InterQual® Coordinated Care

An integrated, cloud-based care coordination solution that helps payers and providers offer complex care management of high-risk members and patients with a single, blended care plan.


ManageHigh-risk and Complex Cases

  • Assess and manage complex cases efficiently with a single, blended care plan, created from a patented assessment that merges condition components.

  • Manage care holistically with assessment questions covering medical, behavioral, and social needs, in addition to comorbidities and cross-condition issues.

  • Enable evidence-based decision making with content developed with the same clinical integrity and standards as InterQual Criteria.
  • Streamline case management with a SaaS solution that is integrated into your existing workflow, offering greater efficiency, timely alerts, and support for clinician delivery of quality, appropriate care.

  • Create a tailored care management program to better control the medical costs of high-risk members and patients, help prevent readmissions and improve clinical outcomes.

  • Meet regulatory requirements with a solution that is URAC accredited for both for care management and disease management. The solution helps you meet NCQA PHM5, MBHO QI9, and SNP requirements.

Integrated Assessments and Patient Information

  • Comprehensive assessments

    • Provide assessments in simple Q&A format, including a Primary Assessment, which addresses common care barriers and can include multiple components.
    • Leverage 40 condition-focused modules, industry-validated screening tools, and five assessments: common barriers to care, case management, condition management, readmission reduction, and palliative care. 
  • Easy integration

    • Integrate our cloud-based solution into homegrown or third-party care management delivery systems. 
    • Leverage the SaaS architecture to provide access throughout a networked system – without increasing IT burden.
    • Gain real-time access to content and software upgrades without waiting for installation and validation, while maintaining control of upgrade timelines.
  • Support for case managers and members/patients

    • Help improve member/patient education with materials to guide case managers through the consistent presentation of condition-related information.
    • Reinforce education concerning specific conditions and condition management with companion member- and patient-facing fulfillment materials.

Our outcomes

View all insights


Need support for
this solution?

Let’s start a conversation

We’re here to help you find out how this solution could benefit your organisation. Complete the quick form to the right, and someone will reach out to you soon.

Our experts will:

  • Discuss your individual use case and business needs
  • Explain our features, benefits, and services
  • Show how this solution can help achieve your goals

Want more information? Start here.

Thank You

We appreciate your interest in Change Healthcare. A member of our team will contact you to better understand your needs and discuss potential solutions.

Together, we are accelerating the journey toward improved lives and healthier communities.