, 2017

On Thursday morning, October 26th, Massachusetts State Representative Kay Khan (D-Newton) visited Change Healthcare’s Newton, Mass., office to learn more about the company and to meet with our InterQual team. A nurse by training, Rep. Khan is a 23-year veteran of the Massachusetts legislature. She works on issues related to behavioral health, domestic violence, and criminal justice reform. She also serves as the House Chair of the Joint Committee on Children, Families, and Persons with Disabilities, and is the Chair of the Mental Health Caucus. Rep. Khan joined the Newton staff for breakfast and engaged in a wide-ranging and informative…

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Unnecessary Care: It’s Not Necessary

Unnecessary Care: It’s Not Necessary

  • October 26, 2017

By Suresh Yarlagadda, MD, Medical Director, Clinical Strategy, Change Healthcare Unnecessary care is unnecessarily in the news these days. We say “unnecessarily” because such care—as well as the associated costs it incurs and risks it poses for patients—can be mitigated. Kaiser Health News just published a report, “So Much Care It Hurts: Unneeded Scans, Therapy, Surgery Only Add to Patients’ Ills” which describes aggressive over-treatment for breast cancer. And a story in Health Affairs, “Low-Cost, High-Volume Health Services Contribute the Most to Unnecessary Health Spending” showed that a preponderance of prescribed low-value health services offered little medical value while increasing…

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InterQual Connect Helps Partners Automate, Streamline Reviews For Providers

InterQual Connect Helps Partners Automate, Streamline Reviews for Providers

  • October 3, 2017

A growing number of healthcare technology vendors are streamlining preauthorizations by integrating the InterQual Connect cloud-based interactive medical review and connectivity solution into their own offerings. Most recently, InfoMC and HealthTrio both announced they are integrating InterQual Connect with their own solutions to automate exception-based utilization management for their provider customers. InfoMC, a provider of cloud-based healthcare management and care coordination solutions, has integrated InterQual Connect into its Incedo Healthcare Management System. The integration will support a more efficient, standardized clinical review process by allowing care managers to easily access care guidelines from within the Incedo decision-support workflow. HealthTrio, which…

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