Better oncology outcomes, more sustainably

A better oncology experience for all

Spiraling costs. Misaligned incentives. Fragmented care experiences.

At Evolent, we don’t believe you can change these realities without first transforming the oncology system. Our solution re-engineers oncology delivery by tackling the root-cause problems facing this highly complex field. By taking financial and clinical accountability for cancer care, we offer payers the peace of mind that their members are getting the best possible outcomes, more affordably.

Unparalleled clinical depth

No individual oncologist can keep pace with the evidence surrounding new drugs, let alone those that have been on the market for years. Evolent addresses this gap by putting a deep clinical bench in providers’ corner, helping ensure treatment decisions follow the evidence. Our team of oncologists, pharmacists, analysts and others constantly comb the medical literature and evaluate data to identify the best options for each clinical scenario. Two scientific advisory boards – in medical and radiation oncology – bring together oncologists from community and academic settings to vet these recommendations for our high-value Precision Pathways.

Evolent’s oncology management system turns the traditionally strained relationship between payers and providers on its head.

Next gen decision support

Our point-of-care tool puts the power of our pathways at providers’ fingertips. Leveraging the latest in precision medicine, this decision-support platform guides providers to enter details about each unique patient, including genomic data, to generate individualized treatment options. 

The pathways prioritize higher efficacy and lower toxicity, while recommending lower-cost regimens only when they deliver better or similar outcomes than more expensive ones. When selected, regimens on pathway receive automatic authorizations.

Provider empowerment, not exasperation

Evolent’s oncology management system turns the traditionally strained relationship between payers and providers on its head. When providers seek to deviate from pathways, our staff oncologists reach out for a peer-to-peer discussion to discuss the case and the evidence base. At the network level, we partner closely with practices on improvement initiatives across the care journey, deliver robust clinical and financial benchmarking, and financially incentivize high-value practices.

Aligned financial incentives

Through delegated risk agreements, Evolent takes full clinical and financial accountability for oncology spending so your plan can focus on your other health care challenges. We lead the way in implementing strategies that support high-value care, mitigate inherent oncology cost volatility, and lead to substantial guaranteed savings. We support a spectrum of effective and scalable financial incentives, such as alternative payment models that enable specialists to move to value-based reimbursement.

Differentiated member journey

Primary care, genetic testing, radiology and beyond – members with cancer typically need many services beyond those they receive from oncologists. Yet these are often managed by different entities, if they’re managed at all. Evolent can bring clinical oversight of several cancer-related services under one umbrella to improve quality, reduce fragmentation and control costs across the member journey. Beyond evaluating provider requests, we work proactively work to ensure that members get the high-value interventions known to improve outcomes. Working with our Advanced Illness solution, we ensure members’ care plans reflect what’s most important to them.