Starting with the appreciation for the relationships between hospitals & post-acute care providers, we provide consulting and care management services to a variety of risk bearing entities including: ACO’s, MCO’s and risk-taking IPA’s. This is accomplished through the use of data analytics, care management technology, onsite & telephonic care coordination services and development of a high value narrow subacute network.
Our goal is to optimize post-acute care through the use of a narrow high performing network to reduce avoidable PAC admissions, LOS and avoidable readmissions.

  • Assessment of patients prior to discharge from the hospital and referral to the appropriate SNF.
  • Technology platform that connects the hospital, the Skilled Nursing Facilities and Evolvere Health Case Managers.
  • Develop SNF networks by utilizing data analytics to meet the needs of the patient population.
  • Innovative contracting, including Value Based Contracting, to align payment and financial incentives on performance and outcomes.
  • Joint Operating Committee (JOC) meetings with SNF/IRF to review data, align with Payor goals and improve collaboration.
  • Evolvere Health Case Managers work with Payor staff to train and utilize existing Evidence Based Guidelines (EBG).
  • Bed-board technology for the SNF to help manage their admissions from their desktops or mobile devices.
  • Data driven models to enhance patient outcomes.
  • Clinical program development and Telehealth services to collaborate and manage the patients within the SNF.
  • Data analytics



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