All Insights

Blog
11.07.2024

There are over 100 different types of known cancers, and out of those, three types are the most common in men and women. We've compiled information on symptoms, helpful tips, and stats on clinical trials on the most common types of cancer.

Infographics
10.01.2024

Mary* is a 60-year-old patient who has been experiencing balance issues. She has fallen several times. Her doctor identifies an abnormal walking pattern. Learn more and click through Mary's journey. 

Infographics
09.24.2024

Utilization management (UM) works to ensure that the right health care service is being issued to the right patient at the right time, with the least possible burden for patients and providers. This is not without challenges on the providers' end. Challenges like outdated manual processes, paperwork, and confusion on benefit packages. With recent regulations and legislation, there have been many advancements in the UM space but our work isn't done. 

Infographics
06.11.2024

60-year-old Don*, who was in a motor vehicle accident a little over a year ago, is still suffering from persistent back pain. Learn how EviCore helped both Don and his provider leverage clinical expertise through EviCore's utilization management. 

Blog
03.13.2024

The Centers for Medicare & Medicaid Services (CMS) recently released its Advancing Interoperability and Improving Prior Authorization Processes final rule. We sat down with Chief Medical Officer Eric Gratias, M.D., to talk about how well prepared EviCore by Evernorth® is for the rule and what it means for patients, providers and payers.

Blog
10.25.2023

The fact that 25%–40% of musculoskeletal (MSK) care spending is wasteful or ineffective is concerning enough. But coupled with the knowledge that more than 50% of U.S. adults over 18 live with an MSK condition, the potential impact of low-value MSK care is staggering. 

Infographics
05.30.2023

Meet Renee, a 47-year-old office manager and married mother of two, and an EviCore patient whose life has been impacted by many of EviCore's solutions

Infographics
05.11.2023

Meet Jacob*, a 61-year-old man who received a diagnosis of stage III non-small-cell lung cancer last year. EviCore approved an evidence-based treatment that included chemotherapy and radiation therapy at a community cancer center. Jacob experienced an excellent response to treatment

Video
04.19.2023

Hear from Dr. Sheldon Scheinert, EviCore’s Associate Chief Medical Officer of Diagnostic Solutions, about how our program urges patients to get the colorectal cancer screenings they need.

Blog
09.13.2022

No matter your role in healthcare, you're likely aware of prior authorization (PA). While some providers and patients find PA time-consuming and frustrating, it remains the best way to help ensure patients receive safe, appropriate and effective care at the lowest overall cost to U.S. healthcare. Recent advances in technology are making PA smarter, more automated and faster than ever before.

Blog
07.01.2022

The cost of cardiovascular disease goes beyond mortality and human suffering. Heart disease costs the United States more than $363 billion annually. Not all of the cardiovascular healthcare spending, however, is effective. In a recently released scientific statement, the American Heart Association notes that low-value cardiovascular care accounts for as much as 30 percent of this healthcare cost, meaning that over $100 billion is spent annually on care that does not improve the patient’s cardiovascular health.

Blog
05.20.2022

Due to the current shortage of CT contrast, EviCore medical reviewers are following guidance regarding the appropriate alternative imaging studies, according to our evidence-based clinical guidelines for individual case scenarios.

Blog
04.09.2022

Recent advances in radiation oncology treatments offer promising alternatives for the nearly 2 million patients diagnosed with cancer in the U.S. each year. One of these treatments is stereotactic body radiation therapy (SBRT). Also known as stereotactic ablative body radiation (SABR), this type of radiation was first used in the early 1990s.

Blog
04.01.2022

One in seven women diagnosed with breast cancer is “overdiagnosed,” according to a new study published in the Annals of Internal Medicine. That means they were diagnosed with tumors that would’ve caused less harm if they’d remained hidden.

Webinar
02.17.2022

Watch our February 15th webinar with Margaret Rausa, EviCore’s Vice President, Oncology Strategy and Growth, and Dr. Rajanish Singla, EviCore’s Chief of Radiation Oncology, who will provide an overview of Radiation Oncology for health plan representatives.

Blog
02.03.2022

U.S. families are drowning in healthcare costs. The median U.S. household spends approximately 20% of disposable income on healthcare, with a projection of $6,832 in yearly premiums and $3,306 on out-of-pocket costs such as deductibles, copays, and coinsurance in 2022. Hospital costs alone have risen 600% since 1990.

Blog
12.22.2021

Welcome to the final 2021 edition of our Ask EviCore feature! In this month’s edition, we’re sharing a list of resources to help you navigate the prior authorization process so you can provide the best, medically appropriate care to your patients.

Webinar
11.19.2021

Listen on-demand for the insights of Miriam Sznycer-Taub, Director with Advisory Board’s Ecosystem Research team. She will discuss the rising popularity of home-based care and what that likely portends for the future of our healthcare system.

Blog
11.11.2021

By providing care in a setting that is comfortable for patients, helpful for providers, and affordable for payers, home health services help improve outcomes and reduce costs. Learn more about the benefits of quality in-home healthcare.

Podcast
11.04.2021

Bonus! Tune into our latest Auth the Cuff podcast episode featuring pediatric oncologists Dr. Michelle Neier and Dr. Jessica Roberson, along with pediatric radiologist Dr. Keith Kronemer, who speak with Dr. Emily Coe on the impact COVID-19 has had, and may continue to have, on pediatric care

Webinar
10.29.2021

Listen to American Physical Therapy Association (APTA) leaders Elise Latawiec and Kelly Sanders, and EviCore healthcare musculoskeletal leaders Dr. Robert Westergan and Victoria Rupakus, in a discussion moderated by medical benefits management veteran, David Baird. Learn more about (1) the value of musculoskeletal conservative care, (2) virtual care and its effect on physical therapy, and (3) the future of conservative care.

Blog
10.22.2021

As there is a wide variety of things that can go wrong with the body's muscles, cartilage, tendons, joints, and spinal discs, there is also a wide variety in how health insurance plans pay for treating musculoskeletal conditions. Variations in benefit structure can have a demonstrable impact on access to appropriate care.

Podcast
10.15.2021

Specialized therapies such as chiropractic, acupuncture, and physical therapy are cost-effective and can provide improved outcomes for chronic pain patients. Tune into our recent podcast episode with EviCore's post-CAM program specialists Dr. Chanta Van Laanen, Dr. Laura Beitz-Walters, and Dr. Mark Leichter to learn more.

Blog
10.08.2021

Musculoskeletal pain is now recognized as a national public health problem. Effective pain management improves a patient's quality of life, reduces costs for all involved, and disrupts the vicious cycle of opioid dependency. Learn how coordination of care for musculoskeletal conditions makes a difference.

Podcast
10.02.2021

Well before the pandemic, consumers were leaning towards home healthcare versus facility-based care when appropriate for a number of reasons. Learn about the growing field, along with EviCore and Alegis Care's home solutions on our new Auth the Cuff podcast episode with Dr. Yvette LeFebvre, Chief of PAC/DME/Sleep Services

Webinar
09.28.2021

Join nationally known Medicaid Managed Care consultant and expert Billy Millwee, President and CEO of Millwee Associates, and Yvette LeFebvre, DO, Clinical Chief of Post-Acute Care, DME, and Sleep Services for Evernorth Home Solutions. They discuss the rapidly changing Medicaid Managed Care environment, and steps that Managed Medicaid health plans can consider to ensure continued success.

 

Infographics
09.09.2021

Many functions of the human body are the responsibility of the digestive system, and a number of conditions can affect it. Evidence-based guidelines can help decide the appropriate care. Here are common conditions associated with the gastrointestinal tract.

Blog
09.01.2021

This month, we’re exploring the Site of Care program. Our primary goal—to ensure patients receive high-quality, patient-centric care that is cost-effective—was the key driver of this new program. 

Blog
08.31.2021

When assisted reproductive technology (ART) clinics join a network such as Evernorth's FamilyPath, it can help both the patient and the fertility practice. Learn more strategies that can help reputable ART clinics grow, and more effectively reach prospective patients.

Webinar
08.26.2021

Watch On-Demand as Dr. Stephen Hamilton, EviCore’s Chief of Medical Oncology, and Richard Emery, EviCore's Vice President of Comprehensive Oncology Strategy, provide an overview of the field for health plan representatives.

Podcast
08.21.2021

Medical knowledge is doubling faster than ever, as are advances on insights to access and treatment options for medical oncology. Tune into our new podcast episode with EviCore's medical oncologists Dr. McLead, Associate Medical Director, and Dr. Gaskins, Sr. Medical Director, for an informative conversation on clinical trials, disparities in medical oncology, and how EviCore is aiming to bridge the gap with the most recent evidence-based options for oncology patients.

Blog
08.19.2021

Over the past 30 years, the number of options for immunotherapy has exploded, and people with many different types of cancer may be able to choose immunotherapy. In fact, the FDA has approved more than 50 immunotherapies to treat cancer—with more on the way.

Blog
08.06.2021

With some gene therapies costing millions of dollars for a single treatment, one major question is how to pay for them. Insurance plans need to start seriously considering the implications, from the perspective of both cost and quality.

Webinar
07.29.2021

Watch our On-Demand webinar as we discuss the respective cost and quality components of various sites of care and what EviCore healthcare is doing to help physicians and health plan members find the lower cost setting that is clinically appropriate for them.

Blog
07.23.2021

For common surgical procedures like knee arthroscopy, anterior cruciate ligament (ACL) reconstruction, rotator cuff repair, or carpal tunnel release, to name a few, it's certainly worth having a conversation with your surgeon to determine if an alternative site of care is a better fit, and can reduce your total cost of care while offering surgical outcomes of the same high quality.

Podcast
07.23.2021

Tune into our new Auth the Cuff episode with EviCore's Dianne Doherty, Sr. Manager, Network Quality Assurance, Anne McLead, Sr. Director, Network Operations, and Christa Gassler, Sr. Director, Affordability SoC, to learn how our site of care program advocates for clients and their covered members, how we identify high-quality freestanding imaging centers, negotiate costs for direct savings, and more.

Blog
07.15.2021

Where do you usually send your patients who need a diagnostic or screening test? Of course, you choose a high quality testing facility because you want your patients to get the best possible test so you can be confident that the results are accurate. But there's another factor that's a concern for many people: the cost of care. With that in mind, providers can help patients get a particular type of screening without breaking the bank.

Blog
07.01.2021

In this edition of Ask EviCore, we are sharing two new processes to make your experience faster, better, and more collaborative. You can now schedule your own peer-to-peer consultations through the portal, and for the CareCore National portal, you can also initiate a reconsideration review on the web.

Podcast
07.01.2021

Emily Coe, PhD interviews EviCore's Dr. Mary Kay Barton, Sr. Medical Director, Medical Oncology, and Dr. Gary Jones, Associate Medical Director, Medical Oncology, for an enlightening conversation on clinical trials in pediatric and adult oncology, treatment innovations, and more.

Blog
06.25.2021

The provider making the initial diagnosis has an important role along the cancer care continuum — even when the patient moves onward to other parts of the health system. As a trusted point of contact, this provider has the opportunity to remain connected to the patient and influence a key process that's frequently overlooked: advance care planning.

Webinar
06.23.2021

The stakes are high for both current and future cancer patients because clinical trials are the primary driver to unearthing new medical evidence that can improve the lives of countless patients throughout the world. In this webinar, we will provide an overview of oncology clinical trials: separate fact from fiction, identify the benefits that clinical trials bring, examine the barriers to enrollment, and discuss opportunities for improvement

Podcast
05.21.2021

There is a notion of utilization management being solely focused on cost savings. In practice, utilization management plays a large role in patient safety and empowerment. Tune into our new Auth the Cuff podcast episode with guest Dr. David-Park, Sr. Medical Director PAC/DME, for a great conversation on over utilization, a real-life patient example, and more.

Webinar
05.19.2021

Watch on-demand for a discussion with David Baird, Richard Emery, and Dr. Norm Scarborough, facilitated by Dr. Eric Gratias. You will learn about (1) common myths and misconceptions attached to MBM/UM, (2) the importance of MBM/UM in ensuring high-quality and safe patient care, and (3) the individual journeys of patients who have been positively impacted by the application of MBM/UM as a part of their self-insured health plan.

Blog
05.04.2021

Did you know that in 2020, 67% of employer-covered workers were in a self-funded health plan? That's nearly 10% more than the year before. In the past, self-insured employers spent too much on over treatment and low-value care, but utilization management is increasingly helping them to lower medical costs for their employees while also improving their quality of care.