Evolent

What Evolent does

Evolent Health, Inc. (NYSE: EVH) is a publicly traded specialty care management company that provides technology-enabled services and clinical solutions to health plans and providers serving patients with complex medical conditions. Founded in 2011 and headquartered in Arlington, Virginia, the company operates across multiple specialty verticals including oncology, cardiology, musculoskeletal care, radiology, genetic testing, physical medicine, surgical management, and advanced illness. Its platform combines proprietary clinical pathways, evidence-based decision support, AI-powered utilization management acquired from Machinify (June 2024), and a cancer care member navigation program supported by a partnership with Careology. Evolent employs 4,000+ people globally, including 1,300+ clinicians (nearly 400 physicians and 750 nurses), and covers 40M+ unique members across its solutions, with named enterprise customers including Highmark and Aetna.

The company's technology architecture includes provider-facing portals (RadMD and CarePro) for prior authorization, clinical criteria access, and eligibility verification, plus specialist scorecards that identify high-quality providers in local geographies. Its scientific advisory boards, composed of academic and community-based specialist physicians, validate and continuously update clinical pathways. The product portfolio is organized into three commercial suites: a Performance Suite delivering at-risk specialty care management on a per-member-per-month (PMPM) basis (Q1 2026 average $17.73 PMPM, 6,078 average lives); a Specialty Technology and Services Suite for ASO arrangements ($0.35 PMPM average, 76,101 lives); and Administrative Services ($14.78 PMPM average, 1,118 lives), supplemented by case-based surgical management and advanced care planning ($3,772 per case). The company holds URAC Health Utilization Management accreditation through December 2028.

Evolent generates revenue through multi-year enterprise contracts with leading national payers and providers, sold via a direct enterprise field sales motion. Q1 2026 revenue was $496.2 million, with FY2026 guidance of $2.4 billion to $2.6 billion. In December 2025 the company divested its value-based primary care subsidiary (Evolent Care Partners) to Privia Health Group to refocus on specialty care. The company maintains international operating presence through Evolent Health International Private Limited in Pune, India, and a Philippines workforce location. Approximately 118.4 million shares were outstanding as of March 31, 2026, and total cash and cash equivalents stood at $142 million.

Name

Evolent

Legal name

Evolent Health, Inc.

Website

https://evolent.com

Company type

Public

Founded year

2015

Operating status

Operating

Headcount range

1,001–5,000 employees

Short description

Evolent Health (NYSE: EVH) provides specialty care management to health plans and providers for patients with complex conditions including oncology, cardiology, and musculoskeletal disorders, using clinical pathways, AI-powered utilization management, and provider portals to cover 40M+ members.

Ownership category

akta.pro rank

Product category

Specialty Care Management

NAICS

Professional, Scientific, and Technical Services (54)

SIC

Services-Health Services (8000)

akta.pro primary industry

Virtual Care Team Collaboration & Provider-to-Provider Teleconsult Platforms (eConsults) (HLALABAI)

Keywords

• Specialty care management
• Clinical decision support
• Utilization management
• Value-based care
• Oncology care management

Headquarters

HQ city

Arlington

HQ country

United States

HQ region

North America

Offices3 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Technology or R&D, Operations, Marketing or Sales, Others

Revenue model

1. Performance Suite: Specialty care management solutions for oncology, cardiology, MSK, and other complex conditions under performance-based arrangements. Revenue is calculated based on lives on platform and PMPM fees. Q1 2026: $17.73 average PMPM fee, 6,078 average lives on platform.
2. Specialty Technology and Services Suite: Technology-enabled services for ASO arrangements including oncology, cardiology, MSK, advanced imaging and diagnostics. Revenue based on PMPM fees per member managed. Q1 2026: $0.35 average PMPM fee, 76,101 average lives on platform.
3. Administrative Services: Administrative services implementation and core performance services for health plan operations. Q1 2026: $14.78 average PMPM fee, 1,118 average lives on platform.
4. Case-based Services: Surgery management and advanced care planning programs billed per case. Q1 2026: $3,772 revenue per case, 11 cases.

Pricing tiers

Go-to-market motion1 record

Distribution channels4 records

Marketing channels6 records

Core offering

Evolent provides specialty care management solutions for health plans and providers, focused on complex conditions including oncology, cardiology, musculoskeletal disorders, radiology, advanced illness, and genetic testing. The company combines proprietary clinical pathways, AI-powered utilization management, provider-facing portals (RadMD, CarePro), and a clinical staff of over 1,300 (including ~400 physicians and 750 nurses) to deliver care management under PMPM and per-case pricing models, covering approximately 40 million unique members.

Product overview

Evolent is a specialty care management company offering a platform of solutions across multiple medical specialties (Oncology, Cardiology, Musculoskeletal, Radiology, Surgical Management, Genetic Testing, Physical Medicine, Advanced Illness, Primary Care, and Administrative Services). The portfolio is organized into three primary suites: (1) the Performance Suite, which provides fully at-risk specialty care management covering lives and generating per-member-per-month (PMPM) fees; (2) the Specialty Technology and Services Suite, delivering point-solution software and services on an ASO (Administrative Services Only) basis; and (3) Case-based products for surgical management and advanced care planning. Complementing the core specialty care solutions are provider-facing portals (RadMD and CarePro) for authorization management, a Cancer Care Member Navigation program (enhanced by the Careology partnership), and AI-powered prior authorization capabilities acquired from Machinify. The company serves a national base of leading payers and providers, covering approximately 40 million unique members across its platform.

Differentiator

Problem solved

Functional benefit

Brands

• Evolent Surgical Management (ESM): Surgical management brand operated by Evolent Specialty Services, Inc., focusing on increasing the value equation of surgical procedures by optimizing device selection and site of care.
• Evolent Care Partners (ECP)

Products and services

• Oncology Solutions Specialty care management for cancer patients offering clinical pathways, decision support, and provider/patient engagement to achieve better outcomes. Targeted at health plans and oncology providers.
• Cardiology Solutions Identifies the most appropriate cardiac services and ensures alignment with treatment and testing guidelines, tackling overuse and misuse of tests and procedures for health plan members.
• Musculoskeletal Solutions Increases high-value pain management and surgery procedures in appropriate settings to optimize the value equation for musculoskeletal care delivered to health plan members.
• Administrative Services Streamlines health plan operations and improves the member experience through an aligned administrative partner, billed on a PMPM basis (Q1 2026: $14.78 average PMPM fee).
• Advanced Illness Solutions Empowers people nearing end of life so their care respects their goals and preferences, including advance care planning and palliative care coordination for health plan members.
• Genetic Testing Solutions

Quantifiable outcome

• 40M+ unique members covered by 1 or more Evolent solutions
• +3 more outcomes

Named customers3 records

Segments2 records

Ideal customer profiles2 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration2 records

AI capability7 records

Feature4 records

Partnerships

Three partnerships are on record, tiered minor and core.

• Privia Health Group, Inc.minorOthers · 1 December 2025Acquisition of Evolent Care Partners (ECP), Evolent's value-based primary care business, by Privia Health Group, Inc.
• MachinifycoreTechnology or Integration · 4 June 2024Agreement to acquire artificial intelligence utilization management products and team from Machinify to enhance Evolent's prior authorization and utilization management capabilities.
• CareologycoreStrategic or Co-development Partner · 9 May 2024Strategic care navigation partnership to enhance cancer care in the U.S. through a patient-facing digital application that supports patients throughout their cancer treatment journey, from diagnosis through survivorship or end of life.

Scale indicators9 records

Recent moves8 records

Expansion highlights6 records

Direct peers

• eviCore (Evernorth/Cigna): eviCore is Cigna's specialty care management arm providing utilization management and clinical decision support across radiology, cardiology, oncology, and MSK - directly competing with Evolent's specialty care management suite for the same payer clients.
• AIM Specialty Health (Elevance Health): AIM Specialty Health, part of Elevance Health/Anthem, provides utilization management and clinical appropriateness review for radiology, cardiology, oncology, sleep, and MSK services - overlapping nearly one-for-one with Evolent's product portfolio.
• Privia Health Group: Privia is a value-based care platform serving providers and payers; it just acquired Evolent Care Partners (ECP) from Evolent, positioning it as both a peer in value-based care and a counterparty on the primary care side Evolent divested.
• New Century Health: New Century Health is a specialty care management company focused on oncology and cardiology clinical pathways and decision support, now integrated within Evolent's portfolio but historically a direct competitor in value-based specialty care.

Broad incumbents

• Optum Health (UnitedHealth Group): Optum is the largest healthcare services platform in the U.S., offering value-based care, utilization management, and specialty care management at massive scale across UnitedHealthcare payer relationships - a broad incumbent competing with Evolent in the same payer-sponsored specialty management category.
• Teladoc Health: Teladoc Health is a large virtual care and chronic condition management platform serving payers and employers, providing overlapping virtual specialty and chronic care capabilities with Evolent's care navigation and specialty offerings.

Emerging players

• agilon health: agilon health partners with primary care physicians to deliver value-based care for Medicare Advantage populations, overlapping with Evolent's payer-facing value-based care capabilities and competing for similar payer risk-bearing contracts.
• Hinge Health: Hinge Health is a digital MSK care platform combining wearable technology, AI, and physical therapists - competing with Evolent's musculoskeletal solution for payer-sponsored MSK management contracts.
• Sword Health: Sword Health delivers AI-powered digital MSK care and is increasingly winning employer and payer contracts that overlap with Evolent's MSK specialty care management offering.
• Progyny: Progyny provides specialty fertility benefits management to employers and payers with a value-based clinical pathway model analogous to Evolent's specialty care management approach, expanding into adjacent women's health specialty areas.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks7 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/evolent
• Xx.com/EvolentHealth
• Facebookfacebook.com/evolenthealth

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles8 records

Subsidiaries4 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Evolent