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CIMRO of Nebraska Uses Milliman Care Guidelines(R) for Nebraska Medicare Reviews
Date:3/17/2009

Use of Clinical Guidelines and Software Improves Quality Review Process

SEATTLE, March 17 /PRNewswire/ -- CIMRO of Nebraska, the Medicare Quality Improvement Organization (QIO) for Nebraska, recently signed a five-year licensing agreement with Milliman Care Guidelines, LLC, A Milliman Company, to use the Care Guidelines for Medicare utilization and quality reviews in Nebraska. The Care Guidelines replace criteria sets that CIMRO of Nebraska adapted from those in the public domain.

CIMRO of Nebraska will use all Care Guidelines products -- Ambulatory Care, Inpatient and Surgical Care, General Recovery Guidelines, Recovery Facility Care, Home Care, Chronic Care Guidelines and Behavioral Health Guidelines -- through Web software to support utilization review, as well as quality of clinical care for Medicare beneficiaries.

The Centers for Medicare & Medicaid Services (CMS) contracts with QIOs in each state to conduct various reviews and quality initiatives. CMS does not mandate or endorse the use of any specific criteria set by QIOs or hospitals. Twelve QIOs now license the Care Guidelines.

The Care Guidelines promote quality care by providing healthcare professionals with access to best practices based on annually updated evidence. The Care Guidelines also display quality measures used by CMS, and each inpatient guideline topic lists key care elements and hospital care planning information highlighting interventions that offer the highest probability for improving outcomes.

Designed for prospective, concurrent and retrospective reviews, among other care management activities, the Care Guidelines enable informed and consistent clinical care decisions and support the best possible care management using current evidence-based medicine.

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SOURCE Milliman Care Guidelines
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