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Medicare Plan to Use Analytics App


May 15, 2008

Heritage Health Systems Texas Management Inc., which operates Medicare HMO plans covering 265,000 beneficiaries, has licensed software to assess the appropriateness of care.

The firm will use the InterQual Criteria application of McKesson Corp., San Francisco. The software analyzes medical records received from providers and other information to determine the appropriateness of treatments and level of care. For instance, the software can help the firm decide if a patient is best served in an acute care hospital, long-term care facility or via home health care.

The Web-based software will facilitate decision making during pre-certification, admission, concurrent stay and retrospective review processes.

Heritage Health is a subsidiary of Universal American Corp., Rye Brook, N.Y. More information is available at universalamerican.com and mckesson.com.

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