CMS & State Program Compliance
• Staff fully trained on CMS guidance and
state-specific requirements, including
for specialized populations
• Consistent, reliable performance against
program- & plan-specific SLAs
• Experienced support for regulatory
readiness reviews
Quality-Focused MCO Program Support
• Member-, provider- and plan-level interventions
targeted toward top HEDIS scores performance
• Plan performance measurements
assess resource allocation, member
redetermination and outreach, impact of
pilot interventions and member incentives
Whole-Person Approach to Care
• Proven evidence-based programs and care
models blend clinical and community-based
interventions such as transportation and housing
• Community health workers coordinate
clinical, social and community services
Health Equity Focus
• Equity-centered supplier program targets
contracts with diverse vendors
• Racial Disparities Dashboard evaluates
membership to help identify and
mitigate health disparities
Actionable Opportunities
• Medical economics studies identify
clinical and financial opportunities to
elevate partners' performance.
• Timely, accurate reporting drives insights to
enable partners to expand access to care and
identify where best to reinvest in the community.
Medicaid Expertise to Help Plans Thrive
Enabling MCOs to Deliver Cost-Effective, High-Quality,
Whole-Person Care to Vulnerable Populations
Whether you're an established MCO looking to transform your operations
or considering entry into the Medicaid arena, Evolent Health Services has
the expertise to power your success. We can guide you at every stage,
from partnering on RFP responses and passing state readiness audits,
to managing on-time implementations and running ongoing operations.
CAPABILITIES TO MEET STATE REQUIREMENTS AND MEMBER NEEDS
1M+ lives
supported across multiple markets
