Reduced settlement speed, shifting from weeks to minutes
Automate + Clarify
Intelligent Performance and APM Settlement
Health plans have spent decades optimizing core administration systems for fee-for-service claims processing. But today’s value-based and alternative payment models operate outside those core administration systems, creating complexity, fragmentation, and limited visibility and making it increasingly difficult to manage payments consistently and transparently.
Arrangements like shared savings, quality incentives, and capitation are often the most strategically significant payments a plan makes, yet most plans still administrate them manually. Settlement takes months, there is no single source of truth for contract terms, and no easy way to understand how payments are calculated and paid. You can’t scale programs that run on institutional knowledge and spreadsheets, and you can’t defend a payment you can’t trace.
NASCO Evolve is the first system of record for administering Alternate Payment Model (APM) programs. This cloud-native, AI powered platform is designed explicitly for the complexity and variability of performance-based provider arrangements, taking plans from contract ingestion through settlement with the operational control and confidence you need.
What is a System of Record for APM Program Administration and What Does It Do?
A modern APM administration platform must do more than just analyze contracts or calculate payments. It must operationalize the entire lifecycle from contract ingestion and modeling through settlement, payment execution, governance, and auditability – at scale.
Ingest
Contract ingestion & repository
AI-assisted extraction of APM contract terms – shared savings thresholds, quality metrics, capitation rates, incentive structures – into structured, arrangement-specific schemas. Contracts are stored in a centralized repository with version history, approval workflows, and linked payment data.
Model
Contract modeling & financial controls
Models how contract terms behave financially before and during execution, including what-if scenario analysis, overlap detection, and stacking exposure identification. Built-in logic controls help prevent downstream calculation errors and reduce operational risk.
Execute
APM settlement & payment execution
Purpose-built settlement engine that calculates and executes accurate payments across shared savings, capitation, fee-for-service with quality incentives, and risk-based arrangements. Settlement outputs flow directly into payment distribution without manual reconciliation.
Analyze
Performance analytics & reporting
Provides financial visibility into provider and program performance against contract terms. Provides the portfolio intelligence teams need to identify savings opportunities, performance risks, and areas for investment optimization.
Trace
Audit trail & settlement traceability
Every payment calculation is traceable back to source contract terms and input data. Native auditability supports provider dispute resolution, regulatory compliance, and audit readiness without manual reconstruction.
Govern
System of record governance
Enterprise-grade governance with role role-based access controls, approval routing workflows, audit logging, and multi-environment management designed for high-volume, high comlexity payment administration at scale.
Scale
Sustainable program expansion
Enables APM program expansion without corresponding growth in headcount or consulting spend.
NASCO Evolve: Designed to Support the Health Plans Existing Complexity and Workflows
Built-to-Pay
Evolve was purpose-built to administer and settle provider payments, not just analyze them. The platform produces precise, auditable settlement outputs traceable to source contract terms across complex APM arrangements.
- Reduced settlement errors and manual reconciliation
- Accelerate settlement cycles from 3 weeks to 15 minutes.
- Minimize provider disputes with defensible calculations
- Proactively and tranparently monitor performance so you can impact the course of care
Contract-First Design
Evolve is built from the contract itself, meaning no reformatting, standardization, or manual translation is required. AI-assisted contract ingestion extracts and codifies the precise contract terms that drive settlement, creating a traceable contract record for downstream calculation.
- Reduce settlement variance with 99% accurate contract ingestion and codification
- Lower consulting and manual interpretation costs
- Improve contracting strategy with real-time performance insight
System of Record
Evolve provides a single, authoritative source of truth for provider payment administration, with enterprise grade governance, audit readiness, and operational scalability for high-volume APM programs.
- Scale programs without adding operational overhead
- Improve audit readiness and compliance
- Gain portfolio-level visibility into performance and risk
Our Results Speak For Themselves
99.95
99.95
%
2
2
Million
member lives supported
New arrangements can be onboarded in days—or in some cases, minutes, significantly reducing time to value.