Evolent Health Services

Explore insights about health plan administration and other health care transformation topics.

  • How the Right PBM Can Boost the Member Experience—and Star Ratings

    How the Right PBM Can Boost the Member Experience—and Star Ratings

    As member ratings, complaints and other experience measures take on added weight in the Medicare Stars program, having the right pharmacy benefit management is critical for drug plans.

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  • 7 Reasons Data Science Should Be Part of Your Risk Adjustment Coding Strategy

    7 Reasons Data Science Should Be Part of Your Risk Adjustment Coding Strategy

    Big-data approaches can improve coding accuracy while relieving documentation burdens.

    Download Fact Sheet
  • Driving Continuous Improvement in STARS Adherence Measures50:04

    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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  • Built for Speed and Savings: How a Nimble PBM Can Help Health Plans Control Drug Spend

    Built for Speed and Savings: How a Nimble PBM Can Help Health Plans Control Drug Spend

    Whether it's rapidly detecting fraud, waste and abuse or quickly adopting new generic medications, a nimble pharmacy benefit manager can drive drug savings for health plans.

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  • Breaking Up with Your Core Administration Partner: 7 Reasons Why

    Breaking Up with Your Core Administration Partner: 7 Reasons Why

    Evolent Health’s Emily Rafferty and Michael Miller share reasons to consider choosing a new administrative platform.

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  • Managing Drug Spend Without ‘Squeezing the Balloon’: The Case for Integrating Pharmacy and Medical Benefits

    Managing Drug Spend Without ‘Squeezing the Balloon’: The Case for Integrating Pharmacy and Medical Benefits

    Integration supports better care, member experience and cost control.

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  • The Heart of Care: Thorough Review Uncovers a Missing Medication

    The Heart of Care: Thorough Review Uncovers a Missing Medication

    Performing a patient’s annual medication review, Evolent Clinical Pharmacist Avani Arora recognized a vital missing drug and quickly addressed the issue.

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  • Remote Care Management Lowered Hospital Visits and Health Costs for Medicare Beneficiaries

    Remote Care Management Lowered Hospital Visits and Health Costs for Medicare Beneficiaries

    Medicare beneficiaries in Evolent’s care management programs had fewer hospitalizations and lower health costs.

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  • The Stretch Test: How Flexible is Your Health Plan's PBM Partner?

    The Stretch Test: How Flexible is Your Health Plan's PBM Partner?

    Several criteria can help determine whether a PBM is truly willing to bend to meet a plan’s goals.

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  • The Heart of Care: Addressing Behavioral Health, Immediate Needs Go Hand in Hand During Social Isolation

    The Heart of Care: Addressing Behavioral Health, Immediate Needs Go Hand in Hand During Social Isolation

    Behavioral Health Specialist Teena Lovern takes a whole-person approach to help patients facing challenges on multiple fronts.

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  • Taming the Wave: How Risk Adjustment Can Guide COVID-19 Recovery

    Taming the Wave: How Risk Adjustment Can Guide COVID-19 Recovery

    As pent-up demand releases into the health care system, plans and providers need to quickly reassess patient populations. A well-run risk adjustment program can be a major asset in that effort.

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  • Playbook: Evolent's COVID-19 Risk Stratification Approach

    Playbook: Evolent's COVID-19 Risk Stratification Approach

    Evolent shares detailed approach to identifying and engaging individuals at highest risk of COVID-19, so others can leverage the information in their own identification and outreach efforts.

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  • The Heart of Care: Navigating Post-Discharge Care Gaps During a Pandemic

    The Heart of Care: Navigating Post-Discharge Care Gaps During a Pandemic

    When a patient did not receive critical medications for her respiratory problems, Evolent Health's Linda Cassidy stepped in to help close the gap.

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  • Deploying Data to Prevent COVID-19 Cases…One Door Handle at a Time

    Deploying Data to Prevent COVID-19 Cases…One Door Handle at a Time

    Evolent is combining clinical data, social determinants of health and the latest evidence about COVID-19 to identify and outreach individuals at the greatest risk of severe outcomes from the disease.

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  • Move Beyond "Chart Chasing": Why Prospective Risk Adjustment Should Be the Anchor of Your Program

    Move Beyond "Chart Chasing": Why Prospective Risk Adjustment Should Be the Anchor of Your Program

    Evolent’s Brandon Barber explains how health plans can transform risk adjustment from a back-office, financial task to a patient-focused activity with clinical benefits.

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  • The Heart of Care: Removing Roadblocks to Help a Vulnerable Patient Stay Home

    The Heart of Care: Removing Roadblocks to Help a Vulnerable Patient Stay Home

    Evolent's Sara Plucker helped a man with multiple chronic diseases obtain important medications and avoid out-of-pocket pharmacy costs as COVID-19 threatened his community.

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  • Four Signs Your Health Plan's Administrative Platform is Becoming Obsolete

    Four Signs Your Health Plan's Administrative Platform is Becoming Obsolete

    Cobbling together an administrative platform from various point solutions can produce IT headaches, hurt care coordination and detract from the provider experience.

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