The Evolent Difference

Ensuring Appropriate Care

More competition than ever exists in healthcare today. Through our population health-based model of care, we can identify populations with unmet clinical needs and create an appropriate clinical journey to accelerate the time to full recovery and wellness — all with the goal of improving outcomes and reducing costs for the individual and health plan alike.

Here's how our solutions can help:

• Administrative services only or risk-based utilization management (UM) arrangements accommodate clients’ operational and financial goals.
• Powerful analytics and artificial intelligence drive automated UM and help in the identification of serious conditions and the evaluation of provider performance.
• Varying levels of clinical intensity with:
  • Evidence-based, proprietary guidelines to help determine procedure appropriateness and minimize unnecessary care.
  • Specialty-matched medical reviewers that provide in-depth evaluations and meaningful input that facilitate accurate determinations.
  • Practicing physicians who offer peer-to-peer consults on best practices to improve performance, patient safety and outcomes.