Humana and Evolent Expand Partnership to Enhance Oncology Care
Humana (NYSE: HUM) and Evolent Health (NYSE: EVH) have expanded their strategic medical oncology partnership to streamline prior authorization processes for radiation and surgical oncology services. The collaboration aims to expedite approval requests and improve patient access to care through Evolent's advanced technology platform. Under the expanded partnership, Evolent will serve as Humana's designated utilization management and pathway vendor for radiation and surgical oncology services.
The platform enables providers to access up-to-date therapy choices, submit prior authorization requests in minutes, and receive approvals in seconds, reducing administrative burdens while ensuring CMS compliance.
Humana (NYSE: HUM) e Evolent Health (NYSE: EVH) hanno ampliato la loro partnership strategica nel campo dell'oncologia medica per semplificare i processi di autorizzazione preventiva per i servizi di oncologia radioterapica e chirurgica. La collaborazione punta a velocizzare le richieste di approvazione e a migliorare l'accesso alle cure per i pazienti attraverso la piattaforma tecnologica avanzata di Evolent. Nell'ambito della partnership ampliata, Evolent fungerà da fornitore designato da Humana per la gestione dell'utilizzo e dei percorsi relativi ai servizi di oncologia radioterapica e chirurgica.
La piattaforma consente ai fornitori di accedere a scelte terapeutiche aggiornate, presentare richieste di autorizzazione preventiva in pochi minuti e ricevere approvazioni in pochi secondi, riducendo i carichi amministrativi e garantendo la conformità con il CMS.
Humana (NYSE: HUM) y Evolent Health (NYSE: EVH) han ampliado su asociación estratégica en oncología médica para simplificar los procesos de autorización previa para los servicios de oncología radioterápica y quirúrgica. La colaboración tiene como objetivo acelerar las solicitudes de aprobación y mejorar el acceso de los pacientes a la atención mediante la avanzada plataforma tecnológica de Evolent. Bajo la asociación ampliada, Evolent actuará como el proveedor designado de gestión de utilización y de vías de Humana para los servicios de oncología radioterápica y quirúrgica.
La plataforma permite a los proveedores acceder a opciones de tratamiento actualizadas, presentar solicitudes de autorización previa en minutos y recibir aprobaciones en segundos, reduciendo las cargas administrativas y asegurando la conformidad con el CMS.
휴마나 (NYSE: HUM)와 에볼렌트 헬스 (NYSE: EVH)는 방사선 및 외과 종양학 서비스의 사전 승인 프로세스를 간소화하기 위해 전략적 의학 종양학 파트너십을 확장했습니다. 이 협력은 Evolent의 첨단 기술 플랫폼을 통해 승인 요청을 신속하게 처리하고 환자의 치료 접근을 개선하는 것을 목표로 합니다. 확장된 파트너십에 따라 Evolent는 방사선 및 외과 종양학 서비스에 대한 휴마나의 지정된 이용 관리 및 경로 공급자로 역할을 합니다.
이 플랫폼은 제공자가 최신 치료 옵션에 접근하고, 몇 분 안에 사전 승인 요청을 제출하며, 몇 초 안에 승인을 받을 수 있게 하여 관리적 부담을 줄이고 CMS 준수를 보장합니다.
Humana (NYSE: HUM) et Evolent Health (NYSE: EVH) ont élargi leur partenariat stratégique en oncologie médicale pour rationaliser les processus d'autorisation préalable pour les services d'oncologie radiothérapeutique et chirurgicale. La collaboration vise à accélérer les demandes d'approbation et à améliorer l'accès des patients aux soins grâce à la plateforme technologique avancée d'Evolent. Dans le cadre de ce partenariat élargi, Evolent agira en tant que fournisseur désigné de gestion d'utilisation et de parcours pour Humana pour les services d'oncologie radiothérapeutique et chirurgicale.
La plateforme permet aux fournisseurs d'accéder à des choix thérapeutiques à jour, de soumettre des demandes d'autorisation préalable en quelques minutes et de recevoir des approbations en quelques secondes, réduisant ainsi les charges administratives tout en garantissant la conformité au CMS.
Humana (NYSE: HUM) und Evolent Health (NYSE: EVH) haben ihre strategische Partnerschaft im Bereich medizinische Onkologie erweitert, um die Verfahren zur vorherigen Genehmigung für strahlen- und chirurgische Onkologische Dienstleistungen zu optimieren. Die Zusammenarbeit zielt darauf ab, Genehmigungsanfragen zu beschleunigen und den Zugang der Patienten zur Versorgung durch die fortschrittliche Technologie-Plattform von Evolent zu verbessern. Im Rahmen der erweiterten Partnerschaft wird Evolent als Humana's benannter Anbieter für die Nutzungskontrolle und die Prozesse für strahlen- und chirurgische Onkologie-Dienstleistungen fungieren.
Die Plattform ermöglicht es den Anbietern, auf aktuelle Therapieoptionen zuzugreifen, Genehmigungsanfragen in wenigen Minuten zu stellen und in Sekunden Genehmigungen zu erhalten, wodurch administrative Belastungen reduziert und die Compliance mit CMS gewährleistet wird.
- Partnership expansion into radiation and surgical oncology services
- Implementation of rapid authorization system (minutes to seconds)
- Reduction in administrative burden for providers
- None.
Insights
The expanded partnership between Humana and Evolent Health represents a significant strategic development in healthcare service optimization. The integration of radiation and surgical oncology services into their existing medical oncology partnership creates a comprehensive cancer care management system. This expansion has multiple revenue implications:
- Enhanced operational efficiency through streamlined prior authorization could lead to increased patient volume and revenue for Evolent
- The partnership strengthens Evolent's market position in the growing
$200+ billion oncology care management sector - Technology-driven automation of approvals should reduce administrative costs while improving scalability
The deal positions Evolent as Humana's primary oncology care management partner, potentially leading to stable, recurring revenue streams. For investors, this represents a positive catalyst for Evolent's growth trajectory in the value-based care space.
The technological implementation of this partnership demonstrates significant advancement in healthcare automation. The platform's ability to deliver instant approvals and streamlined authorization processes represents a competitive advantage in the healthcare technology sector. Key technical benefits include:
- Real-time clinical decision support integration
- CMS-compliant workflow automation
- Unified platform for multiple oncology specialties
This comprehensive technical solution addresses a critical pain point in healthcare delivery, potentially leading to increased platform adoption and market share growth for Evolent. The scalability of this technology positions the company well for similar partnerships with other major insurers.
Partnership Focuses on Improving Prior Authorization Process, Helping Drive Better Patient Outcomes
“This partnership underscores our commitment to delivering a better healthcare experience and, most importantly, better health outcomes for our members,” said Paul Davis, Vice President of National Provider Network Management at Humana. “Our members who need radiation and oncology care deserve access to high-quality, timely care, and this collaboration will help give them the support and care they need.”
Humana is working to simplify the prior authorization process by leveraging Evolent's advanced technology platform and expertise across the patient’s cancer journey. Through the Evolent platform, providers can access the most up-to-date, clinically appropriate therapy choices for specific clinical scenarios. Prior authorization requests are submitted in minutes and approvals are delivered in seconds. This connected experience, which is well organized, simple to navigate and CMS compliant, will reduce administrative burdens for both providers and patients and ensure that Humana members receive timely access to high-quality care.
“We are thrilled to continue partnering with Humana to drive meaningful change across the continuum of oncology care,” said Dan McCarthy, President at Evolent, a health care company that delivers proven value-based specialty care solutions to payers and providers. “Building upon our longstanding work with Humana in medical oncology, this national expansion into radiation therapies and surgical procedures will help enable a more coordinated, high-quality, and efficient experience for both members and providers throughout the cancer journey.”
Under the expanded partnership, Evolent will serve as Humana's designated utilization management and pathway vendor for radiation and surgical oncology services. The partnership represents a significant milestone in modernizing authorization processes and underscores both companies' dedication to improving healthcare outcomes.
About Humana
Humana Inc. is committed to putting health first – for our teammates, customers, and company. Through our Humana insurance services and our CenterWell health care services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
About Evolent
Evolent (NYSE: EVH) specializes in better health outcomes for people with complex conditions through proven solutions that make health care simpler and more affordable. Evolent serves a national base of leading payers and providers and is consistently recognized as a top place to work in health care nationally. Learn more about how Evolent is changing the way health care is delivered by visiting evolent.com.
View source version on businesswire.com: https://www.businesswire.com/news/home/20241107578119/en/
Evolent:
Jamie Manfuso
jmanfuso@evolent.com
Humana:
Kevin Smith
Ksmith305@humana.com
Source: Evolent Health, Inc.
FAQ
What is the expanded partnership between Humana and Evolent Health (EVH) announced in 2024?
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