A holistic, quality-first approach to cardiology management
Identify the best services and ensure alignment with treatment and testing guidelines.
Evolent helps avoid inappropriate utilization that often result in patient discomfort, complications, and additional unnecessary services.
We go beyond traditional cardiology management by proactively guiding providers to elect evidence-based services that often go underused.
We earn providers’ trust and sustainably improve practice patterns through a collaborative evidence-based approach that puts patient outcomes first.
Tackling the total cost of cardiology care
Medical costs in cardiology are projected to increase by about 25% every five years, skyrocketing to $750 billion by 2035. Unfortunately, about one-third of that spend may be for clinically inappropriate services.
Evolent helps payers to increase care quality while reining in costs by ensuring they use the most appropriate care in each patient case. We offer cardiologists point-of-care guidance and automatic pre-approvals that promote the use of evidence-based protocols. Our value-based physician reimbursement models align incentives to significantly reduce unnecessary diagnostics and preventable hospitalizations.
Key elements of our solution include:
High-value cardiology pathways
Our comprehensive, proprietary clinical pathways guide providers to the highest-quality choice for almost any clinical scenario in cardiology. Based on the American College of Cardiology’s Appropriate Use Criteria and vetted by our independent Cardiology Scientific Advisory Board, these pathways help reshape practice patterns over time, deter clinically inappropriate services and prevent downstream health events.
Dynamic clinical decision support
Our point-of-care platform puts pathways at providers’ fingertips and provides instant authorization when they select high-value services. Cardiologists rely on our clinical quality reporting for patient-level scoring and practice pattern benchmarking.
Collegial peer-to-peer outreach
When clinical review is required, these conversations are led by Evolent physicians with deep expertise and experience in cardiology and its subspecialties. Our board-certified cardiologists treat these discussions not only as an opportunity to ensure that a given patient receives the most appropriate services, but also as a chance to engage providers, ensure they are on top of the clinical evidence and, hopefully, influence long-term decision making.
A focus on underuse as well as overuse
Traditionally, health plans' dominant strategy to prevent inappropriate use in cardiovascular care has involved denying requested services via utilization management. However, such a one-dimensional approach misses large opportunities to improve care and control spending. Evolent takes proactive steps to increase adoption of low-cost, high-value services that can avoid downstream hospitalizations, procedures and other costly utilization.
Insights and action plans
Our analytics team identifies the highest-impact performance initiatives. Dedicated medical economics staff partner to surface further opportunities for improvement.
Comprehensive scope
Evolent has the capability to enter capitated risk agreements in which we take full clinical and financial responsibility for cardiology spend, so plans can focus on other challenges. Our scope includes many sub-specialties, such as cardiovascular interventions, electrophysiology and surgeries.
Complementary Solutions and Products
Our solutions are designed to work together to connect the complex care experience.
Reducing cancer therapy’s toll on the heart
Evolent is leveraging our expertise in two key specialties to reduce cardiovascular damage related to cancer drugs.
