Evolent Health, Inc. is a market leader in connecting care for people with complex conditions such as cancer cardiovascular disease and musculoskeletal diagnoses. The company works on behalf of health plans and other risk bearing entities and payers to support physicians and other healthcare providers in delivering high quality evidence based care to their patients. Evolent combines specialty care management services with administrative services and uses proprietary…
Evolent Health, Inc. is a market leader in connecting care for people with complex conditions such as cancer cardiovascular disease and musculoskeletal diagnoses. The company works on behalf of health plans and other risk bearing entities and payers to support physicians and other healthcare providers in delivering high quality evidence based care to their patients. Evolent combines specialty care management services with administrative services and uses proprietary technology to align financial incentives with best evidence and improve outcomes while lowering costs.
Evolent generates revenue primarily through its Specialty Care Management Services which are offered under both non capitation arrangements where fees are paid for services rendered and capitation arrangements where the company assumes responsibility for the cost of medical claims under its scope. The Administrative Services business provides recurring multiyear platform and operations contracts that include health plan services pharmacy benefit management risk management analytics and reporting and leadership and management offerings. Revenue is generally structured as a fixed fee per member per month with additional case based fees for certain specialty services. The company’s earnings grow as it adds more members expands the breadth of services sold to existing partners and attracts new partners through risk sharing arrangements.
The company operates through the following segment.
• The Operating Segment encompasses the company’s Specialty Care Management Services which focus on oncology cardiology and musculoskeletal markets supported by diagnostics such as radiology and genetic testing and the Administrative Services that provide the Identifi® platform health plan services pharmacy benefit management risk management analytics and reporting and leadership and management solutions.
Evolent holds a strong position in the fragmented market for value based care solutions where it competes with a range of participants from smaller niche firms to large well financed and technologically sophisticated companies. The company’s early entry into the sector its integrated offering of specialty and administrative services and its proprietary Identifi® technology provide competitive advantages. Evolent’s provider heritage brand and partnership driven model further differentiate it by aligning incentives with physicians and payers and enabling scalable delivery of evidence based care.
Evolent serves health plans other risk bearing entities and payers as well as physicians hospitals and other healthcare providers across the United States. The company’s customer base includes national and regional Medicare Advantage plans Medicaid managed care organizations commercial insurers and health systems that seek to improve quality and reduce costs in specialty care.
Read more ↓
Sector: Healthcare Industry: Health Information Services CIK: 0001628908