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Major sections of the seven-product Care Guidelines series -- AmbulatoryCare, Inpatient and Surgical Care, General Recovery Guidelines, RecoveryFacility Care, Home Care, Chronic Care Guidelines, and Behavioral HealthGuidelines -- have criteria and content that support specific NCQA standards.Milliman clinicians mapped Care Guidelines content to NCQA's UtilizationManagement and Quality Management and Improvement standards, and confirmedthat much of the content supports those standards.
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This standards-mapping approach supports Milliman Care Guidelines clientsin national review and accreditation processes, said Sherrie Dulworth, RN,CPHRM, Milliman Care Guidelines Vice President of Quality and Product Design.
"Our mission is to advance the delivery of optimal healthcare," Dulworthsaid. "Aligning the Care Guidelines content with nationally recognizedquality standards and processes is one very effective way to do that.
"This standards mapping helps Care Guidelines clients understand how touse our criteria and content to support their activity related to nationalaccreditation or certification. Care Guidelines users can refer to mappedsections of our products to help prepare for review and to meet the qualityorganization's requirements," she said.
For example, NCQA's Quality Improvement Standards & Guidelines identify 14elements that an organization's case management procedures should address.Even though NCQA has not officially evaluated the Care Guidelinesstandards-mapping effort, the Chronic Care Guidelines and various caremanagement tools in Inpatient and Surgical Care already support 11 of thoseelements with detailed, "look-ahead" guidelines and specific assessment andevaluation steps.
For more information on mapping quality standards to the Care Guidelines,healthcare organizations should contact Tiffanie Lenderman, Manager ofStrategic Outreach, via email at [email protected].
About Milliman Care Guidelines
Milliman Care Guidelines is located in Seattle, and independently developsand produces evidence-based clinical guidelines and a variety of softwareoptions that are used by more than 1,000 clients, including six of thecountry's seven largest health plans to support the care of nearly two-thirdsof US health plan members. Covering the continuum of care, the seven-productCare Guidelines series is updated annually by an experienced team ofclinicians. For more information, visit www.careguidelines.com.
Milliman Care Guidelines is a wholly owned subsidiary of Milliman, Inc.Milliman is among the world's largest independent actuarial and consultingfirms. Founded in Seattle in 1947 as Milliman & Robertson, the companycurrently has 48 offices in key locations worldwide. Milliman employs overtwo thousand people, with a professional staff of more than a thousandqualified consultants and actuaries, including specialists ranging fromclinicians to economists. The firm has consulting practices in healthcare,employee benefits, property & casualty insurance, life insurance and financialservices. Milliman serves the full spectrum of business, financial,government, union, education and nonprofit organizations. For furtherinformation, visit www.milliman.com.
SOURCE Milliman Care Guidelines
