MEDecision Integrates Medical Management at Blue Cross and Blue Shield of Oklahoma

Integrated Medical Management to Improve Quality of Care and Slash Costs; MEDecision Selection Based on Superior Usability, Flexibility and Service

WAYNE, Penn., March 11, 2003 -- MEDecision Inc., a software and services leader in care management, today announced that Blue Cross and Blue Shield of Oklahoma has licensed MEDecision's Integrated Medical Management (IMM) solution for integrated case, disease and utilization management. With the announcement, Blue Cross and Blue Shield of Oklahoma becomes the sixteenth Blue Cross and Blue Shield organization to rely on MEDecision for integrated care management.

Blue Cross and Blue Shield of Oklahoma signed a license for the Advanced Medical Management component of IMM. The managed care organization (MCO) cited superior usability, flexibility, and service as key factors in selecting IMM over competing systems.

"Our primary goal is to improve patient outcomes, as well as contain the costs associated with ongoing care management," said Dr. Rodney Huey, group vice president and corporate medical director at Blue Cross and Blue Shield of Oklahoma. "In our evaluations, MEDecision's Advanced Medical Management emerged as the best solution for integrating our utilization, case and disease management. Similarly, the company's responsiveness and thoroughness confirmed MEDecision as the partner best able to help us reach our goals."

Added John H. Capobianco, executive vice president and chief marketing officer at MEDecision, "Blue Cross and Blue Shield of Oklahoma validates our approach to care management, which couples best-of-breed solutions with premium service and support. For Oklahoma, MEDecision becomes a trusted partner in care provision, setting the stage for improved quality of care and reduced MLR by uniting case, disease and utilization management under IMM."

Behind the Oklahoma Decision

In choosing IMM over competing care management solutions, Blue Cross and Blue Shield of Oklahoma identified several highlights. Oklahoma evaluators cited usability, especially the user-friendly interface, as a key differentiator, as well as MEDecision's exemplary service and support.

MEDecision's Integrated Medical Management also demonstrated superior workflow flexibility when compared to competing solutions. Specifically, Blue Cross and Blue Shield of Oklahoma can modify workflow to accommodate Oklahoma's existing internal organization and its established business processes.

Continued MEDecision's Capobianco, "Our business isn't to dictate the business strategy of the MCO. Instead of demanding strict adherence to MEDecision's idea of case workflow, we designed IMM to be very flexible so that it can adapt to each MCO's environment." Once in production at Blue Cross and Blue Shield of Oklahoma, IMM will integrate with Milliman USA's Care Guidelines clinical criteria. The integration represents MEDecision's ongoing association with Milliman, establishing an unsurpassed degree of clinical and business consistency by applying Care Guidelines across Oklahoma's case, disease and utilization management.

About IMM

With Integrated Medical Management (IMM), MEDecision dramatically improves the relationship between providers, patients and managed care organizations to create the greatest impact on the quality and cost of care. IMM gives MCOs the tools to identify high-risk, high-cost members, diseases and conditions, and then implement the programs needed to improve patient care and optimize costs. Further, IMM automates healthcare transactions between MCOs and providers, and drives a consistent clinical philosophy throughout the care management process.

IMM relies on three tightly coupled components to help MCOs identify areas of financial and clinical risk, implement programs to manage these risks, and continuously evaluate the effectiveness of these programs.

-- Analytics and Disease Management provides the predictive capabilities, clinical picture, management tools, and data analysis, enabling MCOs to create the right programs, target the right members and provide the appropriate feedback to providers.

-- Advanced Medical Management unites clinical staff with care management processes through automated workflow and detection tools. MCOs can thereby manage their population across the continuum of care and assess the clinical and financial outcomes of care management programs.

-- Transactioning and Automated Authorizations create the necessary bridge to electronically link physicians, hospitals and the MCOs, supporting the direct submission and processing of healthcare transactions, including referrals, authorizations and extensions.

Working together, these three components place all the data, both historical and current, in the hands of the care managers and provide comprehensive, automated tools that ensure the most efficient handling of information and consistent application of rules throughout the medical management decision-making process.

With IMM, MEDecision takes a fundamentally different approach to traditional care management, treating the integration of individual IMM components as a core design element, rather than an afterthought. The result is a solution that closely mirrors the way chief medical officers and MCO executives intuitively think about their business and their health care responsibility, where the interdependencies of care management, analytics, and transaction/authorization systems are recognized and leveraged.

About Blue Cross and Blue Shield of Oklahoma

Blue Cross and Blue Shield of Oklahoma is a member of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.

About MEDecision

MEDecision is a leading software and services provider of integrated care management solutions. Founded in 1988, the firm specializes in linking patients, providers and payers in an information network to improve overall health outcomes and reduce costs. MEDecision customers include multiple Blue Cross and Blue Shield organizations, complex health management organizations, integrated delivery networks, Medicaid managed care organizations, major insurance carriers and specialty managed care firms.

MEDecision's software products are being used by 47 managed care organizations to improve the quality of healthcare and reduce both administrative and unnecessary clinical costs for over 33 million people -- approximately one in every seven Americans with health insurance. MEDecision's solutions include integrated case, disease and utilization management, high-risk patient identification, automated authorizations, provider profiling and quality analysis.

For more information about MEDecision and Integrated Medical Management, please call 610/254-0202, email Marketing@MEDecision.com or visit www.MEDecision.com.

Note to Editors: MEDecision is a trademark of MEDecision, Inc. The MEDecision logo and product names are also trademarks or registered trademarks of MEDecision, Inc. Other products and brand names are trademarks of their respective owners.


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      CONTACT: MEDecision
               Laura Paden, 650/344-1260
               Laura.Paden@MEDecision.com