Deliver on your promise of better care
In an era of increased spending and greater utilization of specialty care, our clinical solutions stand above the rest. Led by physicians and deployed through our industry-leading technology and operations, our clinical solutions span the most complex, costly specialties and deliver value by driving evidence-based care. As a result, they help you fulfill your mission of providing your members access to quality care.
A comprehensive approach to evidence-based care and affordability
We use a multifaceted approach to help assure your members access to appropriate, safe, and affordable care. Our solutions also provide data-rich insights on program performance and practice trends so you can power your strategies and manage your networks.
- CLINICAL APPROPRIATENESS REVIEW
- PROVIDER OUTREACH
- MEMBER ENGAGEMENT
- PEER-TO-PEER CONSULTATIONS
- REDIRECTION OF CARE TO HIGH-VALUE SETTINGS
- PROGRAM PERFORMANCE AND PRACTICE TRENDS REPORTING
Explore our clinical solutions
Musculoskeletal Solution
Genetic Testing Solution
Medical Oncology Solution
Radiation Oncology Solution
Sleep Solution
Cardiology Solution
Radiology Solution
Rehabilitation Solution
Our capabilities, your advantages
Our core capabilities fuel your transformation into a resilient, agile organization dedicated to its members’ health.
Aligning care with best practices: clinical appropriateness review
Helping physicians keep up with the latest best practices in evidence-based care is complex. We use our clinical guidelines, physician-led outreach, and innovation to make it easier. It’s our best practice.
Realizing the value of value-based reimbursement
The new value-based healthcare environment demands a proven platform engineered to support plans and providers. Meet ours.
Navigating the new health care landscape
The path to long-term success for health plans involves savings, quality improvements, and closer alignment with members and providers. We can pave that path.