Why Care Guidelines?

Milliman Care Guidelines, the acknowledged leader in evidence-based clinical guidelines, has licensing agreements with more than 1000 clients across the country to provide its clinical guidelines through a variety of software options. All told, the care management of one in three Americans is supported by the use of the Milliman Care Guidelines^®.

Some of the attributes and developments that have led to this wide-spread acceptance are the same that would make them the appropriate choice for your organization:

• Evidence-based Medicine — The full-time clinical staff that produces the Care Guidelines prides itself on rigorous adherence to an evidence-based methodology. Over 100,000 articles were retrieved during the development process, with 14,000 unique citations currently included in Milliman’s seven-product series. This evidence is integrated into the Care Guidelines themselves through hyperlinks and “pop-ups” that provide access to references, footnotes, quality measures and a comprehensive Annotated Bibliography.
• Variance Tracking and Reporting — CareGuideQI^® and CareWebQI^® enable documentation of users’s interactions with a variety of criteria, including: care pathways, indications for admission/procedure, ambulatory authorizations, and chronic guidelines.
• Chronic Care Management — The Chronic Care Guidelines were developed using URAC standards for case management as a model. Each guideline provides a companion set of patient education materials that are written at a fourth-grade level, and can be sent to the patient as part of the intervention. These materials are also available in the Spanish language.
• Quality Measures — Nationally-recognized quality measures are integrated within the Care Guidelines’ workflow. These measures include those from the CMS Hospital Quality Alliance, NCQA HEDIS^® and The Joint Commission.
• Management of Complex Patients — The General Recovery Guidelines provide expanded decision support for management of comorbidities, multiple illnesses, or unclear diagnoses. They also provide reliable guidance for clinical situations so complex that another guideline cannot easily be applied.