Preventive Care Outreach
Health Plans | Care Coordination

Preventive Care Outreach

EviCore by Evernorth’s preventive care outreach team engages members to address their screening needs as well as assist them with appointment scheduling and other barriers to care. Our agents call members to educate them on the screenings they need and help schedule them for a wellness visit. We also assist with establishing a primary care provider for a member. 

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Personalized Care Program

By identifying members' preventive care gaps, we can leverage our existing outreach for approved authorizations to address their specific needs. This allows us to schedule both a member’s overdue screenings and their needed procedures in a single outreach. 

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Screenings and Outreach

Our agents can address gaps in care for

  • breast, colon, cervical and low-dose CT lung cancer screenings;
  • prostate exams;
  • wellness visits, vaccines and immunizations;
  • osteoporosis management and screenings; and
  • health risk assessments/house calls. 
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Preventive Care Concierge

Concierge-level support makes it easier for members to navigate care and empowers them to stay well. EviCore partners with health plans to identify members who are overdue for a screening. Our concierge agents use various outreach methods to assist with scheduling preventive screening appointments as well as facilitating in-home testing or other appointments as needed. 

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Member Awareness

Members are often not aware of the preventive screenings available to them and those screenings’ associated benefits. Some members may not get their preventive care screenings due to scheduling difficulties, the fear of being diagnosed with cancer or a lack of support when attending their appointments. Many members think of the doctor only when they are not feeling well; this means they are missing out on the benefits of preventive care. Through our outreach, we educate members on the screenings available to them and assist in closing gaps in care, leading to better outcomes at a fraction of the cost of care at later stages. 

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Unnecessary Spending

75% of U.S. health care spend is due to avoidable chronic disease.1 It is estimated that missing prevention opportunities costs the United States roughly $55 billion annually.2

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Better Patient Care

90% of U.S. health plans rely on HEDIS measures to compare performance.3 Our preventive care programs have higher CMS star ratings, HEDIS performance and Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey scores than industry average. 

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High Touch

In a world where access to live agents is shrinking, EviCore by Evernorth® continues to recognize the importance of person-to-person communication to drive engagement and promote a more personal, member-friendly experience. By using a preexisting outreach for an approved authorization to inform the member of their current gaps in care, we reach more members and successfully close more gaps. Contact rates are much higher when a member is expecting outreach about an authorization for a procedure versus cold calling them. We can address multiple gaps in a single outreach as well as help schedule health risk assessments and in-home care. This happens through contacting members according to their preference: by phone, email, text or direct mail. 

Frequently Asked Questions

EviCore by Evernorth can outreach to members through their preferred method (phone call, text, email) 

  • Members receive the reminder two days before their scheduled appointment.
  • We send appointment reminders by text or we call members to remind them (depending on member preference). 

Health plan will send EviCore by Evernorth eligibility files for members with gaps in care for preventive care screenings 

Post-Acute Care Insights

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