OREANDA-NEWS. November 15, 2013. McKesson Health Solution's new release of its Network Management suite is designed to help plans thrive in a post-reform world. By combining key aspects of provider information management, network design, contracting, and reimbursement, McKesson gives payers the first strategic platform for tackling value-based reimbursement and managing costs in a competitive and uncertain market.

"Network management can't be viewed as an administrative function any longer," says Carolyn Wukitch, senior vice president, Products Division, McKesson Health Solutions. "The new care delivery and reimbursement models need more complex agreements between health plans and providers to help improve care and reduce cost. Unfortunately, current systems weren't designed to accommodate these payment and reimbursement strategies-until now. McKesson's Network Management is the industry's only end-to-end suite designed to help payers align and automate policies to deliver value. Now it's possible to reimburse correctly and consistently, and optimize payment strategies for a post-reform world."

As many as 30 million new members from Medicaid and health insurance exchanges are projected to enter the market, creating intense demand for new payment strategies, care delivery models, and benefit designs. Payers are under pressure to make network management a strategic asset for tackling value-based reimbursement and managing cost. And those who do will get a single source of truth that helps them design the right networks to support the right products, and speed those products to market faster than competitors.

McKesson's Network Management solution suite combines McKesson Provider Manager™, McKesson Reimbursement Manager™ and McKesson Contract Manager™ into a cohesive modular platform. Each solution can be deployed individually and can feed other systems, so health plans can phase implementations and, ultimately, orchestrate value-based reimbursement from start to finish:

McKesson Contract Manager minimizes the financial risk associated with the complex contract terms in new care delivery and reimbursement strategies. It allows for a rules-driven contract process that reduces errors, time and administrative costs.

McKesson Provider Manager provides a single source of truth to manage the complexities of networks, provider information, and affiliations. It integrates all aspects of provider data, from demographic profiles to affiliations and contract details; to serve as a means to inform provider contracting, utilization management, and authorization and provider pick processes.

McKesson Reimbursement Manager helps automate and connect the entire reimbursement lifecycle, associating the right fee schedule with the right provider in real time. When connected with McKesson's ClaimsXten™ and Provider Gateway, complex claims editing, provider and contract selection, and claims pricing functions are centrally handled.

"Payers need an interoperable network management suite that expands automation, supports their vision, differentiates them in the market, and helps them respond with agility to unceasing disruptions," Wukitch says. "By combining and automating network management's four key areas, we're helping health plans collaborate with providers on products, care delivery models, and payment approaches; and ultimately succeed with their strategies."

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