News and Events

The right time. The right partner.

Applied Pathways announced some exciting news this morning: we are now a wholly-owned subsidiary of AIM Specialty Health, one of the leading specialty benefits management providers in the United States. And our authoring and rules engine technology, recently certified as a Clinical Decision Support Mechanism by the Center for Medicare and Medicaid Services, has long been core to its offerings.

The Applied Pathways leadership team has been in this industry for a long time and we have been involved in literally dozens of company combinations. We want to share why we are excited about this one in particular.

First, healthcare is suffering from a knowledge problem (shout out to Dr. Atul Gwande of the Checklist Manifesto and his interview with Ezra Klein from September 2016). It’s not that we don’t know what to do, it’s that we don’t do it or aren’t aware of it.  I am not a clinician, so admit my own knowledge gap, but the research seems fairly compelling that we both over and under care for people. There are many reasons why but most relate to shortcomings in today’s systems and tools.

Second, costs are exploding with minimal, if any, impact on quality by any macro metric. This is driven by variance in decision-making or an over-reliance on gut and judgement versus what clinical evidence tells us is the best approach to take. We all know we can do better but we simply don’t know how. Many thought electronic health records were going to be the answer, but we now know they’re only a part of the solution.

Third, knowledge is changing so quickly, complexity continues to grow at an astonishing rate, and new tools like AI and deep learning come along promising to solve all of our problems. Who isn’t struggling to manage multiple EHR platform, seemingly infinite versions of medical policy, too few IT resources to keep back-end systems current, and a strong desire to use the latest cool thing?

Applied Pathways is helping many organizations solve this problem TODAY. It’s what drew our leadership team to Applied Pathways over the past 24 months: The ability to deliver evidence- based insight, appropriately and seamlessly into the workflow without the overhead of solutions that create alert fatigue and screen “whack a mole”. And it’s what will continue to drive us. It’s why we sought CDSM certification from CMS and it’s why we have been working with AIM behind the scenes as a client for more than 2 years to provide solutions with clinical and economic value. We want to help clinicians, payers, and other tech services companies make better, more appropriate decisions that help patients and the bottom line.

What does this have to do with AIM? Well, AIM Specialty Health, shares our vision for delivering clinical decision support into the workflow at the point of care. Coming together with them gives us with the single best opportunity to drive adoption of our Curion® platform and position our employees for long-term success. For our collective clients and prospects it means more meaningful solutions that deliver real, measurable value.  

We’re already collaborating on an automated prior authorization solution that will allow doctors to get approval on orders at the point of care. It will ensure that patients get the care they need while saving time and money.   

The future for healthcare and for Applied Pathways is brighter today than it was yesterday and we can’t wait to talk to you about it.

Steve Lefar, CEO of Applied Pathways       By Steve Lefar, CEO of Applied Pathways

 

Read MoreThe right time. The right partner.

AIM Specialty Health® (AIM) Acquires Applied Pathways to Accelerate Delivery of Technology-Enabled, Evidence-Based Clinical Solutions for Payers and Providers

FOR IMMEDIATE RELEASE

Chicago, IL, August 17, 2017 – AIM Specialty Health, a leading specialty benefits management company, has acquired Applied Pathways, a leader in visual authoring and rules engine software for health care. AIM currently leverages Applied Pathways’ software solutions to simplify, encode and utilize complex clinical content into a standardized, repeatable, evidence-based system for making decisions within AIM clinical programs.

Together the companies have deep experience in both the payer and provider markets.  For more than two decades, AIM has been a leader in solutions for clinical review, provider collaboration and member engagement. In addition to its work with AIM, Applied Pathways’ clients have used its sophisticated visual authoring and rules engine platform to inject clinical knowledge into their applications, such as electronic health records, patient portals, nurse triage call centers, and other clinical applications.  

Combined, the companies offer an industry-leading approach to both clinical decision support and clinical appropriateness review, supporting providers and health plans. Their technology-enabled and evidence-based solutions mean better clinical decision support tools that increase the quality, efficiency and value of health care decisions for patients, physicians, and payers.

In addition, both AIM and Applied Pathways are qualified participants in the CMS Appropriate Use Criteria Program addressing outpatient advanced imaging services. The program, part of the Protecting Access to Medicare Act, mandates that providers use CMS-approved clinical decision support criteria, through a qualified mechanism, that documents the appropriateness of a high-tech, diagnostic imaging order to receive full reimbursement for Medicare fee-for-service beneficiaries effective January 1, 2019.

“Our companies share a common goal to promote evidence-based medicine and ensure that services are appropriate, safe and affordable,” said Brandon Cady, president and CEO of AIM. “Together, AIM and Applied Pathways support greater provider collaboration with highly automated tools that enhance clinical value for physicians and health plans. This marks another important investment in innovation for our customers.”

Steve Lefar, CEO of Applied Pathways, said, “We are clearly aligned in our mutual vision to make it easier for physicians and other care givers to measurably reduce variance and improve quality of care. Joining forces with AIM gives us new opportunities to drive even more meaningful solutions that deliver real, measurable value to our expanding set of customers.”

 

About AIM 
AIM Specialty Health® provides clinical solutions that drive appropriate, safe and affordable care. Serving more than 50 million members across 50 states, D.C. and US territories, AIM promotes optimal care through use of evidence-based clinical guidelines and real-time decision support for both providers and their patients. The AIM platform delivers significant cost-of-care savings across an expanding set of clinical domains including radiology, cardiology, oncology, specialty drugs, sleep medicine, musculoskeletal and genetic testing. AIM is a wholly-owned subsidiary of Anthem, Inc. (ANTM). For more information, visit www.aimspecialtyhealth.com and www.aiminform.com.

About Applied Pathways
Applied Pathways is focused on reducing the unwanted variance in healthcare that leads to unnecessary spending without positively impacting quality of care. Our visual authoring, rules engine software, and workflow specific EHR embeddable applications simplify the process of encoding and utilizing clinical knowledge and institutional best practices to deliver a standardized, repeatable system for making decisions across the clinical continuum. To learn more visit appliedpathways.com or follow us on Twitter at @appliedpathways.

Contact:                      

AIM Specialty Health
Lori McLaughlin 317.407.7403
Lori.McLaughlin@anthem.com

Read MoreAIM Specialty Health® (AIM) Acquires Applied Pathways to Accelerate Delivery of Technology-Enabled, Evidence-Based Clinical Solutions for Payers and Providers