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Evolent Health helps health plans and other organizations responsible for patients’ medical costs manage care for complex conditions such as cancer, cardiovascular disease and musculoskeletal disorders. It connects specialist networks, treatment guidelines and technology to support physicians’ treatment decisions and manage medical spending. Its CarePro platform supports clinical decisions and monitors whether treatment follows care plans. Specialty care management generates most of its revenue; a smaller administrative business runs services such as health-plan administration and claims processing.
Customers generally pay a monthly rate for each member Evolent manages, with payments also depending on the population covered and the services purchased. Its largest revenue source is Performance Suite, where Evolent receives these payments but must pay medical claims within the agreed scope. Earnings therefore depend not only on membership and contract rates, but also on treatment use and costs. Contractual limits reduce some of that exposure. Other specialty-care arrangements charge for technology and services without assuming those claims costs, and some services are billed per case.
Revenue is concentrated among a small group of partners, led by Molina Healthcare, making those relationships important to the business. Evolent also relies on access to patient information to deliver its services. HIPAA privacy and security requirements govern how it handles protected health information.
The risk section is the longest, dullest part of the filing. This keeps only what can really hurt you: where it hits, how hard, when it plays out.
Every company claims an edge. Each one is checked against hard numbers like margins and returns: which hold, and which line gives way first.
Evolent also relies heavily on contracts with Cook County Health and Hospitals System and Florida Blue, which together supplied 30.6% of its 2025 revenue.
Molina buys Evolent’s specialty-care management services and supplied 25.7% of its 2025 revenue, so Molina’s membership and contracting decisions directly matter to Evolent. Molina collects premiums to arrange and pay for members’ care; watch its Medicaid enrollment and medical costs, as Medicaid supplied 75% of its 2025 premium revenue.
Centene pays Evolent for specialty-care management and supplied 12.2% of its 2025 revenue, leaving Evolent exposed to both this customer’s decisions and the Medicaid membership and medical-cost pressures they share. Centene provides health coverage through Medicaid, Medicare and commercial plans; its Medicaid business, which supplied 57% of its 2025 external revenue, is the clearest area to watch.
Starling Oncology’s disclosed TOI business competes with Evolent for contracts in which health plans pay them to manage cancer care and bear financial risk. Unlike Evolent’s support for providers, TOI also delivers cancer treatment directly; watch its arrangements that share treatment gains or losses with health plans.
Humana’s insurance business pays Evolent for specialty-care management, but its share of Evolent’s revenue fell from 19.3% in 2024 to below 10% in 2025. Humana sells health insurance, including private Medicare plans; medical-cost trends in those plans matter because both companies face Medicare cost pressures.
agilon health and Evolent both bear the risk that treatment costs outgrow payments from health plans, but agilon manages patients’ total healthcare costs while Evolent takes responsibility for defined specialty costs. agilon receives per-member payments under global-capitation agreements; watch how Medicare Advantage care costs compare with those payments.
Astrana Health and Evolent are both sensitive to medical claims costs relative to contracted payments: Astrana bears risk through physician networks, while Evolent bears defined specialty-care risk. Insurers commonly pay Astrana’s affiliated physician associations a fixed monthly amount per member to arrange care, making the balance between those payments and medical costs worth watching.
Molina Healthcare, Inc. earningsMOH
Molina Healthcare buys specialty-care services from Evolent, and its report will show whether Medicaid membership and care costs support continued demand for them.
Watch Molina’s Medicaid membership alongside its medical costs. Stable membership and contained costs would suggest a firmer business base for this major customer and more capacity to maintain Evolent contracts. Shrinking membership or costs squeezing plan economics could push Molina to tighten contracts or reduce services, putting Evolent’s customer revenue at risk.
Fed Interest Rate Decision
Evolent’s Fed-linked SOFR loans make the Fed’s benchmark borrowing rate matter to how much the company pays in interest and debt service.
Expected4.0%Last release4.0%
If it comes in above expectations
If the Fed sets rates higher than expected, Evolent’s SOFR-based loans may cost more to service as their rates reset, leaving less cash for operations and other needs.
If it comes in below expectations
If the Fed sets rates lower than expected, Evolent’s SOFR-based loans may cost less to service as their rates reset, leaving more cash for operations and other needs.
agilon health, inc. earningsAGL
agilon health bears patients’ overall care costs, and its report will show whether Medicare Advantage medical costs are outrunning health-plan payments per member—a useful signal for Evolent’s narrower specialty-claim exposure.
Compare agilon’s per-member payments with its Medicare Advantage care costs. If payments keep pace, broader medical-cost pressure in that market appears more contained, which is a less adverse backdrop for Evolent’s specialty claims. If costs rise faster, care spending may be outrunning payments; Evolent could also face tighter margins if its contract rates fail to keep up with claims. The companies bear different scopes of risk, so this is a market signal, not a result for Evolent.
Evolent Health, Inc earningsThis company
Evolent Health manages specialty care for health plans, and its report will show how member volumes, contracted services and medical claims together shape revenue and profitability.
Read Performance Suite revenue alongside its claims and medical expense ratio—the ratio of claims to that suite’s revenue. Steady or rising revenue with a flat or falling ratio would show that the business is still covering the claims it bears. Falling revenue or a rising ratio would point to shrinking membership or contract scope, or higher care costs per dollar of revenue. Together, these figures show whether the scale of Evolent’s specialty-care business still matches the risk it takes on.
