MCG Health

Guiding the most effective care.

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Overview

MCG Health, part of the Hearst Health network, provides unbiased, evidence-based clinical guidelines and software solutions used by health plans and providers. The guidelines help drive effective care by supporting decisions about utilization management, case management, care transitions, and health equity.

✨ Key Features

  • Evidence-based care guidelines
  • Inpatient & Surgical Care guidelines
  • Ambulatory Care guidelines
  • Chronic Care and Behavioral Health guidelines
  • Integration with provider and payer systems
  • Analytics and benchmarking

🎯 Key Differentiators

  • Focus on guiding 'effective care' based on clinical evidence
  • Annual updates to guidelines based on rigorous literature review
  • Strong market penetration in the payer space

Unique Value: Helps payers and providers align on effective care decisions, improving patient outcomes while managing costs.

🎯 Use Cases (4)

Utilization management and prior authorization Case management and care coordination Determining appropriate level of care Managing care transitions and readmissions

✅ Best For

  • A leading solution used by a majority of US health plans and many hospitals to inform care management and medical necessity decisions.

💡 Check With Vendor

Verify these considerations match your specific requirements:

  • Point-of-care diagnosis and treatment for clinicians
  • Drug monograph reference

🏆 Alternatives

Change Healthcare (InterQual)

MCG and InterQual are the primary players in this market, offering competing sets of evidence-based guidelines for utilization and case management.

💻 Platforms

Web EHR-integrated

🔌 Integrations

Epic Cerner Various case management and payer platforms

🛟 Support Options

  • ✓ Email Support
  • ✓ Phone Support
  • ✓ Dedicated Support (All tier)

🔒 Compliance & Security

✓ HIPAA ✓ BAA Available ✓ SSO

💰 Pricing

Contact for pricing

Free tier: N/A

Visit MCG Health Website →