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Evolent Acquires Machinify’s AI-Driven Medical Authorization Solution

by Fred Pennic 06/04/2024 Leave a Comment

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Evolent Acquires Machinify's AI-Driven Medical Authorization Solution

– Evolent Health, Inc. (NYSE: EVH), a leader in improving health outcomes for patients with complex conditions, announced today an agreement to acquire key assets from Machinify, including the exclusive license to their AI-powered platform, Machinify Auth. 

– Additionally, certain Machinify employees will join Evolent. Both companies plan to establish a long-term services agreement to ensure smooth integration and ongoing platform development. This innovative technology aims to revolutionize Evolent’s specialty condition management platform by leveraging advanced machine learning and data analytics.

Transforming Specialty Condition Management with AI:

Machinify Auth utilizes cutting-edge artificial intelligence to streamline clinical workflows and enhance the quality and efficiency of clinical reviews for various specialty conditions. Evolent plans to integrate Machinify’s team, software applications, and AI capabilities into its industry-leading platform. This acquisition is expected to benefit health plans, clinicians, and members alike.

This powerful combination will be integrated into Evolent’s platform to automate clinical workflows, leading to:

  • Increased Efficiency: Evolent believes the integration of scalable AI will significantly improve efficiency by automating tasks and reducing manual data collection and analysis. This will free up valuable clinician time to focus on higher-value activities.
  • Improved Clinical Quality: Machinify Auth’s AI technology has a proven track record of reducing clinician workload by an average of 55% for complex reviews. This allows Evolent’s clinicians to dedicate more time to guiding providers towards optimal treatment choices, potentially leading to improved patient outcomes.
  • Reduced Costs: Streamlined workflows and improved quality can translate into significant cost savings for healthcare providers and health plans. Additionally, reduced administrative burden for both providers and members can enhance the overall patient experience.

“The acquisition of Machinify Auth will create an incredibly powerful opportunity for Evolent and for our client base of approximately 70 health plans,” stated Seth Blackley, Co-Founder and Chief Executive Officer of Evolent. “Machinify has built a proven AI business that currently reviews over $200 billion in medical claims annually. The acquired assets consist of developers and proprietary, scalable software code as well as existing client relationships that fit with our product strategy at Evolent. Further, we believe by embedding Machinify technology into our platform and wrapping it with broader condition management services we can unlock additional value for health plans, providers, and members. Finally, this solution will allow Evolent, on a SaaS basis initially, to support value-based condition management and provider engagement across all specialties, not just for our three focus areas of oncology, cardiology and musculoskeletal care.”

The acquisition is subject to customary closing conditions and is expected to finalize in the third quarter of 2024. Evolent anticipates a neutral impact on both revenue and adjusted EBITDA in the first year following the close.

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Tagged With: Artificial Intelligence, Automated Prior Authorizations, Healthcare Mergers & Acquisitions, Prior Authorization, Revenue Cycle Management

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