Name

Vital Decisions

Legal name

Evolent Health LLC

Website

https://vitaldecisions.net

Company type

Private

Founded year

2012

Operating status

Operating

Headcount range

251–500 employees

Ownership category

akta.pro rank

Product category

Healthcare Care Management Services

SIC

Services-Health Services (8000), Services-Misc Health & Allied Services, Nec (8090)

akta.pro primary industry

Order Sets, Care Plans & Clinical Pathways (CPOE-integrated) (HLACAGAC)

Keywords

• Advance care planning
• Behavioral health solutions
• Patient engagement services
• Healthcare consulting
• Care planning software

Headquarters

HQ city

Edison

HQ country

United States

HQ region

North America

Offices3 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. Specialty Care Management Services: B2B services to health plans providing specialty care management across oncology, cardiology, MSK, radiology, surgical management, genetic testing, and physical medicine. Revenue derived from administrative services agreements and value-based care arrangements with health plan partners.

Go-to-market motion2 records

Distribution channels3 records

Marketing channels5 records

Core offering

Vital Decisions is a hospital and health care company specializing in care planning and behavioral science solutions. It works with health care organizations to engage patients and families in advance care planning, shared decision-making, and behavioral change interventions for complex medical conditions.

Product overview

Evolent offers a unified specialty care management platform with multiple interconnected solutions spanning oncology, cardiology, musculoskeletal, radiology, surgical management, physical medicine, genetic testing, and care navigation. The company operates provider-facing portals (RadMD for radiology and CarePro for specialty care) and partners with digital health platforms like Careology to deliver comprehensive care coordination. The portfolio includes clinical decision support tools, utilization management, provider engagement platforms, and patient navigation programs designed to work together across the care continuum.

Differentiator

Problem solved

Functional benefit

Brands

• Careology: A digital cancer care management platform partnered with Evolent to support patients' physical and mental wellbeing during cancer treatment. Members can use the Careology app or website to understand and monitor symptoms, track medications, and get answers to common questions.

Products and services

• Care Planning and Behavioral Science Solutions A service offering for hospitals and health care organizations that applies behavioral science to engage patients and families in advance care planning and complex medical decisions.

Quantifiable outcome

• 30%+ increase in adherence to high-value clinical pathways
• +5 more outcomes

Named customers3 records

Segments3 records

Ideal customer profiles1 record

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration1 record

AI capability2 records

Feature5 records

Partnerships

Three partnerships are on record, tiered core.

• American Oncology NetworkcoreStrategic or Co-development Partner · 1 November 2025Partnership with one of the nation's fastest growing community oncology networks to enable top-quality, more affordable, and connected cancer care. The innovative model aims to improve cancer care while eliminating prior authorization burden for community oncology providers.
• CareologycoreStrategic or Co-development PartnerStrategic care navigation partnership providing a patient-facing digital cancer care management platform. Careology app empowers individuals to understand and monitor symptoms and side effects, track medications, and share updates with family and care navigators. Members with smart watches can link with Careology to track steps, heart rate, oxygen saturation, and blood pressure.
• IPG (Integrated Surgical Solutions)coreStrategic or Co-development PartnerPartnership with IPG's surgical cost management solutions for implant device management. IPG brings surgical cost management capabilities including device carve-out from reimbursement, surgeon engagement on clinically appropriate device selection, and site-of-care optimization for procedures using implants such as knee replacement, rotator cuff repair, and spinal fusion.

Scale indicators10 records

Recent moves1 record

Emerging players

• Cohere Health: An AI-powered prior authorization and intelligent care navigation platform serving health plans across specialty procedures. Targets the same payer procurement RFPs as Evolent with a more modern, automation-led approach to specialty care utilization management.
• Astrana Health (formerly Apollo Medical Holdings): Value-based care organization managing Medicare Advantage and ACO populations with delegated specialty and primary care. Adjacent peer to Evolent as both organizations monetize value-based contracts with payers, though Astrana is more provider-aligned than platform-aligned.
• Aledade: Value-based primary care enablement platform partnering with independent practices and community health providers. Adjacent to Evolent's prior primary care strategy (ECP) and competes for the same payer relationships focused on cost-of-care management for attributed populations.

Others

• Surgery Partners: Owns and operates ambulatory surgical facilities and partners with payers on site-of-care optimization. Comparable to Evolent's surgical management line, which shifts cases to optimal ambulatory sites of care, though Surgery Partners is on the provider/owner side rather than the platform side.
• Privia Health Group: Value-based care and medical group enablement platform that acquired Evolent Care Partners. An adjacent rather than directly competing peer — tied to Evolent through the divestiture and through the broader value-based care ecosystem for complex-condition populations.
• Health Catalyst: Healthcare data and analytics platform for hospitals, health systems, and providers. Adjacent to Evolent's clinical analytics layer (40M+ member data advantage) but operates more upstream in data infrastructure rather than downstream clinical decision support delivery.

Direct peers

• AIM Specialty Health: A wholly owned subsidiary of Elevance Health (formerly Anthem) that provides specialty health management solutions including radiology, cardiology, oncology, MSK, and sleep programs to health plans. Directly comparable to Evolent's specialty care management platform across the same therapeutic categories and customer base.
• eviCore healthcare: A Cigna/Evernorth subsidiary offering utilization management, prior authorization, and specialty care management solutions across radiology, cardiology, MSK, oncology, and post-acute care. Competes head-to-head with Evolent for health plan specialty management contracts using similar clinical decision support and provider portal workflows.

Broad incumbents

• CVS Health (Aetna/Caremark): Integrated payer-CVS-Caremark entity with growing specialty management capabilities, particularly through Caremark's specialty pharmacy utilization and prior authorization functions. A broad incumbent whose combined payer and provider footprint overlaps with Evolent's health plan services.
• Optum Health: UnitedHealth Group's care delivery, clinical care management, and behavioral health arm. Operates at massive scale with in-house specialty management programs serving UnitedHealthcare's members and external payer clients — the most formidable broad incumbent in specialty care management.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat2 records

Key risks6 records

Key highlights7 records

Customer concentration

Compliance5 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Subsidiaries6 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 Vital Decisions