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Milliman Care Guidelines(R) Products Drive Efficiency Through Expanded Quality Tools

Clients Optimize Resources With Imaging, Behavioral and Chronic Management Criteria

SEATTLE, May 21 /PRNewswire/ -- Delivering efficient, high-quality healthcare is now easier for providers and payors, thanks to quality and workflow tools embedded in the new Milliman Care Guidelines(R) 13th Edition.

Milliman Care Guidelines has integrated diagnosis-specific national quality measures within the Care Guidelines' workflow by mapping its clinical content to national quality standards and accreditation requirements; enhancing variance-tracking and workflow tools; and expanding educational materials for clinicians and patients.

Quick and efficient diagnosis and treatment lead to higher quality care for patients. The Care Guidelines support provider and payor efforts by integrating evidence-based practices into healthcare professionals' workflow -- practices that deliver efficient, best-practice care, and achieve desired patient care outcomes using an optimal level of resources.

Integrated Quality Tools

Included within updated Care Guidelines interactive software are reports, tools and resources enabling organizations to deliver quality care:

  • Nationally recognized Quality Measures from the Hospital Quality Alliance, NCQA HEDIS(R) and The Joint Commission are integrated and flagged within the Care Guidelines' workflow
  • Crosswalk documents detail exactly how the Care Guidelines support accreditation requirements and quality-improvement activities of national agencies, such as NCQA, URAC, CMS, IHI and NQF
  • Several Care Guidelines products include patient education information for clinicians, and printable patient discharge handouts
  • Annotated bibliographies, references, footnotes and abstracts are easily accessible through Care Guidelines software hyperlinks and pop-ups
  • Care pathways incorporate evidence-based care elements, recovery milestones and Quality Measures, promoting proactive care and discharge planning
  • Evidence-based goal lengths of stay and other best-practice data enable clients to benchmark performance and track patient and care-delivery improvements
  • Detailed Care Management Tools facilitate safe transitions of care and decrease unnecessary readmissions

Efficiency-Creating Clinical Products

In addition to these quality-specific tools, Milliman Care Guidelines offers several products that enable organizations to manage specific care areas in-house, including:

  • The Ambulatory Care product, which enables evidence-based management of imaging, DME, injectables, diagnostic testing, genetic medicine and more
  • The Chronic Care Guidelines product, which supports case or disease management programs, and include English- or Spanish-language educational materials for patients
  • The Behavioral Health Guidelines product, which addresses appropriateness of specific psychological, behavioral and pharmacologic therapies across five levels of care

Based on a strong foundation of rigorous, evidence-based medicine, the Care Guidelines deliver updated clinical content from a full-time clinical editorial staff that cites more than 15,000 unique references in the current seven-product Care Guidelines series. Editors assessed each reference and updated more than one-third in this most recent annual update.

About Milliman Care Guidelines

Milliman Care Guidelines, LLC, A Milliman Company, is located in Seattle, and independently develops and produces evidence-based clinical guidelines and software used by more than 1,000 clients, including hospitals, providers and seven of the eight largest US health plans. Covering the continuum of care, the seven-product Care Guidelines series supports the care of nearly two-thirds of US health plan members. For more information, visit

About Milliman

Milliman Care Guidelines is a wholly owned subsidiary of Milliman, Inc., which is among the world's largest independent actuarial and consulting firms. Founded in Seattle in 1947 as Milliman & Robertson, the company now has 49 offices in key locations worldwide. Milliman employs more than 2,000 people, with a professional staff of more than 1,000 qualified consultants and actuaries, including specialists ranging from clinicians to economists. The firm has consulting practices in healthcare, employee benefits, property and casualty insurance, life insurance and financial services. Milliman serves the full spectrum of business, financial, government, union, education and non-profit organizations. For more information, visit

SOURCE Milliman Care Guidelines
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