Leading publisher of unbiased, evidence-based clinical guidance
incorporates changes to support CMS-4201-F compliance
SEATTLE, Feb. 27,
2024 /PRNewswire-PRWeb/ -- MCG Health, part of the
Hearst Health network and an industry leader in technology-enabled
evidence-based guidance, announces the release of its 28th edition
of the MCG care guidelines. Many new changes to the
industry-leading guidelines were made to help payers and providers
support compliance with the 2024 Medicare Advantage and Part D
Final Rule (CMS-4201-F) which was announced by the Centers for
Medicare & Medicaid Services (CMS) in April 2023.
"This past year has seen some extraordinary
work by the MCG clinical and technology teams as they help our
payer and provider clients adapt to a rapidly changing regulatory
landscape." - Jon Shreve, President
& CEO, MCG Health
MCG care guidelines are among the most widely used clinical
guidelines in the healthcare industry. They are currently licensed
by a majority of U.S. health plans, over 3,100 hospitals, and
several state and federal agencies. For the 28th edition, MCG
clinical editors reviewed 217,640 scientific articles leading to a
total of 48,137 unique citations in the MCG evidence base
(including 5,565 brand new citations).
For the 28th edition, clinical experts enhanced MCG Inpatient
& Surgical Care, Multiple Condition Management, Ambulatory
Care, General Recovery Care, and Recovery Facility Care guidelines
with Supplemental Medicare Criteria and new evidence summaries. The
updates were designed to help payers and providers support
compliance with the 2024 Medicare Advantage and Part D Final Rule
(CMS-4201-F). For its software solution suites, Cite and Indicia,
MCG made parallel updates to support visibility of the criteria and
evidence summaries. In addition, MCG Cite for Guideline
Transparency includes new enhancements that will allow Medicare
Advantage payers to share the evidence supporting their coverage
decisions more efficiently with providers and current (or
prospective) health plan members.
Additional updates in the 28th edition include:
- New observation care guidelines for pediatric patients and
substance-related disorders within MCG Inpatient & Surgical
Care
- Language supporting a "whole person care" approach for care
coordination has been added to MCG Behavioral Health Care.
Additional substance use disorder content was updated to align with
the recently released ASAM (American Society of Addiction Medicine)
Criteria (Fourth Edition)
- A new Social Vulnerability Index Dashboard was added to MCG
Benchmarks and Data to present information on socioeconomic status,
household characteristics, racial & ethnic minority status, and
housing type & transportation for U.S. populations (including
Puerto Rico) by zip code, county,
and state
- MCG Home Care now contains a statistical companion that
includes data on the average number of home care visits by MCG care
guideline, visit type, days from start of care, and average minutes
per day by visit type (for both commercial and Medicare
populations)
Regarding the 28th edition, MCG President and CEO, Jon Shreve, said, "This past year has seen some
extraordinary work by the MCG clinical and technology teams as they
help our payer and provider clients adapt to a rapidly changing
regulatory landscape. I am confident that these new updates will
help our customers meet compliance with CMS rules while continuing
to drive healthcare decisions with the best available scientific
evidence."
MCG clients will learn more about the new updates in the 28th
edition through training webinars available on the MCG website at:
https://www.mcg.com/client-resources/education-training/escholar-webinar-training/.
In addition, MCG will hold several educational sessions related to
the 28th edition at their annual Client Forum in Phoenix, Arizona (April
22-24).
About MCG Health
MCG, part of the Hearst Health network, provides unbiased clinical
guidance that gives healthcare organizations confidence in
delivering patient-centered care. MCG's artificial intelligence and
technology, infused with clinical expertise, enable its clients to
prioritize and simplify their work. MCG's world-class customer
service ensures that its clients maximize the benefits of licensing
MCG solutions – demonstrating improved clinical and financial
outcomes. For more information visit http://www.mcg.com..
About Hearst Health
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. Care guidance from
Hearst Health reaches the majority of people in the U.S. The Hearst
Health network includes FDB (First Databank), Zynx Health, MCG,
Homecare Homebase, and MHK (formerly MedHOK). Hearst also holds a
minority interest in the precision medicine and oncology analytics
company Aster Insights. Follow Hearst Health on X @HearstHealth and
LinkedIn @Hearst-Health.
Media Contact
Arri, Burgess, (206) 389-5405, arri.burgess@mcg.com,
https://www.mcg.com/
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SOURCE MCG Health