Amerigroup Selects McKesson Clear Coverage to Improve Care Quality, Cost Efficiency and Provider Communication

New Contract Closely Follows Amerigroup’s Selection of InterQual as Its Single Source of Clinical Decision Support Content

NEWTON, Mass.--(BUSINESS WIRE)--Amerigroup Corporation, a national managed care company, has selected Clear Coverage™ from McKesson as its point-of-care utilization management, coverage determination and network compliance platform. This agreement follows Amerigroup’s choice last fall to license the InterQual^® evidence-based clinical decision support criteria suite, supporting greater consistency in determinations of medical appropriateness while improving provider satisfaction. Using Clear Coverage, Amerigroup will be able to share InterQual Criteria with providers at the point of care, encouraging greater collaboration and better decisions while containing costs.

“McKesson’s decision management solutions enable our company to excel at establishing a common language and a common technology framework between our members and providers for efficient workflows and optimal decisions”

“McKesson’s decision management solutions enable our company to excel at establishing a common language and a common technology framework between our members and providers for efficient workflows and optimal decisions,” said Lisa McCormick, vice president of Health Care Programs for Amerigroup.

With InterQual as its single source of criteria, Amerigroup then opted to use Clear Coverage, which incorporates InterQual Criteria and enables automated medical review, authorization, notification, eligibility and direction of members to in-network service providers. Providers have immediate access to coverage, medical appropriateness and network rules at the point of care. This access supports evidence-based care delivery and ultimately lower costs with better quality. Additional reasons for the selection included the solution’s friendly user interface and ease of customization, as well as the quality of the McKesson project team, which created a thorough project plan that included support in driving provider adoption.

“One of the most exciting developments in healthcare is that payers and providers are partnering more than ever before. This partnership will ultimately optimize the healthcare system and achieve better, more accessible care at lower costs. Solutions such as InterQual and Clear Coverage provide the necessary foundation for connection, communication and collaboration with intelligent decision-making,” said Matthew Zubiller, vice president of decision management at McKesson Health Solutions.

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About Amerigroup Corporation

Amerigroup, a Fortune 500 company, coordinates services for individuals in publicly funded health care programs. Currently serving approximately 2.7 million members in 12 states nationwide, Amerigroup expects to expand operations to its 13th state, Kansas, as a result of previously awarded state contracts. Amerigroup is dedicated to offering real solutions that improve health care access and quality for its members, while proactively working to reduce the overall cost of care to taxpayers. Amerigroup accepts all eligible people regardless of age, sex, race or disability. For more information, please visit www.amerigroup.com

About McKesson Corporation

McKesson Corporation, currently ranked 14th on the FORTUNE 500, is a healthcare services and information technology company dedicated to making the business of healthcare run better. We partner with payers, hospitals, physician offices, pharmacies, pharmaceutical companies and others across the spectrum of care to build healthier organizations that deliver better care to patients in every setting. McKesson helps its customers improve their financial, operational, and clinical performance with solutions that include pharmaceutical and medical-surgical supply management, healthcare information technology, and business and clinical services. For more information, visit us at www.mckesson.com.

Tags: McKesson, McKesson Health Solutions, Amerigroup, utilization management, clinical criteria, clinical decision support, InterQual, Clear Coverage, point-of-care decision support, payer-provider partnership