InterQual Decision Support for Private Payors


The Gold Standard in Evidence-Based Clinical Decision Support

Healthcare payors have always wanted to ensure that healthcare is built on a solid, scientifically valid foundation of medical evidence, both to improve care quality for their members and to achieve optimal efficiency in its delivery. Over 30 years ago, the InterQual product line was founded on the desire to establish that foundation and to empower payors, providers and others to more easily communicate, collaborate and ultimately determine what is best for patients.

Today, McKesson's InterQual products are the undisputed gold standard in evidence-based clinical decision support, and its wide use facilitates alignment among providers, payors and government in care management decisions. Our criteria cover the medical and behavioral health continuums of care, so they can be applied in a range of clinical situations. InterQual is the most widely used InterQual products are used by:

  • 300 health plans 
  • Over 3,700 hospitals
  • The Centers for Medicare & Medicaid Services
  • Military Health System 
  • 21 Veterans Integrated Service Networks (175 facilities)
  • Quality Improvement Organizations in over 40 states, Washington DC, Puerto Rico, and US Virgin Islands
  • 9 out of 10 Medicare Administrative Contractors (MACs)





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