Arizona Tribune - NASCO Evolve Sets New Standard for Alternative Payment Model Management

ATLANTA, GA / ACCESS Newswire / October 2, 2025 / NASCO, a healthcare company with a holistic portfolio of administrative products and services, has launched NASCO Evolve, the first purpose-built, claims system agnostic solution for alternative payment model (APM) management that can help accelerate expansion of value-based care programs.

The goal of value-based care is to provide the right care to the right individual at the right time. A value-based care approach can vary significantly from fee-for-service models. The complexity and variability of value-based care delivery programs, which often extend beyond the borders of the traditional insurance claim, make implementing and scaling APMs a difficult yet essential step to increasing adoption of value-based programs. That's because adjudicating non-claim-based payments under value-based care is especially difficult as there is no traceable link from the member to the accountable provider for payment and performance measurement.

NASCO Evolve solves this problem by accurately automating settlement across key attributes such as quality, risk, and total cost of care. It streamlines and simplifies payment model management to ensure value-based programs are optimized for performance and positioned to drive affordability by leveraging multi-level attribution and providing data and insights for deeper analysis and proactive action.

"NASCO Evolve solves health plans' biggest barrier to affordability, accurately adjudicating payments in a growing mixed-model environment of claims and non-claim transactions," said Lori Logan, President and CEO for NASCO. "In doing so, NASCO Evolve can help expand adoption of value-based care, which will positively impact healthcare affordability as well as patient outcomes."

Despite the challenges surrounding APM management, health plans are expected to increase adoption in the coming years. According to a report in 2023 from the Health Care Payment Learning & Action Network, just over 41 percent of medical spend among leading health plans involves alternative payment arrangements.

"Increasing adoption of alternative payment models presents new challenges for health plans-particularly in adjudication, payment reconciliation, and financial settlement," said Todd Van Tol, Executive Vice President of Health Care Value for Blue Cross Blue Shield of Michigan. "NASCO Evolve provides actionable insights and precise, penny-perfect settlements for alternative payment models, enabling health plans to identify which alternative payment models are delivering the most value and manage both performance and the total cost of care. This capability is central to our mission of delivering affordability to our members."

NASCO Evolve enables health plans to operationalize affordability across the APM life cycle - from informing provider contracting to understanding cost and quality performance and determining settlement based on results - empowering health plans to understand the total cost of care faster.

NASCO Evolve's advanced contract ingestion and catalog uses proprietary AI to ingest contracts and codify them against key settlement terms, providing health plans with the information needed for settlement in seconds rather than hours or days. Other key capabilities of NASCO Evolve include performance analytics, program overlap identifier, and a declarative settlement engine, tools which enable business users to easily design their own settlement logic based on the APM. With NASCO Evolve, Blue Cross Blue Shield of Michigan expects an 80+ percent gain in operational efficiency for administering value-based settlements.

"NASCO Evolve delivers real-time performance insights across all care delivery arrangements, enabling health plans to improve results, enhance care coordination, scale value-based care, and advance affordability," Logan said.

NASCO has provided products and subject matter expertise to help health plans succeed and grow for more than 40 years. NASCO Evolve is the company's latest product that puts health plans in control of innovation and helps them manage the total cost of care.

To learn more, go to nasco.com/solutions

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About NASCO

NASCO helps health plans manage the total cost of care. Our holistic portfolio of healthcare administrative products puts health plans in control and enables them to drive affordability, deliver better member experience and grow. Our products are NASCO Edge, a comprehensive membership, benefits and billing solution; NASCO Empower, a reimbursement solution that accelerates the care-to-payment journey; NASCO Evolve for adjudication of alternative payment models; and NASCO Engage, a CRM that delivers exceptional member and provider experiences. Learn more at nasco.com.

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SOURCE: NASCO

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A.Ruiz--AT