Mastering Medicaid
How Evolent Health Can Help Win Arizona's
Complete Care Contract Expansion
STRATEGIC PARTNER WITH DEEP MEDICAID EXPERTISE
Evolent Health Services manages 1M+ Medicaid lives nationally and has been administering Medicaid
operations for over a decade. We can partner with you at every stage, from responding to RFPs
and preparing for and passing state readiness audits, to managing on-time implementations and
running ongoing plan operations.
Below are areas we identified in the contract expansion where a partnership with Evolent could
improve your chances of winning this business from the Arizona Health Care Cost Containment System
(AHCCCS).
Whole-Person Approach to Care
As part of the contract expansion, AHCCCS has a dedicated Whole Person Care Initiative focused
on social determinants of health (SDoH) and their impact on a member's health and well-being.
Evolent provides proven evidence-based programs and care models that blend clinical and community-
based interventions such as access to transportation and housing. In addition, Evolent's community
health workers coordinate clinical, social and community services depending on the member's needs.
Flexible & Modern Claims Processing Capabilities
The contractor is responsible for payment of all behavioral health claims for Non-Title XIX/XXI, Title XIX
behavioral health covered services and payment of all physical health claims for Title XIX covered
services.
Utilizing our modern, integrated core administration platform, Identifi, Evolent processed over 14M
claims in 2019 and has experience with both medical and behavioral health claims for our plan partners,
with an average auto-adjudication rate of 80%.
Health Disparity & Equity
A key component of the contract expansion is around the plan developing and implementing a Health
Disparity Summary and Evaluation Report that provides an analysis of the effectiveness of implemented
strategies and interventions in meeting its health equity goals and objectives.
Evolent has an equity-centered supplier program that targets contracts with diverse vendors. In
addition, we deploy our Racial Disparities Dashboard that evaluates membership to help identify and
mitigate health disparities, and our advanced risk stratification incorporates SDoH.
evolenthealthservices.com
