Managing many rules that change often or require localization?

We can help.

Diverse stakeholders. Universal value.

Leading healthcare organizations are reducing cost and improving quality of care with our rules-engine software.

Payers

Streamline your utilization management processes.

  • Minimize variance in your UR/UM processes
  • Make faster decisions to improve the patient experience
  • Quickly localize, customize or modify clinical and business rules
  • Understand and document why the decision was made

Health Tech Services

Improve patient experience and outcomes.

  • Standardize decision-making across patient-facing teams
  • Quickly and easily manage increasingly complex clinical rules
  • Deliver consistent, contextually-relevant patient experiences

Hospitals/Health Systems

Deliver standardized, high-quality, evidence-based care across all platforms.

  • Centrally author rules and distribute across disparate systems
  • Improve access to primary care
  • Break free of need for engineering staff
  • Empower your clinical experts to write, publish and update rules
  • Improve the patient experience

Content Providers

Rapidly synthesize new clinical knowledge and publish it to your clients.

  • Position your content to help your clients reduce variance
  • Simplify maintenance and delivery of clinical rules to the community of care

With Applied Pathways we are doing what is clinically correct and appropriate. The algorithms have given us the ability to get really granular so we can effectively filter and route requests.

– Medical Director, #1 Medical Necessity Company

One platform. Many use cases.

Our software will help you address a variety of business issues.

Utilization Management / Appropriate Use

Consistently make appropriate and affordable decisions based on the best clinical evidence available.

Results at #1 medical necessity company :close
  • Drive cost-per-case to nearly $0 since fewer cases will need review
  • Reduce hassle for providers
  • Make easy and frequent updates to prevent inappropriate utilization
Care Management

Ensure that there are no gaps in care plans for your patients.

Referral Management / Advanced Scheduling

Execute appropriate, advanced specialty scheduling so each patient gets to the right specialist at the right time.

Results at specialty referral management company:
  • Managing ~200k transactions for large payers and Academic Medical Centers
  • Patients get to the appropriate specialist at the right time with better satisfaction for all
Primary Care Access

Recommend the appropriate level of care in the right location at the right time to optimize patient outcomes, satisfaction and cost.

Results at Mayo Clinic:
  • 10% increase in patient access
  • 36% of patients redirected to a lower level of care than they thought
  • 99% patient satisfaction
Patient Engagement / Population Health

Provide contextually-relevant, meaningful interactions for your patients that  create the desired behavior change.

Patient Self-Triage

Empower patients to do symptom self-triage so they get to the optimal level of care.

Results at top three health plan:
  • Redirect care away from costly acute or ambulatory facilities when appropriate
  • Integrate with other patient portal capabilities to improve patient satisfaction
  • Keep people in network if care is required

Our Clients

Leading healthcare organizations use our software.

How can we help you?

Let’s find out.

Demo