The Value of MCAP™

MCAP™ Clinical Review Criteria Methodology

It begins with our methodology. MCAP Clinical Review Criteria is different from all other criteria products. We think it's why we're better.

When you consider what clinical review criteria are created to do, we wonder why more people don't stop and ask why they employ a tool that is hard to use, leads to evaluation "gaming" by reviewers and often provides inaccurate results?

We wonder. But when you look at the industry as a whole, that's exactly what the majority of healthcare institutions do. Why?

Does the CMS Mandate a Clinical Review Criteria?

If you think it's because the government says you have to, we understand. There is a lot of misinformation out there. If you carefully review the only relevant guidelines from the Center for Medical Services (CMS) , you will note that no particular criteria product is specified or required. Reviews performed by MCAP Clinical Review Criteria are just as acceptable to CMS as those performed by any other criteria product.

Often, we hear that they use the leading criteria product because their payer uses it—it's just easier to use the same criteria product, they say. We accept this logic, but we still wonder why any healthcare institution, provider or payer, would use a product that leads to inaccurate outcome when they don't have to?

The good news is, the old way of thinking is changing. Leaders in the healthcare industry are switching to MCAP Clinical Review Criteria because:

MCAP is easier to use;
MCAP requires patient information that is readily available; and
MCAP provides clear, accurate, consistent results across the continuum of care.

The role of case review criteria is to ensure the highest quality of care from the shortest length of stay and the lowest possible cost. Leading healthcare institutions in the United States and Canada choose MCAP Clinical Review Criteria because it helps them achieve these goals quickly, accurately and reliably.

Leading healthcare institutions choose MCAP Clinical Review Criteria for one more reason—The Oak Group is a good company to do business with.