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Evolent specializes in connecting care for patients with complex health conditions. This digest delivers our latest thinking on trends and issues impacting complex condition management, the future of utilization management, and best practices to deliver better outcomes.   

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Evolent partners with health plans and physicians to achieve better outcomes for people with the most complex health conditions. Working across specialties and primary care, we seek to improve the care journey — more connected, higher quality, more efficient — for patients diagnosed with cancer, cardiovascular diseases, musculoskeletal disorders, and other conditions.

Our Approach:

Article: True peer-to-peer conversations will improve prior authorization 

One big step to make peer conversations more collegial and productive 

Most providers experience the peer-to-peer call from one perspective – as the one requesting authorization for a service or the one reviewing it for medical necessity on behalf of a health plan. As both a practicing orthopedic spine surgeon in West Virginia and a medical director at Evolent, Dr. Matthew Walker regularly sees it from both vantage points. Writing in STAT, he highlights one big thing that could help make these calls more collaborative and productive in his field: ensure that the reviewers are true peers in the same specialty. 

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Podcast: The Dystopian State of Primary Care 

“A common theme is that when a patient enters the realm of specialty care, that's a black box where primary care providers lose touch with their patients altogether. That's a really important area of innovation and it's actually one that we here at Evolent...are working to solve."   Our medical director for value transformation, Vishnukamal Golla, speaks with Healthcare Financial Management Association (HFMA)'s "Voices" podcast on the need to better connect primary and specialty care providers. 

Listen Here 

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