Milliman Guide User Instructions
I received a heads up a little over a month ago that Milliman Care Guidelines had been adopted by CMS to determine appropriate level of care. I scoffed at the concept because federal guidelines that you and I get to review as proposed rule before they become final would certainly not be overridden with private company standards without little or no warning. Yet, sure enough, the posted this newsworthy announcement back in 2010: (SEATTLE) November 11, 2010 — Milliman Care Guidelines will provide its evidence-based clinical guidelines to Centers for Medicare & Medicaid Services (CMS) healthcare review contractors through a license with Buccaneer Computer Systems and Services, Inc.” Milliman website company description: “Parent company Milliman is among the world’s largest independent actuarial and consulting firms. Founded in Seattle in 1947 as Milliman & Robertson, the firm has more than 50 offices worldwide, and employs more than 2,400 people in healthcare, employee benefits, property and casualty insurance, life insurance and financial services consulting practices.” Its history and strength is actuarial driven with guidelines that provide LOS targets, utilization models, guidance for extended stay and continued stay discharge criteria. They note these are driven through best practice and evidence-based management articles.
However, last I checked, beneficiary reasonable and necessary decisions were legally based on Medicare manual regulations. If you feel we have been doing a great job in post acute care to provide the needed published research that helps to support specific criteria to determine IRF versus SNF specific care and continued stay – you can stop reading and let these predictive guidelines be your marker for decision. If you are still reading (and I hope you are), you agree there is limited best practice publications and only recently specific rules to begin tracking quality outcomes. Take notice that per the Milliman announcement, CMS ”Contractors will have access to Milliman Care Guidelines products spanning the continuum of care, including Ambulatory Care, Inpatient and Surgical Care, General Recovery Guidelines, Recovery Facility Care, Home Care and Behavioral Health Guidelines.
They will access the guidelines using CareWebQI ® interactive software, enabling reviewers to track variances and clearly document decisions during concurrent and retrospective reviews.” And I question, do the unique skills and interventions of an inpatient rehabilitation facility fall under “General Recovery” or “Recovery Facility”? I am not sure what due diligence was done to align the Code of Federal Regulations and CMS Manual mandates against each and every Milliman guideline.
So it begs to question that when Medicare administrative contractors and recovery audit contractors have access to these products, are the clinical standards close enough to published federal standards to approve or deny. Stay ahead of the changes CMS is bringing to your IRF. Access and payment? If Milliman guidelines can be used to judge appropriateness of care and continued access with CMS approval, everyone with Medicare provider status needs to completely understand how they will be used. A whole host of insurance companies other than Medicare reference Milliman, therefore, to advocate for patient access and continued care it seems facilities need to know information requirements for documentation. If you don’t agree with the standards as they relate to an IRF level of care, what can be done to provide the evidence to help update the standards? I think we would all agree that practices must be adopted with specific expectations so that variances are appropriately managed.
Staff and processes must be supported to fulfill expectation criteria. Those of us long in the field have had some dispute with actuarial guidelines used to inappropriately limit access to care. The clinical picture and progress of documented care and response to care is hugely important. The patients documented functional and clinical care and training to enable increased independence is crucial. What can you do to be sure the patients you treat show continued response to the care provided?
Does your documentation provide information that can be used to concurrently and retrospectively stand toward Milliman specific measurements? Can you be sure that resources provided can stand up to payment scrutiny? If these standards are not consistent with Medicare manual guidelines, is your staff ready to recognize the differences and to dispute where appropriate? Another level of pay for performance has been unveiled. Were you ready? Did you recognize that it already occurred? Outcomes are important – swift changes are occurring!
Evidence-based clinical standards are highly dependent on evidenced-based management. We must know our expectations and clearly be accountable toward them. First and foremost – you also must know the standards used to guide decisions. Finally, a search for Milliman Guidelines at the CMS website revealed no matches. Generally I receive a Medicare Learning Network (MLN) update for significant beneficiary access and payment criteria.
Steve Morgan Chief Operating Officer Steve Morgan serves as chief operating officer for Mediware and is responsible for setting direction and executing against the company’s strategic objectives and priorities. With 16 years of industry experience, a passion for company culture, and an emphasis on the client experience, Steve leads Mediware’s diverse teams focused on optimizing client workflows, efficiencies, and outcomes. Prior to joining Mediware in June 2018, Steve served as COO for OptumInsight, a division of Optum, which is the health services platform of UnitedHealth Group. Steve was broadly responsible for the company’s annual operating plan with a focus on employee engagement, client management, growth, and innovation. He was fundamental to the growth and strategic scalability of OptumInsight on an organic basis and through the completion of several critical acquisitions that were integrated into the company. Steve holds a bachelor’s degree in accounting and business administration from the University of Kansas. Bill Miller Chief Executive Officer Bill Miller is the CEO of Mediware and a recognized leader in the healthcare industry.
He has a rich background that includes a more than 20 year history of bringing groundbreaking growth strategies and technological innovation to the healthcare marketplace and a proven track record of launching and leading highly successful healthcare IT companies. Prior to joining Mediware in July 2017, Bill was the CEO of OptumInsight, a division of Optum, which is the health services platform of UnitedHealth Group. Under Bill’s leadership, OptumInsight experienced unprecedented revenue growth, expanded margins, and claimed a transformative position in the health services market. He led the evolution of Optum into the leader in health care analytics and launched several tech-enabled business platforms. Prior to OptumInsight, Bill served as senior vice president of technologies at Cerner Corporation, where he had global responsibility for the company’s managed services, outsourcing, and technology services business units. A graduate of the University of Kansas, Bill holds a bachelor’s degree in economics and a master’s degree in urban planning and public policy. Chris Hester President, Home Care Chris Hester founded Kinnser Software in 2003, when he developed an innovative web-based application for home health agencies.
He served as the company’s president for 14 years of rapid growth, which saw Kinnser become the most widely used EMR in home health and expand into new markets, including hospice and private duty home care. Kinnser Software was acquired by Mediware in June 2017. Today, Chris serves as president of Mediware’s home care division, which includes applications for home care, home health, and rehabilitation. Rob Weber President, Community Care Rob Weber serves as president of Mediware’s diverse community care division, overseeing applications for behavioral health, homeless management, long-term services and supports, medication management, and blood management. Rob has held this position since 2017, and he previously also managed many of Mediware’s other clinical applications, including blood services and medication management. Rob joined Mediware in January 2004, originally serving as executive vice president and general counsel, and he continues to serve as the company’s general counsel for legal and regulatory matters. Robert Watkins Chief Financial Officer Robert “Bob” Watkins started at Mediware as corporate controller in 2008.
In 2011, he was promoted to vice president and corporate controller and to CFO in 2012. Prior to joining Mediware, Bob held a number of financial management positions, including serving as corporate controller for Titan Machinery (TITN), a $1 billion provider of agricultural and construction equipment. His prior experience also includes a corporate controller position at AFS Financial, where he also served as chief financial officer.
Bob is a current member of the AICPA and Financial Executives International. Joel Dolisy Chief Technology Officer In his role as chief technology officer, Joel Dolisy manages both product development and information technology for Mediware. Before joining Mediware as CTO, Joel was CTO of Kinnser Software, where he led the company’s engineering and product organizations. Before Kinnser, Joel was SVP, CTO, and CIO for SolarWinds, a leading provider of IT management software. With more than 20 years of experience in product strategy and software engineering, Joel is a leader in developing and delivering commercial software products to market.
Chris Stansbury Executive Vice President, Growth As executive vice president of growth, Chris Stansbury works with all sales teams within Mediware to create and standardize best practices for selling, interacting, contracting, and negotiating with clients. With over 25 years of health care IT services sales leadership, Chris has experience in all aspects of health care, including the provider side when he was at Cerner, the payer side when he was at TriZetto, and the Wellness side as he most recently was a vice president at Welltok. Shoma Sarkar Thomas Senior Vice President, Marketing and Communications As the senior vice president of marketing and communications, Shoma Sarkar Thomas oversees the marketing strategy for all Mediware products and is responsible for building the Mediware brand, which includes public relations, communications, and all strategic marketing activities. Previously, Shoma served as vice president of marketing for Kinnser Software, where she led marketing and strategic growth initiatives. She holds a bachelor’s degree in economics and international relations from the University of Virginia. Stephen Greenberg SVP of Human and Social Services Stephen (Steve) Greenberg is responsible for Mediware’s Homeless & Community, Behavioral Health and LTSS businesses. Prior to joining Mediware, Steve was President of DecisionHealth, LLC for six years, after which time he successfully helped execute the sale of this revenue cycle management decision-support company.
Before that, he worked at OptumInsight for 12 years as a senior leader of many of its provider software and service solutions and, in his last role as SVP, Government Solutions, built a prospective and retrospective fraud, waste and abuse detection capability for UnitedHealthcare’s Medicare and Medicaid businesses. Dana Streck Senior Vice President, Human Capital Dana Streck leads Mediware’s human capital organization. Before joining Mediware, Dana was senior director of workforce transitions for Cerner Corporation, where she welcomed and transitioned new team members into Cerner through client partnerships and acquisitions. With more than 15 years of experience in human resources, Dana has successfully partnered with business leaders to drive workforce initiatives that benefit both companies and clients, while simultaneously creating environments that support growth and innovation. Jason Baker VP, Corporate Development As vice president of corporate development for Mediware, Jason Baker is responsible for acquisitions, partnerships, and new market strategies. Prior to joining Mediware, he was a managing director for Alpine Healthcare Advisors and Healthcare Growth Partners, both of which provide investment banking services in healthcare technology and services. Jason also served as head corporate development executive for Cerner Corporation.
He holds an MBA from the University of Chicago Graduate School of Business and a bachelor’s degree in business administration from the University of Missouri. Wes Little Vice President, Applied Insights As vice president of analytics, Wes Little leads Mediware’s unified analytics strategy to deliver data-driven insights and innovative solutions. He previously served as director of product management for Kinnser Software, where he oversaw rapid product innovation for the company’s home health electronic medical record software.
Wes holds a Master of Business Administration from the University of Texas at Austin’s McCombs School of Business and a bachelor’s degree in economics from Washington and Lee University.
Free Iphone Se Manual Guide User Guide
A user guide or user's guide, also commonly known as a manual, is a intended to give assistance to people using a particular system. It is usually written by a, although user guides are written by programmers, product or project managers, or other technical staff, particularly in smaller companies. User guides are most commonly associated with electronic goods, and. Most user guides contain both a written guide and the associated images. In the case of computer applications, it is usual to include of the human-machine interface(s), and hardware manuals often include clear, simplified. The language used is matched to the intended, with kept to a minimum or explained thoroughly.