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Northeast Health Care Quality Foundation QIO Uses Milliman Care Guidelines(R) for Medicare, Medicaid Reviews

SEATTLE, July 14 /PRNewswire/ -- Northeast Health Care Quality Foundation, one of the nation's leading Quality Improvement Organizations (QIOs), has 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 Maine, New Hampshire and Vermont, and for Medicaid utilization and quality reviews in New Hampshire.

Northeast Health Care Quality Foundation 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 appropriate quality of clinical care for Medicare and Medicaid beneficiaries.

The Centers for Medicare & Medicaid Services (CMS) contracts with QIOs to conduct Medicare reviews and quality initiatives across a variety of healthcare settings in each state. CMS does not mandate or endorse the use of any specific clinical guidelines or criteria set by QIOs.

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 topic includes care planning information highlighting interventions that lead to improved outcomes. Designed for prospective, concurrent, and retrospective reviews, the Care Guidelines enable informed and consistent clinical care decisions, and support the best possible care management using the most current evidence-based medicine.

"The Care Guidelines incorporate Hospital Quality Alliance measures," said Scott Harris, Milliman Care Guidelines Senior Vice President of Sales and Marketing. "Access to these evidence-based clinical tools that improve quality of care enables QIOs to effectively manage their review processes and quality initiatives."

About Northeast Health Care Quality Foundation

The Northeast Health Care Quality Foundation (NHCQF) is a non-profit, educational health care organization, headquartered in Dover, New Hampshire. NHCQF contracts with the United States Centers for Medicare & Medicaid Services (CMS) to serve as the Medicare Quality Improvement Organization (QIO) for the states of Maine, New Hampshire, and Vermont. NHCQF also contracts with the New Hampshire Department of Health and Human Services to review hospital services provided to the Medicaid population. For more information, visit

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 health plans. Covering the continuum of care, the seven-product Care Guidelines series is updated annually by an experienced team of clinicians and are used to support the care management of a majority of Americans. 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 2,100 people, with a professional staff of more than 1,100 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 nonprofit organizations. For more information, visit

SOURCE Milliman Care Guidelines
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