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COLLABORATIVE CARE MANAGEMENT. throughout the continuum

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throughout the continuum

COLLABORATIVE

CARE MANAGEMENT

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Morrisey Concurrent Care Manager

(MCCM

)

MCCM supports acute and community case management; discharge planning; documentation reviews;

audits, denials and appeals management; quality/peer review; online risk incident reporting and tracking; liability claims management; and infection control. This fully integrated suite of applications is the only Web-based system to include an executive dashboard for point-and-click trend analysis.

Key features

• A longitudinal, patient-focused relational database

• Convenient online access

• Apple® iPad® and tablet support for remote access

• A rules engine that identifies and schedules patients for reviews automatically

• Configurable work lists

• Standard and ad hoc reporting options

• Point-and-click graphical reporting for department managers and executives

Care/Utilization Management

The Care/Utilization Management module helps hospital case managers optimize care processes to ensure quality outcomes and patient satisfaction. The software supports criteria-based reviews for medical necessity, standardized documentation and detailed communication with payors, physician advisors, post-acute care providers and others.

MCCM integrates McKesson’s browser-based CareEnhance® Review Manager and the Milliman® CareWebQI application. The system also enables users to define and load their own criteria for case reviews.

Enter unlimited notes and use pre-defined comment templates to simplify and standardize documentation.

MCCM integrates this information with detailed clinical documentation, lab results and medication orders to generate clinical information packets. These packets provide the details needed to communicate effectively with healthcare stakeholders.

Key features

• Real-time HL7 messages for updates to patient records

• Customizable rules for automatic identification of pre-admission, observation, admission, readmission and continued-stay reviews

• A link to continuum of care assessments, interventions and documentation to ensure continuity of care

• Automated referrals to internal and external physician advisors

• Standardized documentation and clinical information packets for use in payor contacts

• Automated identification and documentation of coverage notices, including important messages

• Variance tracking, including readmission assessments, and avoidable days and delays

Denials, Audits and Appeals

The Denials, Audits and Appeals module integrates with the Care/Utilization Management module.

MCCM records the financial effect of audits and denials and the outcomes based on the appeals process, allowing analysis of losses and recoveries by payor.

Key features

• Online audit tracking from insurers’ initial records requests to resolution

• Online denial tracking from insurers’ initial verbal denials to resolution

• Medical records tracking of requested and sent documents

• DRG validation, including initial and revised coding details

• Reporting that includes audit and denial types, and reasons and outcomes for revenue analysis

• Contact logs for recording and tracking interactions with payors and auditors

• Automated, organization-specific work lists

Morrisey helps hospitals and other healthcare providers achieve measurable

clinical, process and financial outcomes. Our products support reviews throughout the continuum of care, from pre-admission assessments to transitional care

planning and community-based population health management.

Our comprehensive care management software and optional modules, and Transitions of Care (TOC) solutions automate case management processes, streamline work flows and support collaboration among multidisciplinary teams.

These solutions exchange information with one another and integrate with existing hospital systems.

OPTIONAL modules

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Documentation Review

The Documentation Review module helps hospitals achieve their full reimbursement potential by enabling them to track and manage patient records for accuracy and completeness. The software uses automated rules to identify patients for documentation reviews. It supports automated queries to care providers who request clarifications to documentation and enables reviewers to escalate cases to internal and external physician advisors.

Key features

• Automated rules to identify populations that need documentation review

• Standardized physician queries when issues need clarification

• Configurable work lists

• Integration of concurrent coding, including working DRGs, procedures and diagnoses

• Report generation for reviewer productivity, physician query response rates and financial savings

• Case-specific reports for health information management to ensure accurate coding and billing

Transitions of Care Solutions

Morrisey’s integrated Transitions of Care (TOC) solutions facilitate online care coordination and

communication to close potential gaps in care and ensure safe, effective hand-offs. Case managers and post-acute care providers collaborate and share confidential information using a secure Morrisey-hosted website. Active and ongoing communication promotes adherence to treatment plans and reduces the potential for medical errors and unnecessary readmissions.

The TOC package includes the MCCM Provider Networking module, the Morrisey Care Communications Networking™ (MCCN™) website and the Survey Management module.

Key features

• Care communications networking from a Morrisey-hosted website that includes a national provider database

• A Web portal for post-acute care providers

• Survey capabilities to track compliance with care plans and patient outcomes

• Integration with MCCM’s acute and community care management modules

Discharge Planning

The Discharge Planning module integrates with the Care/Utilization Management module. The software helps case managers assess patient and family needs and develop effective discharge plans.

Enter discharge planning assessments, document patient and family needs and interventions, refer patients to social workers and other hospital support staff, and schedule follow-up reviews. Users can also track expected and actual discharge dates and dispositions in the system.

Key features

• Discharge planning assessment and referral tools

• Instant access to critical information for accurate discharge planning

• Online documentation of patient and family needs and interventions

• Online referrals and scheduling with social workers and other hospital support services

• Easy scheduling of follow-up reviews

• Documentation of transportation and required post-discharge service types and providers

• Documentation of patient choice to meet regulatory requirements

Provider Networking

The Provider Networking module helps hospitals identify and schedule post-acute care providers that meet specific patient needs, helping to prevent gaps in care and improving patient and provider satisfaction. Improving patient care transitions also helps hospitals reduce length of stay and unnecessary readmissions.

The module enables discharge planners to communicate electronically with a national network of providers to coordinate follow-up care. Case managers have instant access to providers’ availability, the insurance they accept, the equipment and services they provide, and other care coordination information.

The module includes an extensive library of intelligent forms that post-acute providers require for ongoing medical management. The forms integrate information from the MCCM database, eliminating duplicate data entry. Case managers can route forms to clinical staff members, who can then review

Key features

• Access to Morrisey’s national database of post-acute care providers

• Extensive search capabilities

• Required state and federal forms that users can complete, route and sign electronically

• Ability for hospitals to report referral volumes and reasons providers declined referrals

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MCCN Website Post-Acute Care Provider Portal

The MCCN website contains a portal for post-acute care providers, including skilled nursing facilities, rehabilitation centers, home healthcare companies, durable medical equipment providers and other post-acute care providers. These providers use the portal to manage patient referrals, communications and follow-up surveys from hospital case managers.

Intake coordinators review and approve or deny service requests. When they deny requests, they must document the reasons. For approved requests, hospital case managers can send required clinical documentation and forms to the post-acute care providers through the portal.

To encourage providers’ online participation, Morrisey does not charge providers to access the Post-Acute Care Provider Portal.

Key features

• Secure portal connects hospital case managers and post-acute care providers

• Free MCCN website access for post-acute care providers

• Integration with the MCCM system

Survey Management

The Survey Management module helps healthcare stakeholders comply with transitions of care plans by automating surveys and related activities from pre-admission assessment through post-discharge follow-up. Morrisey is the only care management vendor to offer user-defined surveys to ensure compliance with care plans and to track satisfaction and other outcomes.

The module makes it seamless to create and schedule surveys for primary care physicians, specialists, patients and families, and post-acute care providers online. Users can include response dates and get work-list alerts when respondents complete surveys, as well as when their responses are overdue. Reporting and trend analysis allows hospitals to identify problems quickly and take corrective actions, including targeted process improvements.

Key features

• Online survey creation, administration and management

• Work-list alerts for completed surveys, critical deadlines and overdue responses

• Survey delivery online through email or secure portals

• Trend analysis to identify areas for process improvements

Continuum of Care

The Continuum of Care module allows hospitals to manage high-risk patients beyond the acute-care setting. Users can define programs, functional assessments and quality studies for population management and track and report associated patient functional status, satisfaction and other outcomes.

Key features

• A rules engine to identify at-risk patients when they’re admitted and discharged

• Work lists of patients who require care assessments and related follow-up activities

• A link to inpatient case management documentation to ensure continuity of care

• Integrated scheduling of required follow-up activities and assessments

• Ability to document problem lists and goals to generate effective care plans

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Discharge Planning Export

The Discharge Planning Export module enables customers to export discharge planning documentation automatically for use in their electronic medical records systems. Hospitals can transmit complete discharge planning reports to patients’ electronic medical records or they can identify specific MCCM data elements to send to patients’ discharge planning flow sheets.

Morrisey’s development team works with customers to confirm integration requirements and develop the required export solution.

Key features

• Concurrent updates to inform clinical care teams about patients’ discharge plans

• Elimination of duplicate data entry in electronic medical records

• Integrated reporting and trend analysis available from MCCM

Financial System Export

Case managers use MCCM to document payor contacts, including initial and ongoing certifications, authorization numbers and days of stay approvals. This information is critical to accurate billing after patients are discharged. Hospitals can transmit complete payor authorizations and denials from MCCM to their billing systems. Morrisey’s development team works with customers to confirm integration requirements and develop the required export solutions.

Key features

• Concurrent updates that keep the business office apprised of payor authorizations and denials

Morrisey Enterprise Solutions

MCCM and TOC can stand alone or work in cooperation with Morrisey’s other enterprise solutions and modules, including MSO for the Web™ (MSOW®) and Morrisey Practitioner Performance

Reporting™ (MPPR™). MCCM, MSOW, TOC and MPPR provide integrated clinical and administrative data that supports effective, efficient operations and reporting.

Robust Reporting

MCCM features point-and-click graphical reporting for executives, physicians and nurse managers. In addition, MCCM integrates SAP® Crystal Reports® and SAP BusinessObjects™ Web Intelligence® for standard and ad hoc reporting.

The Morrisey Difference

• Comprehensive care management. Morrisey is the only company that offers a full spectrum of Web-based care management applications – from pre-admission review through community-based care management, including management of patient care transitions.

• Unique development process. We collaborate with customers on product requirements before we begin development. Customers work with us to shape, refine and test applications to ensure they meet market needs. We also work with customers to implement their suggestions for enhancements so that we remain agile, innovative and responsive to fast-changing business challenges.

• Flexible installation options. Install MCCM in a client-hosted environment or on Morrisey’s private cloud, Software as a Service+ (SaaS+). SaaS+ eliminates the need to buy, implement and maintain hardware and system software. You get the same functionality with both options, including secure access to your data for reporting.

• Annual customer conference. Morrisey brings together healthcare leaders, industry experts and customers to share best practices and strategies for overcoming business challenges, improving profitability and efficiency, and meeting regulations. Customers also learn how to optimize

Morrisey’s software solutions.

Integration with Hospital Clinical and Financial Systems

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The Care Management Life Cycle

Identify High-Risk Patients

Perform Assessments

Document Problems, Goals

Record Actions, Interventions

Coordinate Care with Providers

Assess Patient Risk

Identify Patient, Family Needs

Generate Discharge Plans

Coordinate Services, Placements

Document Patient Choice

DISCHARGE PLANNING

Search for Providers

Communicate via Portal

Complete Required Forms

Send Clinical Packets

Schedule Follow-Up Surveys

TRANSITIONS OF CARE

CONTINUUM OF CARE MANAGEMENT

Review Trends

Identify High-Cost Variances

Improve Processes

Track Improvements

DECISION SUPPORT ANALYSIS MORRISEY’S CARE AND TOC MANAGEMENT

SOLUTIONS

Complete Medical Necessity Reviews

Improve Clinical Documentation

Refer to Physician Advisors

Communicate with Payors

Track Delays, Other Variances

INPATIENT CARE AND UTILIZATION MANAGEMENT

Import Audit Requests

Document Denial Types, Reasons

Track Appeals

Record Financial Outcomes

AUDITS, DENIALS AND APPEALS MANAGEMENT

MCCM APPLICATION

SERVER

LONGITUDINAL PATIENTMCCM DATABASE

Electronic Medical Record Business Office

ADT HIM Coding Lab Results Pharmacy Orders Clinical Documentation Microbiology Cost Accounting

• Discharge Plans

• Payor Authorizations

DATA FEEDS DATA EXPORTS

FIREWALL

MORRISEY CARE COMMUNICATIONS

NETWORKING WEBSITE

MORRISEY NATIONAL PROVIDER

DATABASE

COMPUTER/TABLET COMPUTER

Inpatient Case Managers

Community Case Managers

Discharge Planners

Social Workers

HOSPITAL USERS

Intake Coordinators

Provider Administrators

POST-ACUTE CARE

PROVIDER PORTAL

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222 S. Riverside Plaza Suite 1850

About Morrisey Associates

Morrisey Associates is a world-class healthcare solutions provider that offers enterprise-level applications for practitioner credentialing and privileging, care management and practitioner performance

References

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