Medicaid

Control Your Own Medicaid Destiny

Medicaid Health Plan Built for Providers

Evolent offers a complete solution for health systems in managed Medicaid states, including:

  • Determining the feasibility of a provider-led Medicaid plan option across financial, legislative and network considerations
  • Developing state Medicaid Request for Proposal (RFP) responses
  • Launching a provider-led Medicaid plan across a state or region
  • Jointly operating a provider-led Medicaid plan across clinical, administrative and regulatory domains

Capabilities Designed to Support Your Medicaid Population

Population Health Management

Success in Medicaid requires treatment of the whole person—physically, mentally and behaviorally. Our team of care managers, mental health and community engagement specialists pair evidence-based clinical and behavioral interventions with innovative clinical thinking and leading-edge predictive technology to improve care coordination, patient access and address social service needs. Learn More

Health Plan Administration

We offer an attractive alternative to partnering with a large Medicaid Managed Care Organization to launch a Medicaid plan. We help you stand up and operate a plan, providing a seamless experience for members and providers with the support of our team of health plan experts spanning functions including actuarial analysis, member services, regulatory and compliance, and provider relations. Learn More

Risk Adjustment

In certain states, Medicaid risk adjustment has been implemented to adjust reimbursement based on patient acuity. Physician engagement is the most significant driver of risk adjustment accuracy. We outperform on engagement because we have worked with physicians to build a solution that is simple to adopt, and creates real clinical value for physicians and their patients. Learn More