Inpatient and Surgical Care
The evidence-based Inpatient and Surgical Care product provides a broad array of easy-to-use care management tools that enable proactive, quality-driven care. The current best evidence is integrated with these tools, giving users easy access to references and footnotes throughout.
Achieve your care management goals with:
- Actionable admission/procedure and discharge criteria enabling efficient pre-authorization
- Detailed, day-by-day care pathway tables that assess level of care, clinical status, activity, routes, interventions and medications
- Comprehensive observation care admission/discharge criteria provided for over 80 topics, including abdominal pain, syncope, and chest pain
- Quality measures that are incorporated within users’ workflow and flagged, including: CMS Hospital Quality Alliance and NCQA HEDIS®
- Actionable case management content that provide a case manager “job description” by diagnosis, emphasizing proactive care management
- Annotated Bibliographies that provide an interpretive summary of the evidence along with the evidence grading.
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Download Inpatient and Surgical Care Brochure |
Important Information About the Milliman Care Guidelines: The Care Guidelines can be used by qualified, healthcare professionals as a tool in making medical necessity decisions, but they should not be used as the sole basis for denying coverage of payment. The Care Guidelines must be applied to the individual patient on a case-by-case basis and always in the context of a qualified, healthcare professional’s clinical judgment.