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McKesson Launches Episode Management Solution to Promote Bundled Payments and Value-Based ReimbursementOctober 18, 2011 |
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Aligning Payment for All Services Related to an Episode of Care Helps Payers and Providers Collaborate on Delivering Value, Not Driving Volume McKesson has introduced McKesson Episode Management™, a software solution that supports the shift toward value-based reimbursement models by automating complex bundled payment programs of all sizes. Using a single, “bundled” payment for all services delivered in treating an episode of care — such as a total knee replacement — is emerging as one of the more promising healthcare reform initiatives because it moves payers and providers from a volume-based system to one that is based on best practices and value. According to The Commonwealth Fund , bundled payment has the potential to reduce health expenditures in the United States by as much as $300 billion between 2010 and 2020. Pilot programs have been shown to minimize treatment variation, wasteful services and complications, improving outcomes while minimizing healthcare expenditures. “Bundled payment is one of the most innovative initiatives addressing fragmented, inconsistent care delivery, which drives up costs and can also have a negative impact on quality,” said Jim Evans , vice president, Payment Management, McKesson Health Solutions. “The challenge for the industry has been finding the right technology to streamline program design and management. McKesson has successfully leveraged its proven payment and decision management solutions in Episode Management, which helps payers and providers come together in new, more meaningful ways to achieve significant and sustainable results with these programs.” Episode Management is a highly configurable, rules-based software application that enables scalable episode programs with automated, prospective bundled payments, leveraging McKesson’s industry-leading solutions for optimizing clinical decision support and automating even the most complex payment decisions. Whether plans choose to work with vendor-based models or custom episode content, Episode Management automates flexible and configurable episode definitions, including authorizations, then helps plans bundle and pay episode claims accurately, in real time and within current claim workflows. In addition, McKesson offers expert services to assist health plans with evaluating program strategies, designing and managing episode programs, and analyzing potential and actual program impacts. The goal is to streamline implementations and optimize value from this new and promising payment approach. “This is an exciting time for the industry because so much payer-provider collaboration is occurring, which is exactly what we needed for real transformation to move forward,” said Melanie Marcus , vice president, Emerging Solutions, McKesson Health Solutions. “Solutions such as Episode Management are enablers of that transformation. As payers and providers break new ground with strategies such as bundled payments, they must have solutions that are flexible enough to support whatever shape those programs take, not create barriers themselves. McKesson’s combination of proven, robust technology, clinical content knowledge and expert services is ideally suited to deliver rapid and sustained return on investment in these innovative programs.” About McKesson McKesson Corporation, currently ranked 15th on the FORTUNE 500, is a healthcare services and information technology company dedicated to making the business of healthcare run better. We partner with payers, hospitals, physician offices, pharmacies, pharmaceutical companies and others across the spectrum of care to build healthier organizations that deliver better care to patients in every setting. McKesson helps its customers improve their financial, operational, and clinical performance with solutions that include pharmaceutical and medical-surgical supply management, healthcare information technology, and business and clinical services. For more information, visit http://www.mckesson.com .
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McKesson Health Solutions
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