EviCore by Evernorth

Medical benefits management that improves care and reduces costs by enabling evidence-based care decisions for patients, providers and health plans.

Female doctor with plus grid background

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.

Elderly black woman with Male doctor
Evidence-based care delivers better outcomes

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.

Male physician

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
+ Musculoskeletal
+ Comprehensive oncology
+ Home health
+ Consumer engagement
+ Prior authorization automation
+ Durable medical equipment 
+ Radiation oncology
 

+ Gastroenterology 
+ Radiology
+ Implant management 
+ Site of care
+ Laboratory management 
+ Sleep
+ Medical oncology

Radiology Site of Care

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.

Woman sitting at MRI with attendant
Since 80 million CT scans alone are performed each year,2 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.

60%
of imaging is performed in higher-cost hospital settings, typically without clinical reason1

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.

EviCore Report on Tablet
Peripheral Vascular Disease

The human and financial cost of peripheral vascular disease (PVD) 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.

When performed outside of evidence-based guidelines, 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.4

50%
of peripheral vascular interventions don’t meet evidence-based guidelines.3

What’s driving this overtreatment and how can we work together to help protect patients?

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.

EviCore report on tablet

Connecting millions of lives to better care

What can EviCore do for you? Contact our dedicated and experienced team to learn how we can help your plan deliver the right care at the right time for less.
Asian male physician speaking to elderly Asian male patient

Sources

  1. Levin DI and Janiga NJ. “2021 Outlook: Diagnostic Imaging Centers and Radiology Practices.” HealthCare Appraisers. May 3, 2021
  2. Harvard Health Publishing. “Radiation risk from medical imaging.” September 30, 2021
  3. 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. 
  4. 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.