Pathways and Low-Value Regimens

Evolent’s clinical pathways are made available on an individualized basis for limited uses for the determination of medical necessity and appropriate clinical treatment by providers. The clinical pathways are proprietary information of Evolent. Except as expressly permitted by Evolent, you may not modify, copy, reproduce, republish, upload, post, transmit, hyperlink, or distribute in any way the clinical pathways, nor may you sell, transfer, distribute, assign, lease, reproduce, or otherwise use the clinical pathways in commerce, in a manner that competes with or infringes upon Evolent’s intellectual property rights.

Disclaimer: Evolent clinical pathways do not constitute medical advice. Treating health care professionals are solely responsible for diagnosis, treatment, and medical advice. Rather, Evolent provides clinical pathways to physicians for guidance in selecting patient-specific treatment plans. Evolent clinical pathways are periodically updated to incorporate changes in clinical evidence and medication cost information using evidence-based standards. Bookmark this landing page to easily access the most recently published pathways.

Affirmative Statement: Evolent’s policy states that utilization review decisions are based only on medical necessity, appropriateness of care and service and the existence of coverage. There are no rewards, bonuses or incentives for practitioners or other individuals for issuing denials or approvals of coverage, service, or care. There are no financial incentives for utilization management decision-makers to encourage decisions that would result in underutilization or over-utilization. All medical necessity determinations are based upon nationally recognized standards of care and clinical guidelines and are not influenced by financial or in-kind incentives.