Evolent Health Inc (NYSE: EVH) is a healthcare services company that manages specialty care, including oncology, cardiology, radiology, and musculoskeletal conditions, for health plans and other risk-bearing entities. Revenue is generated through fixed fees per member per month across three reporting arrangements: the Performance Suite, where Evolent assumes capitation risk for medical claims costs; the Specialty Technology and Services Suite, covering non-capitation specialty care management; and Administrative Services, covering recurring multi-year platform and operations contracts for health plan administration. Evolent was founded in 2011 by members of its management team alongside UPMC and The Advisory Board Company, initially to help providers adopt value-based care models, and has since expanded into specialty benefit management through acquisitions including New Century Health (oncology), National Imaging Associates (radiology, musculoskeletal), and Implantable Provider Group (surgical management for musculoskeletal conditions). The company is headquartered in the United States and listed on the New York Stock Exchange. Revenue per contract is driven by member count, population type (Medicare, Medicaid, commercial), and the scope of services utilized.

Revenue model

Fixed fee per member per month across three revenue streams: Performance Suite (capitation arrangements where Evolent bears medical claims cost risk), Specialty Technology and Services Suite (non-capitation specialty care management), and Administrative Services (recurring multi-year platform and operations contracts). Certain specialty care services are also billed on a per-case basis.

Products and services

Specialty care management covering oncology, cardiology, radiology, musculoskeletal, and genetics; evidence-based clinical pathways; high-performance specialty provider network development; health plan administration including third-party administration, enrollment and billing, medical and utilization management, pharmacy benefit management, provider network contracting, actuarial services, and regulatory compliance. Subsidiaries include New Century Health (oncology specialty benefit management), National Imaging Associates (radiology, musculoskeletal, physical medicine, genetics), and Implantable Provider Group (surgical management for musculoskeletal conditions).

Customers and end markets

Health plans (regional and national payers) and risk-bearing provider entities. Population types served include Medicare, Medicaid, and commercial members. Referred to internally as 'partners.'

Value-chain role

Outsourced specialty care management and health plan administration vendor sitting between payers or risk-bearing providers and specialty physician networks. Designs clinical pathways, manages provider networks, performs utilization management, and assumes or supports financial risk for specialty medical spend.

Geographic exposure

United States. No international geographic exposure supported by the filing excerpts.

Source: SEC 10-K, filed 2026-02-25

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