Care Management

Relentless Pursuit of Clinical Value

The Right Balance of Discipline and Innovation

Evolent Health helps our partners to focus their care management efforts where they can have the greatest impact on health outcomes and preventable spending. Powered by our advanced predictive technology, we identify which patients are most likely to experience serious and preventable medical episodes. Then, our care advisors draw on their clinical backgrounds and our proven care coordination approach to improve the health status of these patients.

  • Dedicated staff of care advisors utilizing evidence-based National Committee for Quality Assurance-compliant care management programs and innovative patient engagement techniques
  • Technology platform leveraging predictive analytics to avoid hospitalizations, emergency department visits and other costly expenditures that are preventable through improved primary care
  • Rigorous performance management helping to drive continuous improvement across clinical programs, workflow and staff
  • Clinical innovation engine offering our partners pioneering approaches to improving quality and reducing unnecessary utilization

"The resources you have to interact with patients are limited, so you really do need to find the ones you can actually make a difference with."

Donna Littlepage
Senior Vice President, Carilion Clinic

Consistent Value Creation

Providers who accept the financial risks of value-based care want confidence that they can steadily enhance quality and reduce costs. This requires a systematic approach to care management that captures value at every stage of the process: identifying at-risk patients, engaging them and managing their care.

Identify "impactable" patients

Our technology platform leverages clinical, administrative and social/behavioral data to predict the likelihood that a patient will incur preventable health care services, such as a costly hospitalization or emergency department visit.

Engage patients

Our solution also predicts a patient’s willingness to engage in care management before the first outreach attempt occurs. This allows us to use tailored engagement tactics proven more likely to succeed.

Deliver interventions

We use advanced analytics and automation to assist care advisors in the selection and delivery of evidence-based clinical interventions. Standardized workflows reduce variation among care advisors.

Ongoing performance improvement

Tested and refined in more than 30 markets nationwide, our performance management approach ensures accountability across clinical programs, workflow and staff.

Steady Stream of Innovation

Evolent partners have access to the premier clinical innovation engine in the value-based care industry. Our team has the specialized experience and capabilities to deliver pioneering approaches for improving the quality and efficiency of care.

Predictive models

We have built, implemented and refined dozens of risk-stratification models across various lines of business and patient populations. New sources of data and advances in machine learning are increasing the accuracy of our models and allowing us to assess patient risk in real time.

Clinical programs

In addition to refining existing clinical programs such as Complex Care and Transition Care, we continue to research, develop and test new programs such as Advanced Illness and Skilled Nursing Facility.

Network savings initiatives

To complement care management and drive additional improvement, we have introduced new programs that work with primary care physicians and specialists to address avoidable utilization in post-acute care. We have also introduced initiatives to target regionally specific conditions such as congestive heart failure and chronic kidney disease.

Local innovation

Our team of specialized analysts, actuaries and clinical experts work with you to evaluate performance data, identify opportunities and pilot new clinical programs in your market.

"Without having these resources, it would have taken a lot more time from me and taken away from my practice in other ways to make sure the patient is staying engaged."

Brad Scheu, DO
Deaconess Clinic Internal Medicine

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