MCAP™ Clinical Review Criteria
Development Process
Criteria development has been ongoing at The Oak Group and its predecessor organization, Utilization Management Associates, since 1987. Prior to that time, many of the individuals who worked on the original MCAP Criteria participated in the development of the AEP (Appropriateness Evaluation Protocol) criteria, the first attempt to logically understand the reasons that patients are admitted to and continue to stay in the hospital and to decrease the variability of reasons for admission and length of stay.
MCAP Criteria are widely considered to be the most valid in the field. Both Medical/Surgical and Behavioural Health criteria are developed and updated annually through a rigorous and structured process, which is based on medical evidence. The process is ongoing with a thorough review of all of the criteria annually, with purposeful revisions based on updated information. There is a constant furtherance of the ease of use resulting in the refinement of both the words used and the underlying structure of the criteria. This process results in a revised set of criteria being released each year in the spring.
The development process includes review of the following:
- Literature from internationallyrecognized peer reviewed
medical journals; - Current research including outcome studies; clinicians, agencies, and organizations;
- Visits to facilities providing various levels of care; and
- ’ΔΆ Review twice-yearly by panels of medical experts. The Oak Group is committed to continuously refining the MCAP Criteria so that it remains the easiestto-use, most clinically valid system for determining optimal level-of-care placement and for assessing the factors that affect the efficiency of care delivery.
