The structure and format of the criteria are designed with a single purpose: to obtain consistent and reliable information about the process of care delivery. MCAP does not challenge clinicians’ care decisions; it functions as an aid to advise on where care can best be delivered.
The evidence-based clinical criteria have been refined and updated by an international panel of experts during the last years; updated annually by the expert panel whilst reviewing the most up to date literature.
Critically, MCAP takes account of co-morbid and co-occurring conditions, providing assessments for patients of all ages using 55 medical and surgical and 48 mental health and substance abuse criteria sets in more than 30 different levels of care across medical, surgical, rehabilitation, neonatal, mental health and substance misuse services.
MCAP clinical utilization criteria are service-driven, the most effective, accurate, and least problematic method of determining the appropriate service level for patient care. The literature gives little direct guidance to healthcare providers on the appropriate setting in which to provide care, despite increasing recognition of complexity of admissions with co-occurring conditions. There is, however, significant literature providing evidence to support service-level decisions based on what care the patient requires. We have used that literature to create a service-driven tool, enabling our clients to quickly and accurately determine the most appropriate service level for the patient’s care.