Evolent Health Services

Core Administrative and Clinical Services Powered By Modern Technology

Capabilities & Services          Lines of Business          Our Leadership          Contact Us

On-Demand Webinar: Driving Continuous Improvement in STARS Adherence Measures

Learn how data-driven targeting, outreach and monitoring can drive continuous improvement in adherence to help your plan become—or remain—a top performer.

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Transform Your Business With Evolent Health Services

Evolent Health Services partners with health plans and risk-bearing provider organizations to simplify administrative and clinical operations through:

  • A comprehensive yet flexible set of services from a single operating partner

  • A modern platform that converts data into actionable insights and achieves higher levels of automation and efficiency, focusing the human touch where it matters

  • A highly aligned partnership model supported by a collaborative and dedicated team focused on achieving your organization’s goals

  • Deep expertise supporting payers and providers across all lines of business  

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"We also needed an operational partner that could roll up their sleeves and really help us drive comprehensive provider engagement and quality improvement. Evolent checked all the boxes."
Cyndy Demarest
President and CEO, Maryland Physicians Care

Flexible Set Of Services To Meet Your Organization’s Unique Needs

Whether you’re looking for a partner to manage your full scope of administrative services—or something more customizable—Evolent Health Services’ partnership model can work for you. We diligently work with our partners to map the solutions needed to transform your business, while ensuring you retain the functions most important to you.

 

Core Administration
Modern suite of back office capabilities and services to drive operational efficiency through higher levels of automation

Clinical Services
Medical and behavioral health integration, built upon NCQA-accredited Care Management, Population Health Management and Utilization Management services

Risk Adjustment and Quality
Drive improved financial and clinical outcomes in prospective and retrospective risk adjustment

Pharmacy Benefit Management
National scale with a locally tailored partnership model

Data Driven Insights
Actionable analytics and reporting data that serve as an extension of your organization

  

Actuarial Services
Expertise to identify and assess risk exposure and implement strategies for mitigation

Delegated Provider Services
Provider heritage and approach that ensures providers thrive in a delegated model

Integrated Technology Platform
Modern end-to-end platform designed for efficiency and impact

Client-Centered Operating Model
More than a vendor, we view partnership as paramount

Implementation
Proven model focused on partner success, transparency, quality and speed
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Sluggish to nimble. Antiquated to innovative.
Hear from Senior Vice President and Chief Sales Officer Michael Miller about how a forward-looking operations platform can provide better opportunities to grow and innovate.

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Breaking Up With Your Core Administration Partner

To keep pace in today’s health care market, health care organizations must demand greater accountability and productivity from their strategic partners. Check out 7 reasons why replacing your claims system may be in your organization’s best interest.

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Deep Operational Experience Across All Lines Of Business

Evolent Health Services supports over 3 million lives nationally across all lines of business. Learn how we accelerate growth, quality and satisfaction through our unique partnership model.
 

Medicaid
Rich and diverse Medicaid knowledge—from launching new plans, implementation and operations—we’ve done it all for over one million lives 

Medicare
Deep experience across all types of Medicare and Medicare Advantage plans, focused on operational efficiency and STARS

 

  

Commercial
Operational expertise across small group, large group, ASO and fully insured plans

Individual
Holistic set of services to support plans offering products on state and federal exchanges

Specialty Populations
Experience managing specialty populations, including IDD

Our Partners

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Explore Related Thinking

Check out the latest insights on health care transformation in our Knowledge Center

 

Accreditations And Memberships

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ncqa-accredited-case-management-3-years
ncqa-accredited-pop-health-3-years
ACO Member