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.
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.
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.
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.
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.
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.
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
Preventive Care Outreach: Partnering to Improve Health Outcomes, Lower Costs and Increase CMS Scores
Three-quarters of health care spending in the United States is due to avoidable chronic disease. Preventive care is one of the best ways to address this challenge; however, millions of Americans avoid preventive care every year.
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