We leverage guidelines created with input from medical specialty societies, peer-reviewed literature, academic institutions, and community physicians, and we employ next-generation data analytics to drive more appropriate care.
EviCore
Medical benefits management that improves care and reduces costs by enabling evidence-based care decisions for patients, providers and health plans.
Elevating Intelligent Care
At EviCore, we tackle ineffective procedures and treatments, missed diagnoses, and unnecessarily higher costs head-on.
We offer integrated solutions to ensure patient care is aligned with ever-evolving science and best medical practices.
Evidence-based Care Delivers Better Outcomes
Solutions as unique as your challenges.
With 25+ years’ experience and 1,400+ clinicians across dozens of specialties, our expertise and advanced technology help providers and payers guide optimal patient care for better outcomes.
Cardiovascular
Comprehensive oncology
Consumer engagement
Durable medical equipment
Gastroenterology
Gene therapy
Implant management
Laboratory management
Medical oncology
Musculoskeletal
Post-acute care
Prior authorization automation
Radiation oncology
Radiology
Site of care
Sleep
Specialty drug management
Guiding patients to low-cost, high-quality radiology sites of care is a win-win for health plans and patients.
According to a new report from EviCore by Evernorth®, Evernorth’s medical benefits management solution, the majority of patients are paying more than they need to for quality imaging services. In fact, 60% of imaging is performed in higher-cost hospital settings, typically without clinical reason.* And since 80 million CT scans alone are performed each year,** it’s easy to see how quickly those costs add up for health plans too.
On the other hand, by engaging with patients and guiding them to more affordable, quality sites of care, it’s also easy to see the opportunity for mutual savings. And there may actually be more benefits where that came from. Engaging patients about their options can also significantly improve health plan satisfaction.
Want to learn how? The following report explains it all – starting with the challenges with radiology sites of care and then expanding on the broad impact that Radiology Site of Care management can have on the entire patient health care journey.
* Levin DI and Janiga NJ. “2021 Outlook: Diagnostic Imaging Centers and Radiology Practices.” HealthCare Appraisers. May 3, 2021. http://healthcareappraisers.com/2021-outlook-diagnostic-imaging-centers-and-radiology-practices
** Harvard Health Publishing. “Radiation risk from medical imaging.” September 30, 2021. https://www.health.harvard.edu/cancer/radiation-risk-from-medical-imaging
The human and financial cost of peripheral vascular disease overtreatment
According to a new report from EviCore by Evernorth®, Evernorth’s medical benefits management solution, unnecessary interventions for the treatment of peripheral vascular disease (PVD) are happening at an alarming rate. In fact, 50% of peripheral vascular interventions don’t meet evidence-based guidelines.* And when performed outside of evidence-based guidelines, these invasive interventions not only come with serious risks, including major amputation and even death, but they often don’t actually improve patient health outcomes or quality of life.
What’s more, the treatment of PVD is estimated to cost six times more than other medical conditions, which means unnecessary and high costs for patients and health plans alike.**
The question is, what’s driving this overtreatment and how can we work together to help protect patients from the associated risks and costs? The following report delves deeper into the issue and details the evidence-based, symptom-specific treatment approach that can help patients successfully manage their disease without unnecessary surgical interventions.
*Smolderen KG, Romain G, Provance JB, Scierka LE, Mao J, Goodney PP, Henke PK, Sedrakyan A and Mena-Hurtado C. “Guideline-Directed Medical Therapy and Long-Term Mortality and Amputation Outcomes in Patients Undergoing Peripheral Vascular Interventions.” JACC Cardiovascular Interventions. 2023 Feb 13;16(3):332–343. https://doi.org/10.1016/j.jcin.2022.09.022
**Batchelor WB, Guzman E, and Rodrigues CJ. “Peripheral Vascular Interventions in Office-Based Laboratories: Good News for Disparities or Profit Margins?” Circulation: Cardiovascular Quality and Outcomes.2023;16. https://doi.org/10.1161/CIRCOUTCOMES.122.009631