Plans

At our unique position supporting the interaction of patients, providers, and plans, our goal is to maximize quality, medical cost savings, and operating efficiency with integrated medical management.

  

Integrated Solutions – Enabling Better Outcomes

Our capabilities are built on a single platform utilizing scalable, flexible technology that enables our clients to develop customized programs. We offer flexible funding and capitation payment models with the ability to manage capitated risk and shared savings.

We are built with the size and scale necessary to address the complexity of today’s healthcare system. Through our exceptional capabilities — and an acute sensitivity to the needs of everyone involved — we harness the evolving demand and inherent change of healthcare to better manage and optimize health benefits. The result is an evidence-based approach that utilizes our proven talent and leading-edge technology to realize better outcomes.

  

Highlights

Equipped with our expertise in providing medical benefits management, we continually bring our clients practical, innovative, and effective strategies that reduce costs while guiding providers and their patients to higher quality evidence-based care.

  • 100M covered lives
  • UPADSSM: Applies real-time quality metrics to workflows, updates clinical pathways, enables full integration with Claims StudioSM
  • Lines of Business: Medicaid, Medicare, and Commercial
  • Nearly 4k employees, including 1k clinicians
  

The eviCore Value Proposition

Maximizing quality, medical cost savings, and operating efficiency with integrated medical management.