MCG Health and InterSystems Partner to Support Evidence-Based Decision Making for Health Plans, Care Providers
MCG’s New Care Net Solution, Built on InterSystems Interoperability Platform, Streamlines Claims Authorizations, Frees Payers, Clinicians to Focus on Care Quality and Efficiency
CAMBRIDGE, Mass., and SEATTLE, Wash., February 15, 2017— InterSystems, a global leader in health information technology, today announced a partnership with MCG Health, a leading provider of informed care solutions. MCG Health will leverage InterSystems HealthShare® as the interoperability platform to share its evidence-based care guidelines and analytics with health plans and providers. MCG’s new cloud-based Care Net solution, built on HealthShare, will connect payers and providers to enable more efficient care processes and more informed medical decisions based on healthcare best practices.
The exchange of medical necessity documentation between health plans and providers has historically been costly and inefficient, based on manually sharing information via fax machines. The connectivity provided by InterSystems has allowed MCG Health to streamline this entire process.
MCG Health’s solution assists health plans with verifying that a prescribed medical treatment conforms with recommended evidence-based treatments, taking into account unique medical needs and optimal patient recovery standards. Through HealthShare’s standards-based interoperability and workflow automation capabilities, providers and payers can now more easily access and share comprehensive medical necessity documentation for their patients and members.
MCG Health’s customer Children’s Community Health Plan, based in Milwaukee, was planning a new commercial offering in 2017 and needed to integrate exchange of documentation with their partner. Anticipating the process would be time-consuming and resource-intensive, it turned to MCG Health.
“In today’s healthcare market, health plans need to be agile to support new product offerings and new business partners. Children’s Community Health Plan leveraged MCG Health’s evidence-based content to support the clinical necessity and prior authorization of requested services. And thanks to InterSystems’ standards-based interoperability platform, we are able to create new product offerings and scale them up quickly to deliver value to our business partners,” said Lynn Kryfke, RN, MSN, Director of Clinical Services, of Children’s Community Health Plan.
“Value-based care programs rely on evidence-based content to improve the quality and efficiency of care delivery. That documentation should be available to all stakeholders across a person’s health journey,” said Chris Van Waters, CIO at MCG Health. “By working with InterSystems, the leader in the interoperability space, both payers and providers now have the ability to access MCG Health’s market-leading library to ensure that best practices are being followed and that quality patient care is being delivered consistently and efficiently.”
“Providers are responsible for delivering timely well-coordinated care. Burdensome, manual authorization processes introduce care delays and divert staff time away from patients,” said Joe DeSantis, Vice President for HealthShare, InterSystems. “Through our partnership with MCG Health, payers and providers can more quickly and easily exchange essential documentation to demonstrate that treatment plans are in alignment with industry best practices, and to return the focus to patients.”
MCG Health is a part of the Hearst Health network with 79 percent of health insurers relying on its evidence-based treatment library.
Both MCG Health and InterSystems will also be available at the annual HIMSS17 conference in Orlando, FL, February 19-23 at InterSystems Booth #1561 and MCG Health’s Booth #2531 to discuss the partnership in greater detail.
About MCG Health
MCG, part of the Hearst Health network, helps healthcare organizations implement informed care strategies that proactively and efficiently move patients toward health. MCG’s transparent assessment of the latest research and scholarly articles, along with our own data analysis, gives patients, providers and payers the vetted information they need to feel confident in every care decision, in every moment. For more information visit www.mcg.com or follow our Twitter handle at @MCG_Health.
About Hearst Health
The Hearst Health network includes FDB (First Databank), Zynx Health, MCG, Homecare Homebase, MedHOK, Hearst Health International, Hearst Health Ventures and the Hearst Health Innovation Lab (www.hearsthealth.com). The mission of Hearst Health is to help guide the most important care moments by delivering vital information into the hands of everyone who touches a person’s health journey. Each year in the U.S., care guidance from the Hearst Health network reaches 84 percent of discharged patients, 177 million insured individuals, 60 million home health visits, and 3.1 billion dispensed prescriptions.
InterSystems is the engine behind the world’s most important applications. In healthcare, finance, government, and other sectors where lives and livelihoods are at stake, InterSystems is the power behind what mattersTM. Founded in 1978, InterSystems is a privately held company headquartered in Cambridge, Massachusetts (USA), with offices worldwide, and its software products are used daily by millions of people in more than 80 countries. For more information, visit InterSystems.com.
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