Clinical Solutions

for Health Plans

Better care for members — from diagnosis through treatment

Led by physicians and scaled by our automated platform, our clinical solutions for health plans address today’s most complex, costly specialties. Our stand-alone solutions ensure your members access to evidence-based care in a single clinical domain, like medical oncology. And when bundled into suites, they build a continuum of best-practice care that your members need during their journey.

CORE

Focus on the fundamentals: minimizing variation in care and creating long-term value.

Explore Radiology

Explore Cardiology

Explore Sleep

Explore Surgical Procedures

ONCOLOGY

Drive continuity, quality, and affordability across the cancer care continuum.

Explore Genetic Testing

Explore Medical Oncology

Explore Radiation Oncology

MUSCULOSKELETAL

Ensure a balanced perspective on the management of musculoskeletal conditions.

Explore Interventional Pain

Explore Joint And Spine

Explore Rehabilitation

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

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.