Commercial and Self-Funded

Built for Health Systems to Streamline Management and Administration

A Highly Experienced Clinical and Administrative Partner

We offer services ranging from health plan launch, to population health and administrative services only (ASO). Within a financially aligned partnership, we work with health systems focusing on the following commercial product areas:

  • Health system employee plans
  • Affordable Care Act exchange plans
  • Commercial payer partnerships
  • Direct-to-employer, small and large group

Capabilities That Complement Yours

Health Plan Administration and Third Party Administration

We offer an attractive alternative to partnering with a commercial payer. We help you stand up and operate a plan that you ultimately own and control with the support of our team of health plan experts spanning benefit design, actuarial analysis, member services, regulatory/compliance, and medical management. Learn More

Network Performance Management

The physicians in your network determine how well you perform on cost and quality. Performance measurement and management is essential. Our team of data specialists and informaticists, along with our suite of analytic tools, ensure you have reliable information to drive and sustain improvement among physicians. Learn More

Pharmacy Benefit Management (PBM)

In addition to offering a highly cost-effective PBM, we integrate pharmacy and clinical data with your model of care to streamline prior-authorizations, bring better pharmacy data to the care team and provide a unified experience for your patients. Learn More

Population Health Management

Success in risk begins with improving quality while lowering the total cost of the care delivered. Our multi-disciplinary team of population health management veterans bring proven care management, innovative clinical thinking and leading-edge predicative technology to our population health partnerships. Learn More

Technology and Electronic Medical Record Integration

Our unified, end-to-end software platform drives core health plan administration, population health management, medical management, reporting and analytics. Electronic medical record (EMR) integration leverages the host EMR’s data and user interface to act as the perfect complement to fully manage your value-based business. Learn More

industry perspective

Are You Pulling the Right Levers to Rapidly Grow Your Membership?

CASE STUDY: Evolent partnered with the largest health system in southwestern Ohio to grow their Medicare Advantage and Commercial plans quickly. Read this case study to learn how our support in product price and benefit design, network development, and sales and marketing helped them quickly generate critical mass in membership for their plans.