Unlock Up to 12% Savings on Routine Lab Spend Without Adding Provider Burden 

A Smarter Approach to Routine Lab Management  

Avalon can help Aetna achieve up to 12% savings on outpatient routine laboratory spend through our Routine Test Management (RTM) solution. By combining evidence-based clinical guidance, intelligent automation, and a provider-centric approach, Avalon reduces unnecessary testing while supporting a positive provider experience.

Designed for flexibility and ease of implementation, RTM can integrate with existing health plan operations to deliver measurable savings, improve transparency, and help ensure members receive the right test at the right time. 

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Why Choose Avalon?

Deliver Meaningful Savings

Avalon helps health plans optimize diagnostic spending through evidence-based programs that reduce unnecessary testing while improving clinical quality and preserving a positive member and provider experience.

Minimize Provider Friction

Our approach emphasizes transparency, education, and clinical collaboration to help providers navigate testing requirements with minimal disruption.

Low Technical Lift

Flexible implementation models leverage existing infrastructure whenever possible, helping health plans streamline deployment and accelerate time to value.

Tailored to Your Needs

Avalon’s solutions can be customized across lines of business, markets, and regulatory requirements to align with your organization’s goals.

A Trusted Partner

Combining deep diagnostic expertise with actionable insights, Avalon continuously refines programs to maximize value for health plans, providers, and members.

Partner With Trusted Lab Stewards

Avalon stewards care by elevating quality, transparency, and independence while removing waste and delivering demonstrated savings.

Enforcement Based on Science

Medical necessity is essential to laboratory stewardship programs and compliance with the OIG mandate. Our programs enhance compliance efforts by ensuring appropriate test ordering for medical necessity, improving quality, and reducing cost. 

Preventative Care Integration

Avalon policies follow evidence-based practices and national guidelines, such as OIG, Choosing Wisely, and ASCP guidelines, ensuring that wellness testing is clinically appropriate.

Fully Transparent

Avalon policies are reviewed by our independent Clinical Advisory Board. Avalon’s health plan clients have full control over the adoption and adaptation of policies, including variances.

Provider-Friendly Tools

Avalon supports ordering providers via education, policy visibility, and defensible, evidence-based edits. Denials are justified and based on the health plans’ adopted policies. Reconsideration/appeal rates for Avalon programs are low <.01%.

Strategic and Effective Aetna LBM Partners

Avalon transforms lab management into measurable, value-based care using a scalable, science-driven frameworks that unlock the full value of diagnostic intelligence. Unlike other “lab stewardship” programs, our solutions provide tools and critical insights to take back control from lab-owned management programs.

20,000+

lab tests covered under rigorously researched policies

Ongoing in-house clinical policy research to ensure medical relevance and integrity

Over

10 years

of validated outcomes

Let’s discuss your savings potential – find out how Avalon can help Aetna save up to 12% on outpatient routine lab spend

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