Evolent Health Services

California Medicaid: CalAIM

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Ready to Master Medicaid? Let's Talk. Email EHSPartners@evolenthealth.com to discuss how Evolent Health Services can help meet your Medicaid MCO's unique needs. EHS-2112403-1005 TURNKEY BUSINESS PROCESS AS A SERVICE SOLUTION SET Evolent leverages our deep subject matter expertise, administrative scale and global footprint to provide a comprehensive—or select—set of services based on your needs. Core Administration Modern suite of back-office capabilities and services that drive operational efficiency through greater automation for enrollment, claims administration, appeals and grievances, complaint tracking, contact center, premium billing, portals, encounters, payment integrity and FWA. Clinical Services A whole-person approach to managing a member's needs built upon NCQA accredited care management, population health and utilization management. Risk Adjustment & Quality Our integrated approach to risk adjustment and quality includes care gap closure, physician support, HEDIS optimization and records review paired with an industry-leading prospective approach to risk adjustment. Data-Driven Insights Actionable analytics and reporting serve as an extension to your organization, and tailored reporting meets state regulatory requirements. Compliance Support An audit-ready organization closely manages regulatory development and guidance to ensure compliance for Evolent and our partners. Provider Engagement Provider engagement and management includes provider relations, provider communications, incentive development and provider data management to support your network. Payment Management We offer expertise and systematic support for all payment models, including fee for service, capitation, incentive, and value-based payment programs. Proven Implementation Model Our mature and proven model focuses on partner success, transparency, quality and speed that results in on-time implementations.

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