Evolent Health, Inc. (EVH): History, Ownership, Mission, How It Works & Makes Money

When you look at Evolent Health, Inc. (EVH), are you seeing a complex healthcare tech company or a firm that's actually figuring out how to make specialty care affordable? Their focus on value-based care-especially in high-cost areas like oncology and cardiology-is defintely gaining traction, with the company projecting full-year 2025 revenue between $1.87 billion and $1.88 billion and Adjusted EBITDA up to $154 million. This shift matters because Evolent Health's mission is to transform population health by cutting costs and improving care quality, a model that just secured over $500 million in new annualized revenue for 2026 launches. You need to understand how they turn this complex model into real financial and clinical outcomes, so let's dig into the history, ownership, and mechanics of how Evolent Health works and makes money.

Evolent Health, Inc. (EVH) History

You're looking for the bedrock story of Evolent Health, Inc., and honestly, it's a classic tale of seeing a massive, entrenched problem-the US healthcare payment model-and building a solution from the ground up. This company didn't just evolve; it was built to drive the evolution (hence the name) of healthcare from fee-for-service to value-based care.

The core idea was simple but powerful: give health systems the technology and services they needed to take on financial risk for their patient populations, which is the only way to truly control costs and improve outcomes. That strategic focus has been the engine since day one.

Given Company's Founding Timeline

Year established

2011

Original location

Arlington, Virginia (Washington, D.C. Metropolitan Area)

Founding team members

• Frank Williams (Co-Founder, former CEO)
• Seth Blackley (Co-Founder, current CEO)
• Tom Peterson (Co-Founder)

Initial capital/funding

Initial backing came from The Advisory Board Company and UPMC Health Plan. The first significant institutional funding was a Series B round in September 2013, which raised $100 million.

Given Company's Evolution Milestones

Given Company's Transformative Moments

The company's trajectory hasn't been a straight line; it's been a series of calculated, transformative shifts. The biggest change was moving from a broad provider-focused platform to a highly specialized, payer-centric model focused on complex specialty care, especially oncology. That pivot was defintely a game-changer.

The 2015 IPO was crucial, giving Evolent Health the brand and capital to scale quickly, but the real strategic shift came later. You can see the impact of this focus in the 2025 financials. Management has guided for full-year 2025 revenue between $1.87 billion and $1.88 billion and Adjusted EBITDA between $144 million and $154 million. That kind of precision in guidance only comes after years of refining the business model.

Here are the moments that truly defined the current Evolent Health:

• The Value-Based Care Mandate: The original mission was to help providers take on risk, which was a radical concept in 2011. This focus became the foundation for their software and services, making them a first-mover in the shift away from the traditional fee-for-service model.
• The Specialty Care Focus: The 2019 pivot to concentrate on health plan and clinical solutions, particularly for complex, high-cost conditions like cancer, was a massive decision. It narrowed their market but deepened their expertise, creating a defensible niche.
• The 2025 Risk Mitigation: After facing elevated oncology expenses in 2024, the company aggressively restructured key Performance Suite contracts in 2025. This action was a decisive move to restore profitability and reduce future volatility, securing a significant $115 million projected improvement in adjusted EBITDA. This shows a mature business willing to walk away from bad risk.
• Q3 2025 Growth Visibility: The announcement of over $500 million in newly-contracted annualized revenue, set to launch in 2026, signals strong market demand for their Enhanced Performance Suite model. This is a clear indicator that the specialty focus is working.

To really dig into who is betting on this strategy, check out Exploring Evolent Health, Inc. (EVH) Investor Profile: Who's Buying and Why?

Evolent Health, Inc. (EVH) Ownership Structure

Evolent Health, Inc. (EVH) is overwhelmingly controlled by institutional investors, a common structure for a publicly traded health technology company. This means large funds and firms, not individual retail investors, drive the majority of the stock's trading volume and influence major strategic decisions, like the recent divestiture of Evolent Care Partners in September 2025. You're looking at a company where professional money managers hold the reins.

Evolent Health, Inc.'s Current Status

Evolent Health, Inc. is a publicly traded company, listed on the New York Stock Exchange (NYSE) under the ticker symbol EVH. This status requires a high degree of transparency through regular filings with the Securities and Exchange Commission (SEC), which is how we get a clear view of who owns the company. As of late 2025, the company has a market capitalization of approximately $552.42 million, reflecting its position in the healthcare information services sector. Its public nature allows you to buy and sell shares easily, but also exposes the stock to the volatility of the broader market; for example, the share price was around $15.13 in November 2024 but fell to $4.96 by November 2025.

For a deeper dive into the company's financial stability, you should read Breaking Down Evolent Health, Inc. (EVH) Financial Health: Key Insights for Investors.

Evolent Health, Inc.'s Ownership Breakdown

The company's ownership profile shows that institutional money dominates, a defintely critical factor for any investor to understand. When institutions hold such a high percentage, the stock's movement is often dictated by their collective portfolio rebalancing and investment mandates, not individual investor sentiment. Here's the quick math on the breakdown:

The fact that institutional ownership is close to 90% means their buy or sell decisions can create significant price swings. Vanguard Group Inc. and BlackRock, Inc. alone hold massive stakes, representing a substantial portion of the company's equity.

Evolent Health, Inc.'s Leadership

The company is steered by a seasoned executive team, blending co-founder vision with fresh operational expertise, which is important given the rapid changes in health tech. The leadership team is responsible for executing the strategy, particularly the renewed focus on specialty condition management after the recent divestiture.

• Seth Blackley: Chief Executive Officer (CEO), Co-Founder, and Board Member, providing long-term strategic direction.
• Dan McCarthy: President, overseeing the company's core business operations.
• John Johnson: Chief Financial Officer (CFO) as of November 2025. Note that Mario Ramos was appointed to take over the CFO role starting January 1, 2026, signaling a planned executive transition.
• Katie DiPerna: Chief Operating Officer (COO), focusing on the non-clinical services segment.
• Richard Jelinek: Chair of the Board of Directors, a key governance role, effective at the 2025 Annual Meeting.

The Board of Directors also includes influential figures like Dr. Toyin Ajayi and Kim Keck, bringing diverse clinical and industry leadership experience to the governance structure.

Evolent Health, Inc. (EVH) Mission and Values

Evolent Health, Inc. (EVH) is built on a core purpose: to simplify and make healthcare more affordable by focusing on complex conditions, a mission that directly addresses the industry's biggest cost drivers. This patient-centric approach is the bedrock of their value-based care model, not just a marketing slogan.

You're looking for the 'why' behind the numbers, and for Evolent Health, it's about aligning the financial success of payers and providers with better patient outcomes. This isn't just altruism; it's a sound business strategy, especially as the company navigates a challenging market, targeting a full-year 2025 Adjusted EBITDA between $144 million and $154 million.

Evolent Health's Core Purpose

The company's cultural DNA is rooted in the belief that managing high-cost specialties like oncology and cardiology requires a connected, integrated solution, not the fragmented, siloed approach that often drives up costs and compromises care quality. Honestly, that siloed approach is why healthcare is so defintely complicated.

Official Mission Statement

Evolent Health's mission is to specialize in better health outcomes for people with complex conditions through proven solutions that make health care simpler and more affordable. This is the clear mandate guiding their technology and service offerings.

• Improve outcomes for people with complex conditions.
• Make healthcare simpler and more affordable.
• Partner with health plans and providers to drive value-based care.

This focus on specialty care is paying off, with the company securing 13 new contracts in 2025 alone, demonstrating market demand for their model.

Vision Statement

The long-term vision for Evolent Health is to fundamentally change how healthcare is delivered, moving away from a fee-for-service system to one where payment is based on patient results (value-based care). They aim to be the leader in this specialty condition management space.

Their strategic divestiture of the value-based primary care business, Evolent Care Partners, in late 2025, for a total transaction value of up to $113 million, shows a clear commitment to this vision by focusing entirely on their core specialty business.

• Change the delivery of healthcare for complex populations.
• Enhance clinical and financial outcomes for partners.
• Lead the market in specialty condition management.

Core Values and Cultural Tenets

The company's core values are the operational guardrails for its team of over 4,500 professionals. They emphasize the need for ethical, forward-thinking solutions that require deep collaboration with their partners.

• Integrity: Uphold the highest ethical standards in all interactions.
• Innovation: Continuously seek new ways to improve healthcare delivery.
• Collaboration: Work closely with health plans and providers for shared success.

This commitment to innovation is visible in their use of artificial intelligence (AI) tools, like Auth Intelligence, to achieve automation targets by the end of 2025, aiming to auto-approve over 80% of baseline authorization volume.

Evolent Health Slogan/Tagline

The company's official tagline, introduced during its 2023 rebrand, succinctly captures its operational strategy and value proposition.

• Specializing in Connected Care™

This tagline highlights their focus on integrating care across different specialties, providers, and settings, which is essential for managing the complex, high-cost patient populations that drive their projected 2025 revenue of up to $1.88 billion. If you want a deeper dive into the financial implications of this strategy, check out Breaking Down Evolent Health, Inc. (EVH) Financial Health: Key Insights for Investors.

Evolent Health, Inc. (EVH) How It Works

Evolent Health, Inc. simplifies complex healthcare by partnering with health plans and providers to manage high-cost specialty conditions under a value-based care model, shifting the focus from volume to quality and cost-efficiency. They use proprietary technology and clinical expertise to coordinate care for members with conditions like cancer, driving better outcomes while reducing medical expense volatility for their clients.

Evolent Health, Inc.'s Product/Service Portfolio

Evolent Health, Inc.'s Operational Framework

The company's operational process is built on a technology-enabled platform that integrates clinical data and financial incentives to manage care for complex populations. They make money by either taking on the financial risk for specialty care costs (Performance Suite) or by charging a fee for their technology and clinical services (Specialty Technology and Services Suite).

Here's the quick math: Evolent projects full-year 2025 revenue between $1.87 billion and $1.88 billion, with an Adjusted EBITDA of $144 million to $154 million. This outlook is centered on their ability to successfully manage medical costs and utilization for their clients.

• Identify High-Risk Members: Use their data platform, Identifi, to analyze claims and clinical data, pinpointing members with complex specialty conditions like oncology or cardiology before costs spiral.
• Apply Clinical Protocols: Deploy evidence-based clinical programs and care management teams to guide members to high-quality, lower-cost care settings.
• Manage Utilization and Costs: Use AI-driven tools, such as Machinify Auth, to automate and streamline prior authorization (pre-approval for services), ensuring treatments are necessary and appropriate, which reduces low-value care.
• Align Financial Incentives: Structure contracts, especially in the Performance Suite, to share in the savings generated from reduced medical expenses, aligning Evolent's financial success with the client's cost reduction goals.

To be fair, the shift in business mix means they are defintely focused on the less volatile fee-based model, which is a smart move given past volatility in their risk-bearing contracts.

Evolent Health, Inc.'s Strategic Advantages

Evolent's market success comes from its deep specialization in high-cost, high-complexity areas and its dual-pronged business model that offers clients flexibility in how they engage with value-based care. The divestiture of their primary care business in late 2025 allows for a sharper focus on this core specialty platform.

• Specialty Focus and Scale: They target a vast and growing market-the $150 billion specialty care Total Addressable Market (TAM)-with solutions for oncology, cardiology, and MSK, where costs are outpacing historical averages. They cover approximately 84.7 million total lives on their platform as of Q1 2025, providing massive data scale.
• Proprietary Technology Stack: Their platforms, including Identifi and Machinify Auth, provide a tech-driven advantage, helping them manage utilization more efficiently than competitors and delivering measurable return on investment (ROI) for health plans.
• Balanced Revenue Model: Offering both capitation-based (Performance Suite) and fee-based (Technology & Services Suite) contracts allows them to meet clients where they are in their value-based journey, while mitigating the downside risk associated with full capitation models.
• Strong Growth Visibility: The company has secured 13 new contracts in 2025 and is projecting a 2026 revenue forecast of $2.5 billion, driven by new signings and an expanding pipeline.

You can see how their financial health is holding up against these strategic moves by Breaking Down Evolent Health, Inc. (EVH) Financial Health: Key Insights for Investors.

Evolent Health, Inc. (EVH) How It Makes Money

Evolent Health makes money by partnering with health plans and provider organizations to manage the total cost and quality of care for complex patient populations, essentially acting as a specialized risk-management and technology partner. They primarily earn revenue through two distinct models: taking on financial risk in their Performance Suite and charging fees for their Technology & Services Suite.

You're looking for where the dollars actually land, and right now, the business is in a deliberate transition, shifting revenue mix for better, more predictable margins down the road.

Evolent Health's Revenue Breakdown

As of the third quarter of 2025, Evolent Health's total revenue was $479.5 million. The business is strategically moving away from its highest-risk revenue stream, which is why the overall revenue mix is changing so dramatically.

The Performance Suite is where Evolent Health takes on financial risk, managing specialty care costs-like oncology, cardiology, and musculoskeletal (MSK)-for a capitated rate (a fixed payment per member per month, or PMPM). This stream dropped from 70% of total revenue in Q3 2024 to 60% in Q3 2025, but this isn't a bad sign; it reflects a strategic shift toward lower-volatility contracts.

The Technology & Services Suite, which includes their Identifi platform and administrative services, represents the remaining 40% of revenue. This fee-for-service model provides more stable, predictable revenue, and it's where they're seeing proportional growth. Honestly, this shift toward a more balanced portfolio is defintely a necessary move for long-term stability.

Business Economics

Evolent Health's core economic engine is built on the concept of value-based care (VBC), which means they get paid to keep healthcare costs down while improving patient outcomes, especially for complex, high-cost conditions like cancer. Their pricing strategy is a mix:

• Capitation-Based Risk: In the Performance Suite, they receive a fixed PMPM fee. If they manage the patient's specialty care for less than that fee, they keep the difference; if costs exceed it, they absorb the loss. New and renewed contracts now include risk corridors and retroactive adjustments, which is a big deal because it limits their downside risk and makes margins more predictable.
• Fee-for-Service: The Technology & Services Suite charges clients a fee for using their software platform and administrative services, providing a reliable, non-risk-bearing revenue stream.
• Targeted Margin: Management is targeting a 10% mature margin on their enhanced Performance Suite contracts. This is the new goal: less volatility for a reasonable return.

Here's the quick math on their future: Evolent Health secured over $500 million in newly-contracted annualized revenue in 2025, set to launch in 2026. This new business is what supports their preliminary 2026 revenue forecast of approximately $2.5 billion.

To understand the full scope of their work, you can review the Mission Statement, Vision, & Core Values of Evolent Health, Inc. (EVH).

Evolent Health's Financial Performance

The company's financial results for 2025 reflect the challenges of a shifting business mix and industry headwinds, particularly in government-sponsored health programs.

• Full-Year 2025 Outlook: Evolent Health narrowed its full-year 2025 revenue outlook to a range of $1.87 billion to $1.88 billion. Adjusted EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization) guidance is set between $144 million and $154 million.
• Profitability: For Q3 2025, Evolent Health reported a net loss of $26.93 million, though this was an improvement over the prior year. The Adjusted EBITDA for the quarter was $38.96 million, reflecting an 8.1% margin, up from 5.1% in Q3 2024.
• Capital Structure: The company's leverage has increased significantly. Net Debt to Last Twelve Months (LTM) Adjusted EBITDA rose from 2.8x in Q3 2024 to a high 6.7x in Q3 2025. Total debt now stands at approximately $1.06 billion. Managing this debt is a clear near-term priority, with plans to use the proceeds from the sale of the Evolent Care Partners unit to pay down senior debt.
• Market Shift: The mix of customers is changing fast. Medicaid's share of total revenue increased from 35% to 47% year-over-year, while Medicare's share dropped from 38% to 27%. This shift reflects volatility in the Medicare Advantage and government exchange markets.
• Efficiency Gains: To combat rising costs, Evolent Health expects to realize approximately $20 million in annualized AI-driven cost reductions starting in 2026.

What this estimate hides is the impact of the Q3 2025 year-over-year revenue decline of 22.8%, which is largely due to the intentional exit from certain high-risk contracts and membership reductions in the government exchange market. The future growth hinges on the successful launch of the new, more profitable Performance Suite contracts in 2026.

Evolent Health, Inc. (EVH) Market Position & Future Outlook

Evolent Health is strategically positioned as a leader in the high-growth, high-complexity specialty care segment of the value-based care (VBC) market, focusing on oncology, cardiology, and musculoskeletal services. The company is actively shifting its business mix toward higher-margin Technology & Service Suite offerings, with a full-year 2025 Adjusted EBITDA guidance projected to be between $144 million and $154 million. This focus, plus a significant pipeline of new business, points to a strong growth trajectory despite near-term revenue volatility.

Competitive Landscape

You're operating in a highly fragmented market, so a single, universal market share number is misleading. Evolent's true competition is segmented by its focus on specialty care management, where its clinical expertise and proprietary technology give it an edge over general health-tech platforms. The total addressable market (TAM) for specialty care alone is a massive $150 billion, and Evolent's current penetration is still low, which means there's huge running room. We can look at relative standing in the broader provider technology space.

Opportunities & Challenges

Honesty, your next few years will be defined by how well you execute on the AI-driven margin expansion and manage the persistent cost inflation in oncology. Here's the quick map of what's ahead.

Industry Position

Evolent Health is cementing its position as a specialized enabler for payers and providers moving to capitated (Performance Suite) and fee-based (Technology & Service Suite) value-based models. The divestiture of the primary care business, Evolent Care Partners, for up to $113 million, is a clear move to focus capital and expertise on the higher-value specialty care segment. That's a smart, focused pivot.

What this estimate hides is the power of the core technology. The proprietary Identifi platform is key to managing care workflows and risk across approximately 41.4 million unique members. This scale gives them a massive data advantage for refining their AI models, which is crucial for profitability in risk-bearing contracts.

• Focus on margin: Aiming for a Performance Suite care margin recovery back up to the long-term target of 10%.
• Deleveraging Goal: Plan to reduce net debt by roughly 1 turn per year, targeting below 4x leverage by mid- to late-2027.
• Product Strategy: Increasing gross margins in the Tech and Services side, currently around 50%, through automation and AI.

You can defintely get a clearer picture of the institutional backing and investor sentiment by Exploring Evolent Health, Inc. (EVH) Investor Profile: Who's Buying and Why?