McKesson Health Solutions

McKesson Health Solutions

McKesson Health Solutions Corporate Offices:

McKesson headquarters:
McKesson Corporation
One Post Street
San Francisco, CA
5 Country View Rd.
Malvern, PA 19355
275 Grove Street, Suite 1-110
Newton, MA 02466-2273
335 Interlocken Parkway
Broomfield, CO 80021

Brief Corporate History

McKesson’s Roots in Health Care Services

The history of McKesson dates back to the beginnings of organized health care in the United States. Founded in 1833 by John McKesson and Charles Olcott in New York City, the company was focused on the importation and wholesaling of therapeutic drugs and chemicals from its inception.

Run out of a small shop in the city’s financial district, the business quickly began to thrive in an era when sailing ships were introducing America to a new world of global trade. McKesson and Olcott did a brisk business stocking the medicine chests aboard those ships, providing them with drugs imported from Europe and medicinal herbs, roots and spices acquired from Shaker colonies in Pennsylvania.

Soon the partners hired an assistant, Daniel Robbins, who within a few years would be made a partner himself. After Olcott’s death in 1853, the firm was renamed McKesson & Robbins. By then, the company was already distributing pharmaceutical products via covered wagons in 17 states and territories, from Vermont to California.

In 1855, the company became one of the first wholesale houses to manufacture drugs. McKesson & Robbins’ fluid extracts, tinctures, pills and tablets soon became known all over the world, and the company won medals for its pioneering work.

The 20th Century: Expanding Horizons

In the early 1900s McKesson & Robbins made a critical strategic decision to persuade a number of well-established wholesaling firms to become its subsidiaries, forming a national drug wholesaling company. That move made McKesson & Robbins the leading distributor of pharmaceutical drug products in the United States. It also shifted the company’s focus to distribution for various lines of businesses outside of health care.

During the 1960s, McKesson & Robbins continued its focus on distribution by merging with Foremost Dairies of San Francisco to form Foremost-McKesson Inc. The new company included four main operating units: McKesson & Robbins Drug Company, Foremost Foods Company, McKesson Liquor Company and McKesson Chemical Company. Foremost-McKesson became the largest U.S. distributor of drugs, alcoholic beverages and chemicals; the largest supplier of whey by-products; the largest producer of processed water; a leader in the fresh dairy products field; and a multiregional distributor of hospital and laboratory supplies and equipment.

In the 1980s and 1990s, McKesson decided to focus more on health care and divested its unrelated businesses such as Foremost Dairies, McKesson Chemical, McKesson Wine & Spirits and Armor All Products.

During this time, McKesson acquired Automated Healthcare, now part of McKesson Automation, and General Medical, the largest distributor of medical-surgical supplies. The company also acquired HBO & Company for $14 billion in stock and operated for a time as McKesson HBOC—the world’s largest health care services company. In 2000, McKesson divested its only remaining non-health care asset, McKesson Water Products.

McKesson Today

Today, McKesson is ranked 14th on the FORTUNE 500 with more than $108.6 billion in annual revenue. The company delivers vital medicines, medical supplies and health care information technology solutions that touch the lives of patients in every health care setting. The depth and breadth of the company’s product and service offerings, coupled with the largest customer base in the health care industry, uniquely position McKesson to meet the needs of its customers:

~200,000 physicians

~26,000 retail pharmacies

~10,000 long-term care sites

~5,000 hospitals

~2,000 medical-surgical manufacturers

~750 homecare agencies

~600 health care payors

~450 pharmaceutical manufacturers

Empowering the evolution of health care, McKesson’s products and services improve the quality of care, eliminate errors, reduce unnecessary costs, synthesize information for physicians, improve the workflow of nurses and free up pharmacists to counsel patients.

Executive Officers of McKesson Corporation

The following table summarizes McKesson’s Executive Leadership team, led by John Hammergren.

Name Title
John H. Hammergren Chairman, President and Chief Executive Officer
Patrick J. Blake Executive Vice President and Technology Solution Group President
Paul C. Julian Executive Vice President and Distribution Solutions Group President
Jeffrey C. Campbell Executive Vice President, Chief Financial Officer
Jorge L. Figueredo Executive Vice President, Human Resources
Marc E. Owen Executive Vice President, Corporate Strategy and Business Development
Laureen E. Seeger Executive Vice President, General Counsel and Secretary
Randall N. Spratt Executive Vice President, Chief Information Officer

John H. Hammergren, Chairman, President and Chief Executive Officer

John H. HammergrenJohn H. Hammergren is Chairman, President and Chief Executive Officer of McKesson Corporation. He has been a director of McKesson since 1999 and was elected President and CEO in 2001 and Chairman in 2002. He joined McKesson in January 1996.

Under Hammergren’s leadership, McKesson has emerged as the leading provider of supply, information and care management solutions designed to reduce the cost and improve the quality of healthcare. During his tenure, the company has more than doubled its revenues to $106B, expanded into new markets and advanced to number 15 on the Fortune 500. It has also experienced a cultural transformation driven by the establishment of a set of core values, a commitment to continuous process improvement, and a collaborative approach to serving its customers.

In 2008 Hammergren co-authored the book, “Skin in the Game,” where he describes the history of our health care system, provides an explanation of its current state, and outlines the great strides that he sees being made in the near future. In 2009 Hammergren became the chairman of the Healthcare Leadership Council, a coalition of chief executives of the nation’s leading health care companies and organizations. Hammergren is a member of the Hewlett Packard board of directors and serves as a director of Nadro, S.A. de C.V., a leading pharmaceutical distributor in Mexico. He also is a member of the Business Council and the Business Roundtable.

Hammergren earned a BA in business administration from the University of Minnesota and an MBA from Xavier University in Cincinnati.

Patrick J. Blake, Executive Vice President and Technology Solution Group President

Patrick J. BlakePat Blake is Executive Vice President and Group President of McKesson Technology Solutions. He has overall responsibility for all of the businesses within McKesson Technology Solutions, including McKesson Provider Technologies, McKesson Health Solutions, RelayHealth and McKesson’s International Operations Group.

Prior to his current position, Blake served as president of McKesson Specialty Care Solutions, a McKesson business unit that delivers services to manufacturers and providers to ensure specialty pharmaceutical products, coordinated reimbursement and clinical services are available to patients with complex diseases. In this role, he led the successful acquisition and integration of Oncology Therapeutics Network, which included the Lynx® technology platform and redefined McKesson’s offerings for oncology, other specialty practices and specialty pharmaceutical manufacturer customers. Under his leadership, McKesson Specialty Care Solutions grew to become the second largest supplier of specialty pharmaceuticals in the U.S.

Blake joined McKesson in 1996 as senior vice president for McKesson Health Systems. In 1999, he was named president of McKesson Health Systems, and in 2001 he was elevated to president of customer operations for McKesson U.S. Pharmaceutical. Under his leadership, McKesson’s institutional pharmaceutical distribution business grew from $3 billion to $16 billion. Prior to joining McKesson, Blake held leadership roles at Baxter International, Inc., and American Hospital Supply Inc.

Blake earned a bachelor’s degree in economics from Denison University in Granville, Ohio and a Master of Business Administration from the Graziadio School of Business and Management at Pepperdine University.

Paul C. Julian, Executive Vice President and Distribution Solutions Group President

Paul C. JulianPaul C. Julian is Executive Vice President and Group President of McKesson Corporation. He has senior operating responsibility for more than $103.5 billion of the company’s fiscal 2009 $106.6 billion in revenues and the majority of McKesson’s businesses. He oversees U.S. and Canadian pharmaceutical distribution, medical-surgical distribution, specialty pharmacy, retail automation and pharmacy outsourcing.

During his tenure as president of McKesson Pharmaceutical, the company’s largest operating business, McKesson re-gained its position as the largest North American pharmaceutical distributor, rising from the third largest to become the largest wholesaler over a three-year period.

Julian oversaw the largest operations and technology upgrade in McKesson’s history, and spearheaded widespread company adoption of Six Sigma. Today, McKesson is often cited for its U.S. corporate productivity leadership. Additionally, he has helped bring new capabilities into the McKesson portfolio including acquisitions in pharmaceutical packaging, pharmaceutical and medical-surgical distribution, informatics, an enlarged stake in Mexican distributor NADRO and in medical products e-commerce.  Julian has led many of McKesson’s progressive moves in recent years, including the development of the company’s Health Mart independent retail pharmacy franchise network and the company’s creation of the TogetherRx and Rx Savings Access prescription drug discount cards, both innovative efforts to help seniors save money on their prescription medicines.

After joining McKesson in 1996 as executive vice president of McKesson Health Systems, the company’s distribution business for hospitals, Julian went on to become president of McKesson’s medical-surgical business. From 1997-2000 he oversaw a 50 percent increase in medical-surgical distribution revenues and a doubling of operating profit. Also during that time, McKesson signed an unprecedented 20-year distribution agreement with Premier Provider Select for its non-acute care business.

Julian became president of McKesson’s distribution, retail automation, pharmacy outsourcing and services for payors in 2000. A highlight of the period to follow was the 2003 decision by the Department of Veteran’s Affairs to move its pharmaceutical distribution business away from another distributor to McKesson.

In 2004, Julian was named to his current position as group president of the corporation.

Previously, he held a variety of senior management positions in health care companies, notably Owens & Minor and Stuart Medical, Inc. Within five years, he rose from Stuart Medical, Inc. sales manager to group vice president and chief operating officer. Julian serves on the boards of NADRO, Parata Systems, Cancer Clinics of Excellence (CCE), the International Federation of Pharmaceutical Wholesalers (IFPW), as past Chairman, and the Healthcare Distribution Management Association (HDMA), where he serves as Chairman.

He is a 1978 graduate of Salem State College in Massachusetts, where he earned a B.S. degree.

Jeffrey C. Campbell, Executive Vice President, Chief Financial Officer

Jeffrey C. CampbellJeff Campbell is Chief Financial Officer of McKesson Corporation. Jeff Campbell has responsibility for all financial functions of the Corporation.  Prior to joining McKesson in 2003, Campbell served as senior vice president, chief financial officer of AMR Corporation and its subsidiary American Airlines.

Campbell joined AMR/American Airlines in 1990 and held a range of financial and general management positions, including managing American’s European operations based in London for several years.  Prior to AMR, Campbell was a CPA with Deloitte, Haskins and Sells.

Campbell is a member of the board of directors of Hexcel Corporation and the San Francisco Chamber of Commerce.

Campbell holds a B.A. degree in Economics from Stanford University and an M.B.A. degree from Harvard University.

Jorge L. Figueredo, Executive Vice President, Human Resources

Jorge L. FigueredoJorge L. Figueredo is Executive Vice President of Human Resources of McKesson Corporation. The responsibilities of this position include talent acquisition, training and organizational development, compensation and benefits, diversity, community relations, and corporate communications and branding.

Prior to joining McKesson, Figueredo served as senior vice president of human resources at Dow Jones Inc., where he helped transform human resources into a strategic business function. He also played a leadership role in managing Dow Jones’ merger with News Corp. Prior to joining Dow Jones, Figueredo spent 22 years at Liz Claiborne, and concluded his tenure there as president of Liz Claiborne’s international division.

Recognized as one of the 100 most influential Hispanics by Hispanic Business Magazine in 2004, Figueredo holds a B.A. from Fairfield University and an M.B.A from the Stern School of Business at New York University.

Marc E. Owen, Executive Vice President, Corporate Strategy and Business Development

Marc E. OwenMarc Owen, Executive Vice President, Corporate Strategy and Business Development, joined McKesson in 2001. At McKesson he is responsible for overall corporate strategy, mergers and acquisitions, and business development.  In addition, he is responsible for McKesson’s operations in Mexico and Asia Pacific.  Prior to joining McKesson, Owen was a senior partner at McKinsey, advising pharmaceutical manufacturers, healthcare providers, distributors and technology companies, including McKesson, for more than a decade. He was a founding partner responsible for establishing McKinsey’s presence in Silicon Valley and a leader of McKinsey’s Business Technology office globally. Owen was also chief executive officer of MindCrossing. Owen currently sits on the boards of Nadro, S.A. de C.V, Proventys, and MedVantx.

Owen, who was born and raised in Wales, holds a law degree from Oxford University and an MBA from Stanford University.

Laureen E. Seeger, Executive Vice President, General Counsel and Chief Compliance Officer

Laureen E. SeegerLaureen E. Seeger is Executive Vice President, General Counsel and Chief Compliance Officer of McKesson Corporation. As the corporation’s chief legal officer, Seeger oversees the Law Department for McKesson and its subsidiaries. Prior to her appointment in March 2006, Seeger was Vice President and General Counsel of McKesson Provider Technologies (MPT), McKesson’s health care information technology solutions business.

Prior to McKesson, Seeger was with the Atlanta law firm of Morris, Manning & Martin, LLP from 1992 to 2000, where she was Partner-In-Charge of the Technology Litigation Section, and was with the firm of Jones, Day, Reavis & Pogue from 1986 to 1992.

She earned a law degree from the University of Wisconsin-Madison in 1986 and received a bachelor of business administration degree from the University of Wisconsin-Eau Claire in 1983.

Randall N. Spratt, Executive Vice President, Chief Technology Officer and Chief Information Officer

Randall N. SprattRandy Spratt is Executive Vice President, Chief Technology Officer and Chief Information Officer for McKesson Corporation. Spratt is responsible for all technology initiatives within the Corporation. Spratt has been with McKesson for more than 18 years, most recently as chief process officer for McKesson Provider Technologies (MPT), the company’s medical software and services division based in Alpharetta, Georgia. He also managed MPT’s Business Development, Information Technology, and Strategic Planning offices, as well as MPT’s Technology Services business.

Prior to joining McKesson, Spratt held executive positions of increasing responsibility at the start-up Advanced Laboratory Systems (ALS), culminating with the role of Chief Operations Officer. ALS was acquired by HBOC in 1996, which in turn was acquired by McKesson in 1999, and Spratt took on responsibility for HBOC’s laboratory systems business shortly thereafter. Following the acquisition of HBOC by McKesson in 1999, Spratt relocated to Georgia to become part of the reconstructed management team.

Spratt earned a bachelor of science degree in biology, with a minor in computer science, from the University of Utah.

Senior Leadership Team of McKesson Health Solutions

McKesson Health Solutions is led by a visionary and collaborative team of experts who have extensive healthcare backgrounds and in-depth knowledge of a wide range of Medical Management and Payment Management issues. Together, the executive team designs and implements effective strategies that continually position the company at the forefront of healthcare innovation.

The table below summarizes the senior leadership team, led by our president, Emad Rizk, MD.

Name Title
Emad Rizk, MD President
Carolyn Wukitch Senior Vice President, Product Division
Jacqueline Mitus Senior Vice President, Clinical Development and Strategy
John Leonard Vice President, Sales and Account Management
Peter Csapo, CPA CFO and Vice President, Informatics
Elaine Lemke Vice President, Human Resources
Michael Wood Chief Technology Officer
Jerry Doyle General Counsel

Emad Rizk, MD, President, McKesson Health Solutions (MHS)
Dr. Rizk is president of McKesson Health Solutions, a division of McKesson Corporation that delivers intelligent healthcare solutions that enable payors, providers and patients to come together to transform the business and process of healthcare.

A world-renowned healthcare industry expert, he brings over 25 years of experience working with payors, physicians, hospital systems and pharmaceutical organizations to the leadership of MHS. He provides the healthcare industry, both the commercial and government sectors, with transformational strategies and operational execution expertise through healthcare information technology.

In his previous position as the global director of Deloitte, Dr. Rizk led medical cost and quality management practice across all industries. He also spearheaded the largest redesign of care management and delivery models among health plans and providers nationwide.

Sought after for his knowledge of the healthcare industry, Dr. Rizk has served on many healthcare boards, including the National Clinical Advisory Board and National Quality Review, and currently serves on the boards of DMAA: Care Continuum Alliance, National Association for Hispanic Health, University of Miami, University of North Texas, and Managed Care Magazine.

He is a senior scholar professor at Jefferson Medical College in Philadelphia and has an extensive portfolio of published journal articles and books, including his contribution to The Wisdom of Top Health Care CEOs, a collection of interviews published in 2003. His new book, The New Era of Healthcare: Practical Strategies for Providers and Payers, centers on methods to forge a partnership between providers and payors focused on clinical, administrative and economic alignment to bring about more efficient, cost-effective care.

In 2009, Dr. Rizk was named among the Top 100 Most Powerful People in Healthcare by Modern Healthcare. Also in 2009, for the second year in a row, he was named one of the 50 Most Powerful Physician Executives in the United States by Modern Physician and one of the nation’s Top 25 Leaders in Disease Management in 2008 by Managed Healthcare Executive.

Carolyn J. Wukitch, Senior Vice President, Product Division
Carolyn Wukitch is senior vice president for the Products Division of McKesson Health Solutions, accountable for the strategic leadership and management of the broad MHS software solution portfolio for medical management and payment management products. She drives execution and financial performance through the leadership of the research and development, product operations, customer services, strategic marketing and product management functions.

Leading the products division since 2008, Ms. Wukitch has maintained the division’s profitability while growing revenues by 17% in a highly challenged economy. During this time, she has implemented a strong product lifecycle management process that supports smoother product operation and marketing environments. Coupled with an innovative go-to-market approach also implemented under her leadership, the products division of MHS has developed effective cross-functional planning and organizational readiness for bringing new products to market.

Her entire career has been in healthcare, first in the provider setting and then the healthcare information technology business sector. Prior to her current position at McKesson Health Solutions, Ms. Wukitch served as the senior vice president for product operations. In that role, she was responsible for make versus buy decisions and led the integration of new technology acquisitions. She also directed the development of new product offerings that expanded the division’s market reach.

Earlier, Ms. Wukitch held a variety of product management and customer service positions at the company. She started her career at Geisinger Medical Center, in medical records, after earning her BS at the University of Pittsburgh.

Anna Jacqueline Mitus, MD, Senior Vice President, Clinical Development and Strategy
As senior clinician for McKesson Health Solutions, Dr. Mitus oversees the development of clinical content for medical management, payment management and analytics products. She also provides leadership for clinical development and coordination for cross-McKesson initiatives.

Dr. Mitus has been in her current position since 2008. During this time and with her leadership, the clinical team has developed and released clinical criteria for assessing the appropriateness of new genetic and molecular diagnostics tests, addressing an emerging market problem that unchecked has the potential to overwhelm the healthcare industry.

Joining McKesson Health Solutions in 1995, she initially served as vice president of clinical services for InterQual and later as chief operating officer and general manager of the care management products division. During that time, she evolved the product strategy, accelerated sales and developed infrastructure to support clients and operations.

Previously a practicing hematologist-oncologist at the Brigham & Women’s Hospital, Dr. Mitus was also a faculty member at Harvard Medical School, holding several teaching roles. She received her BA/MD from Boston University.

John Leonard, Vice President, Sales, Account Management, Medical Management
John Leonard oversees sales and account management for the commercial and government markets. He brings more than 20 years of healthcare experience in general and sales management, strategic planning and new business development, ranging from start-ups to large national organizations.

Joining McKesson Health Solutions in 1998 as the national sales manager for InterQual, Mr. Leonard previously held various positions at Coral Therapeutics, National Medical Care and Dow Hickam Pharmaceuticals.

He obtained his undergraduate degree from the University of Massachusetts Boston.

Peter Csapo, Chief Financial Officer and Vice President of Informatics
Peter Csapo oversees all product and service pricing, financial and operational assessments, process and control improvements, accounting, payroll, actuary services and compliance with Sarbanes Oxley.

With extensive knowledge in finance, Mr. Csapo is an industry expert on using technology to accelerate the delivery of information to senior executives, facilitating timely decision-making.

Prior to joining the senior leadership team of McKesson Health Solutions, he worked for six years in various financial management positions at McKesson’s corporate headquarters. He has also held various financial and accounting positions with Honeywell Inc. and Sears, Roebuck and Co.

Mr. Csapo is a CPA in the State of Illinois and holds a BBA in accountancy from the University of Wisconsin at Madison.

Elaine Lemke, Vice President, Human Resources
Elaine leads the Human Resources function for McKesson’s Health Solutions Division, one of the fastest growing divisions within McKesson. Recently, she led MPT Customer Operations Group where she was the HR executive lead for organizational effectiveness, including talent assessment/placement, recruiting, compensation review, change management, and employee/legal issue resolution.

Michael Wood, Chief Technical Officer
Michael Wood joined McKesson in November 1999 and has spent the past 16 years in healthcare technology where he has managed software engineering teams on both the provider and payor side of the market. His current position is Chief Technical Officer for the Health Solutions division of McKesson where he oversees software development and internal technology used in the development of integrated Disease Management, Clinical Code Auditing and Contract Management applications for the payor market.

Previously, Mr. Wood held the position of Vice President of R&D for McKesson’s Amherst Product Group (APG) developing decision support and business intelligence software for the provider market. Prior to McKesson, he spent seven years at QuadraMed Corporation as Vice President of Software Development where he developed decision support, contract management, medical records and electronic billing software.

Mr. Wood started his career in healthcare technology with Siemens (formerly Shared Medical Systems) as a programmer and systems analyst working with its physician billing applications and new technology group. In addition to his background in healthcare technology, he also holds an MBA from LaSalle University and has served as an adjunct professor at Philadelphia College for 10 years where he taught a masters level course in Comparative Operating Systems.

Jerry Doyle, Chief Counsel
Attorney Doyle leads our legal support team and provides legal and business leadership across MHS. Mr. Doyle has been with McKesson for five years and has practiced law for over 12 years. He received an undergraduate degree from Princeton University, and his JDD from Duke University.

Areas of Expertise and Products

For 34 years, McKesson Health Solutions has delivered software, clinical content and services to the payor and hospital industries. We are committed to creating a healthcare system in which quality is higher, mistakes are fewer and costs are lower, and are proud the success we have made towards that goal in partnership with our customers. We are #1 in providing clinical care guidelines. We are the industry-leading provider of 24/7 Nurseline services, currently servicing more than 24 million lives. We are an industry leader in providing claims performance software and services. We are #1 in providing in care management workflow solutions. And we are #1 in providing business analytics solutions for healthcare management. Our success is also reflected in our 95% customer renewal rate.

McKesson Health Solutions products and services address administrative efficiencies and quality of care across your business. These include:

Total Coordinated Care Product Suite

Total Coordinated Care provides an integrated and holistic approach to care management that eliminates the inefficiencies caused by having numerous, individual, siloed programs targeted at the same patient. This coordinated and integrated approach allows all stakeholders access to the clinical and technical tools necessary to support a patient throughout the healthcare continuum. By connecting programs and audiences across care management disciplines, Total Coordinated Care drives down medical and administrative expense and improves patient care.

  • CareEnhance® Care Manager integrates utilization, disease, and case management into a seamless process and improves communications among care managers for better outcomes.
  • CareEnhance Care Strategies are the embedded, McKesson-developed care and disease management clinical content that supports more effective, clinically appropriate yet individualized member care. Developed from literature reviews, with input from practicing physicians and care managers, Care Strategies facilitate optimal care by Coventry Health Care’s care and disease managers, define problems, set goals and suggest interventions for the member based on the individual member’s needs. A customization utility allows Coventry Health Care to modify this clinical content or add its own guidelines and protocols.
  • Coordinated Care Content is the evidence-based content used in McKesson’s InterQua®l Criteria that helps organizations manage members with high risk conditions or chronic disease, resulting in improved quality and reduced readmissions. The content also enables organizations to meet accreditation requirements, such as NCQA’s Complex Care Management guidelines. It includes assessments in a Q&A format and Care Plans that are generated based on the information received in the assessment.
  • CareEnhance Disease Monitor is a disease identification and monitoring tool that pinpoints members within a disease population and applies clinical algorithms that detect treatment failures, complications, co-morbidities, non-compliance issues and triggers that suggest exacerbation of illness. Compatible with care and disease management processes, these rules determine if a member requires medical care and recommends an appropriate level of intervention. Disease Monitor can also be used as a population management tool to identify and send notifications to members who meet certain parameters (e.g., women in a certain geographic region, above a defined age, who have not received a mammogram, or identifying members who are prescribed a certain drug and notifying them of the need to call their physician).
  • Coordinated Care Integration Tool Kit, McKesson’s unique combination of technology and services, delivers an integration wrapper that enables data exchange among McKesson solutions and supports a payor’s technology architecture today and tomorrow. Integration with:
  • InterQual Criteria, McKesson’s industry-leading clinical care guidelines, and CareEnhance Review Manager, the software that automates the use of InterQual
  • Clear Coverage, McKesson’s Automated Authorization and Coverage Determination tool
  • Personal Health Advisor, McKesson’s new, integrated online member portal

InterQual Decision Support Products:

  • InterQual Clinical Decision Support Criteria are clinical guidelines that payors and providers use to make sound, timely medical decisions (e.g., should a particular patient stay in the acute hospital setting another day, have an MRI or be prescribed a wheelchair?) In most cases, the medical review that these criteria support is a prerequisite for authorization of payment. With a 57% market share, InterQual is by far the most widely used criteria among payors, providers and government agencies, which helps align stakeholders in their decision-making.
  • InterQual Level of Care Criteria address admissions and continued stays across the continuum of care, from acute settings through home care and outpatient treatment.
  • InterQual Care Planning Criteria support healthcare organizations in promoting clinical quality and cost-effective allocation of medical resources by helping identify when care-related interventions are appropriate.
  • InterQual Behavioral Health Criteria assist in determining initial and successive level of care decisions for psychiatric conditions, chemical dependency and dual diagnosis for individuals at each stage of life.
  • InterQual Retrospective Monitoring Criteria SIM plus helps healthcare organizations evaluate the appropriateness of surgical and nonsurgical invasive procedures, for retrospective justification and validation.
  • InterQual Clinical Evidence Summaries is a collection of current white papers that synthesize medical research on controversial diagnoses to support second-level medical review recommendations and promote evidence-based standards of care.
  • CareEnhance Review Manager Enterprise automates InterQual use for greater efficiency and flexibility. And, InterQual’s Molecular Diagnostics and Imaging criteria sets are both available in the new Advanced Diagnostics Management solution for full automated authorization support between payors and providers.
  • CareEnhance Review Manager Enterprise Integration Toolkit empowers organizations to easily incorporate the criteria-based review efficiencies of CareEnhance Review Manager into other care management applications.
  • CareEnhance Review Manager Enterprise Plus Pak adds documentation, reporting and tracking capabilities to CareEnhance Review Manager to increase the effectiveness of discharge planning and denial management programs.
  • CareEnhance Review Manager Custom Criteria Utility enables organizations to blend all of the clinical content they need—both InterQual Criteria and organization-specific content—into a single, streamlined workflow.
  • InterQual Online, a McKesson-hosted service, is an affordable, easy-to-implement and easy-to-use application for accessing InterQual Criteria via the Web in read-only mode.
  • InterQual Online Anonymous Review is a McKesson-hosted system that lets you perform an interactive review using InterQual Criteria without specifying patient data.
  • InterQual View is a reference only form of InterQual that can be installed on a laptop or server. It provides easy navigation between criteria subsets to quick access to references and past years’ criteria.
  • InterQual Interrater Reliability Suite is a software application that helps organizations achieve the maximum value from the evidence-based content of InterQual products. Our hosted, online IRR Suite allows organizations to measure how well and how consistently their staffs are applying the criteria. The portfolio of 15 standardized tests.
  • InterQual Transparency Solution allows payors to give providers access to the criteria that are critical to their practices. Providers can easily review the criteria online, in an intuitive reference-only format.
  • InterQual Training and Education Services are eared for both new and experienced users, McKesson’s Training and Education Services help organizations optimize their use of InterQual clinical decision support systems, more fully understand and apply the principles of effective utilization review, and support the consistent application of InterQual Criteria across review teams.
  • Certified Professional in Healthcare Management (CPHM) educates healthcare professionals on the value, challenges, history, legal aspects and recent trends in healthcare management. It addresses the growing responsibilities of care managers in the healthcare industry from both the payor and provider viewpoints.
  • InterQual Technology and Integration Services include software customization, Web services development, interface construction, hosting and management services and much more—all designed to help InterQual products deliver value quickly, no matter what the environment.
  • InterQual Business Consulting Services encompass application optimization, operational efficiency consulting and strategic planning. These services are fueled by our team of professionals who bring their extensive field experience and creative problem-solving skills to bear on even the most complex medical management challenges.

Advanced Diagnostic Management

  • Clear Coverage is McKesson’s ground-breaking Automated Authorization and Coverage Determination tool streamlines payor-provider authorizations and medical reviews using evidence-based criteria. It reduces administrative costs and inappropriate medical costs with automated, real-time clinical and financial decision-making at the point of care.
  • Clear Orders aggregates orders regardless of source or format and performs all required medical necessity, ABN and specimen handling checks before a test is performed. The solution then routes orders to your lab information system (LIS) or to an appropriate lab for send-outs.

Care Management Services

  • Personal Health Advisor, McKesson’s new, integrated online member portal, provides members with deep educational content and interactive tools, such as online nurse advice, wellness tools, personal health record, symptom advisor, financial and health statements, alerts/reminders and connection to McKesson’s nurse-advice triage program.
  • CareEnhance Nurse Advice Services are services that help payors control costs by providing members/beneficiaries with the best healthcare information possible, helping them choose the proper type of care.
  • CareEnhance Disease Management Services are services that incorporate telephonic and community outreach, member/beneficiary marketing fulfillment, remote monitoring, physician communications, and data warehousing and exchange to better manage high-cost, high-prevalence diseases.

Business Intelligence

  • CareEnhance Resource Management Software (CRMS™) integrates clinical and financial data and applies a sophisticated series of evidence-based clinical rules and algorithms to assist with key business and care management activities, such as pay-for performance programs, network management, quality improvement, employer management, and HEDIS and other regulatory reporting.

Claims Performance

  • ClaimCheck® Plus is a comprehensive code auditing solution that assists payors with proper physician and facility reimbursement.
  • Total Payment™ Solution is the industry’s first and only comprehensive and automated payment management solution, goes far beyond traditional code editing. Total Payment delivers essential clinical, contract and fraud intelligence to virtually every claims payment decision, including both professional and facility claims.
  • ClaimsXten™ helps payors ensure accurate and consistent payment of healthcare claims by automatically checking them against clinically based “edits” or rules.
  • Total Payment Integrity Suite is a collection of modules that combine clinical rules with data-driven analytics to prevent payment of wasteful or abusive claims, and to create a continuous payment optimization cycle that reduces claims leakage in a complex and dynamic payment environment.
  • Total Payment Contract Compliance facilitates the automated adjudication of contract terms, even highly complex inpatient facility contract terms, to assure more consistent, automated, accurate claims payment in compliance with contract terms and conditions, with much less manual audit or rework.
  • Total Payment Services help you identify and measure error rates, as well as help to identify and address opportunities in your claim processing system. During the implementation, McKesson assists in deciding which edits to turn on. Post-implementation, an Optimization Study, can quantify gaps between edits captured and those that could have been captured by Total Payment. Ongoing Claims Triage, Medical Chart Review and Custom Rule Development services support dissemination throughout the enterprise of intelligence gained to drive further payment optimization decisions.
  • Clear Claim Connection™ is a transparency solution; providers can look up the rules and rationale contained in ClaimCheck or ClaimsXten via a website.
  • InvestiClaim® retrospectively reviews claims and flags unusual patterns or odd claims that could indicate fraud or abuse.
  • Contract Symphony™ gives you the right tools to standardize, automate and streamline your entire contracting process ¾ from initiation through negotiation to renewal.