Evolent Health, Inc. (EVH): Business Model Canvas [Dec-2025 Updated]

You're looking at Evolent Health, Inc. (EVH) right now, trying to map out how they're actually making money after all the recent strategic moves. Honestly, the story in late 2025 is all about their sharp pivot into specialty care, underpinned by a proprietary tech platform that helps health plans slash spiraling costs-they signed 13 new contracts this year alone. They're guiding full-year revenue between $1.87 billion and $1.88 billion, while simultaneously closing the ECP divestiture to pay down debt; that's a clear financial lever being pulled. This isn't just software; it's a realignment of risk. Dive into this Business Model Canvas to see exactly how their Key Activities, Revenue Streams, and Customer Segments are set up to support this high-stakes strategy.

Evolent Health, Inc. (EVH) - Canvas Business Model: Key Partnerships

You're looking at the core relationships Evolent Health, Inc. relies on to drive its specialty care management and technology platforms. These aren't just vendor agreements; they are deep, often risk-sharing, arrangements that define the revenue runway.

The relationships with large national and regional health plans are foundational, especially as medical costs continue to put pressure on payers. The strategic divestiture of Evolent Care Partners (ECP) highlights a sharp focus on the specialty side, which is where the highest growth and margin potential is perceived to be.

Here is the breakdown of the key partnerships as of late 2025, grounded in the latest figures:

Large national and regional health plans (e.g., Centene, Molina)

The relationship with Centene, stemming from the NIA acquisition, was projected to add $85 million of run-rate Adjusted EBITDA by the end of 2024, expanding the cross-sell opportunity from $16 billion to $50 billion. For Molina Healthcare of Iowa, a specific partnership go-live was set for September 1, 2025. These large payer relationships are critical for scaling the core technology and services suite.

New regional Blues plan partner for Oncology Performance Suite

This new agreement is substantial. The regional Blues plan partner will deploy Evolent Health, Inc.'s Performance Suite for Oncology across more than 650,000 members in the Medicare Advantage (MA) and Commercial lines of business. This is part of a strong year for new business; Evolent announced two new revenue agreements in Q3 2025, bringing the year-to-date total to thirteen new contracts. These announcements collectively are expected to launch more than $750 million in new annualized revenue during 2026.

Privia Health Group, Inc. for the ECP divestiture closing in Q4 2025

The sale of the Evolent Care Partners (ECP) business to Privia Health Group, Inc. is set to close in the fourth quarter of 2025. The total transaction value is up to $113 million in cash. This includes $100 million payable at closing, with a remaining balance of up to $13 million contingent on final Medicare Shared Savings Program (MSSP) performance for 2025, due in Fall 2026. Evolent estimates the sold assets currently generate roughly $10 million in adjusted EBITDA. Evolent expects the debt prepayment from the proceeds to reduce annual interest expense by approximately $10 million, making the transaction immediately accretive to annual cash flow by more than $7 million.

Provider groups and physician networks for specialty care delivery

The ECP business being divested partnered with more than 1,000 physicians nationwide, serving over 120,000 members in the MSSP. The retained Performance Suite business, which takes risk on claims, has a steady-state margin target around 10%. For Q3 2025, the Performance Suite had an average of 6,474 cases on the platform. Furthermore, a separate program focused on oncology care, in partnership with a national health plan, achieved a 20.1% reduction in the use of low-value regimens between February and May 2024 compared to the same period in 2023.

Here's a quick look at the scale of the specialty technology and services business retained, based on Q3 2025 figures:

Finance: draft the pro-forma cash flow impact for the full year 2026 incorporating the ECP divestiture run-rate change by Friday.

Evolent Health, Inc. (EVH) - Canvas Business Model: Key Activities

When you look at the core engine of Evolent Health, Inc. (EVH), it really comes down to the continuous, heavy lifting in technology and complex contract management. These aren't just background tasks; they are the primary drivers of future revenue realization.

Developing and maintaining the proprietary CarePro technology platform is central, and you can see the commitment in the financial outlay. For the full year ending December 31, 2025, Evolent Health reiterated its expectation to deploy approximately $35 million in cash for capitalized software development. This investment underpins the entire operational structure.

Managing complex specialty conditions, especially oncology and cardiology, requires constant refinement, which is reflected in their trend monitoring. For instance, in the second quarter of 2025, the normalized oncology trend was reported at 10.5%, which was modestly below the internal forecast of 12%. This type of granular focus is key to managing risk. Furthermore, the company is actively working to drive efficiencies through technology, expecting to realize around $20 million in annualized AI-driven cost reductions in 2026. To give you a sense of scale in oncology, Evolent Health believes it currently touches approximately 9% of all oncology cases in the United States.

The activity around negotiating and restructuring value-based care contracts has been intense to secure better margins against rising utilization. You saw this directly when Evolent Health renegotiated three key Performance Suite contracts to mitigate rising cancer costs, a move expected to improve 2025 profits by $115 million. These contractual enhancements now cover over 75% of Performance Suite revenue, providing a significant buffer. The result of this disciplined approach is visible in the margins; for the third quarter of 2025, the Adjusted EBITDA margin reached 8.1%.

The success of these activities is quantified by implementing new contracts. Evolent Health secured two new customer agreements in the third quarter of 2025 alone, bringing the total number of new contracts signed for the year 2025 to thirteen. These aren't small deals, either. One of the major Q3 signings, a large regional Blues plan for its Performance Suite for Oncology, will cover more than 650,000 members across MA and Commercial lines. The impact of these wins is forward-looking:

These activities are all geared toward scaling the core specialty solutions, which is why the company projects significant growth from these new arrangements. The company is definitely focused on converting pipeline into realized revenue.

Evolent Health, Inc. (EVH) - Canvas Business Model: Key Resources

You're looking at the core assets Evolent Health, Inc. (EVH) relies on to execute its strategy, and honestly, it's all about the tech and the deep know-how in specific, high-cost areas of healthcare.

The first major resource is the proprietary technology platform. This isn't just one thing; it's split between the Performance Suite and the Tech & Services Suite. These platforms are what allow Evolent Health, Inc. to manage risk and drive better outcomes for payers and providers transitioning to value-based care.

For instance, the Performance Suite is clearly a massive asset. Just look at the new contract signed with a major bluecross plan to deploy the Performance Suite for Oncology across more than 650,000 MA and commercially fully insured members. That single deal is expected to bring in north of $500 million in annual revenue.

Next up, you have the clinical data and analytics underpinning those platforms, which is crucial for value-based care insights. This data capability is being hardened through product updates; for example, Evolent Health, Inc. anticipates over 90% of its Performance Suite revenue in 2026 will be covered by their Enhanced Protections, which use data to update pricing based on disease prevalence and mix.

The expertise is the human layer on top of the tech. Evolent Health, Inc. maintains specialized clinical and actuarial expertise focused on managing risk in high-cost specialties. This is where they see significant industry disruption and growth opportunities, especially in areas like oncology, where the normalized trend in Q3 2025 was just under 11% year-over-year.

Finally, you always need liquidity to support operations and growth initiatives. As of the end of the third quarter of 2025, Evolent Health, Inc. held $116.7 million in cash and cash equivalents.

Here's a quick snapshot of some key financial and operational metrics that reflect the current state of these resources as of late 2025:

You can see the pipeline is strong, with probability-weighted pipeline exceeding $650 million annually. The company is using these resources to drive growth, expecting contracts signed in 2025 to drive more than 30% topline growth in 2026.

The core capabilities that drive this are:

• Proprietary platforms: Performance Suite and Tech & Services Suite.
• Deep expertise in managing risk for complex conditions.
• Data analytics informing pricing adjustments and risk corridors.
• Strong pipeline conversion driving future revenue streams.

Finance: draft 13-week cash view by Friday.

Evolent Health, Inc. (EVH) - Canvas Business Model: Value Propositions

You're looking at how Evolent Health, Inc. (EVH) delivers distinct value to its customers, which are primarily health plans. It's all about managing the high cost and complexity of specialty care, and the numbers from late 2025 show where they are making traction.

Reducing spiraling specialty care costs for health plans.

This is a major focus, especially in high-spend areas like oncology. The company's clinical interventions are showing concrete results in steering care toward more appropriate, less expensive pathways. For instance, from February through May 2024, Evolent Health achieved a 20.1% reduction in the use of low-value oncology regimens compared to the prior year period. To give you a sense of the cost difference they are tackling, one low-value lung cancer regimen was 70 times more expensive, costing $40,000 more per quarter than the preferred alternative. Also, the normalized oncology trend in Q3 2025 was running favorably at just under 11%, which is below the forecast of 12%.

The focus on efficiency extends to technology, with Evolent expecting to realize around $20 million in annualized AI-driven cost reductions in 2026.

Improving health outcomes for members with complex conditions.

The value proposition here is tied directly to clinical management for complex conditions. The company is scaling its solutions to cover more lives under these specialized programs. As of Q3 2025, Evolent was deploying its Performance Suite for Oncology to over 650,000 members of a large regional Blues plan.

Here's a quick look at platform scale as of Q2 2025:

Providing a single, integrated platform for payer-provider alignment.

Evolent Health, Inc. is positioning its platform as the connective tissue between payers and providers, especially as they transition toward value-based care models. The company is winning new business that integrates these services. They added two new customer agreements in Q3 2025, bringing the total new contracts for the year to thirteen. These new signings are expected to contribute significantly to future revenue.

Offering enhanced contract protections to mitigate risk volatility.

You know that risk volatility is a constant headache for health plans. Evolent is addressing this by structuring contracts to provide more stability. Management has emphasized enhanced contractual protections to mitigate this cost volatility. This often means accepting a different margin profile for greater predictability. The company is backing this strategy with strong forward-looking commitments, announcing more than $500 million in newly-contracted annualized revenue set to launch in 2026. Overall, the company anticipates a preliminary revenue forecast of $2.5 billion for 2026.

The financial commitment to future growth is clear, with a pipeline of over $750 million in annualized revenue driving that 2026 forecast.

Finance: draft 13-week cash view by Friday.

Evolent Health, Inc. (EVH) - Canvas Business Model: Customer Relationships

You're looking at how Evolent Health, Inc. manages its relationships with large health plans and provider organizations, which is heavily weighted toward deep, ongoing engagement rather than simple transactions. This is a relationship-driven model, especially for the Performance Suite.

• High-touch, consultative sales and implementation for Performance Suite.
• Long-term, multi-year contracts with large health plan customers.
• Driving growth through cross-selling new solutions to existing clients.
• Dedicated clinical and technical support for platform users.

The relationship strategy centers on embedding Evolent Health, Inc. solutions deeply within the customer's operations, which is supported by the fact that the company has full retention of its top customers, which contribute to 90% of its revenue.

The consultative approach is evident in the sales momentum, with Evolent Health, Inc. signing thirteen new customer agreements year-to-date in 2025, following four new agreements in Q2 2025 and two more in Q3 2025.

Growth is explicitly tied to expanding the footprint within the existing customer base, as seen when an existing partner added Oncology to its existing Tech & Services Suite. This focus on expanding services is key to future revenue visibility.

The contracts themselves are designed for durability, with management updating Performance Suite agreements to demonstrate long-term durability. While older NIA contracts typically ran for one to three years with renewal options of one to two years, the current focus is on cementing position through these enhanced agreements.

The expected financial impact from new business is substantial; the 11 new revenue agreements signed year-to-date in 2025 are projected to generate $250 million in annual revenue once they are fully operational. The new contracts signed in Q3 2025 alone are expected to contribute over $750 million in annualized contract value, though the adjusted EBITDA contribution will be minimal in 2026.

The scale of the platform supports the dedicated support structure; Evolent Health, Inc. manages 84.8 million product lives on its platform as of Q1 2025, requiring significant technical and clinical resources to maintain service levels for these large health plan customers.

Evolent Health, Inc. (EVH) - Canvas Business Model: Channels

You're looking at how Evolent Health, Inc. gets its solutions into the hands of customers, which is clearly a mix of direct selling, platform access, and strategic alliances. Honestly, the numbers coming out of their recent contract signings really highlight where the action is right now.

Direct sales team focused on large national and regional payers.

The sales channel is clearly geared toward landing major contracts, as evidenced by the sheer scale of the deals announced. Evolent Health, Inc. secured 13 new revenue agreements year-to-date in 2025. These efforts are aimed at large entities, such as the recent signing with a large regional Blues plan to deploy the Performance Suite for Oncology. This direct engagement is what drives the massive expected future revenue streams.

Technology platform access (CarePro) for provider and payer users.

The technology platform is the delivery mechanism for the value proposition, managing a significant footprint. Evolent Health, Inc. manages 84.8 million product lives on its platform as of Q1 2025. The platform's capabilities, like the AI-powered Copilot review tool rolled out in musculoskeletal workflows, are key to showing value to users. The AI tools are projected to cut administrative overhead by 20-30% in specialties like those covered by the Auth Intelligence platform.

The success in expanding platform reach through new and existing relationships can be mapped out like this:

Strategic partnerships for co-development and market access.

Partnerships are crucial for market penetration, especially in complex areas like oncology. Evolent Health, Inc. announced a strategic partnership with American Oncology Network to strengthen provider alignment. The new contracts secured are structured with risk corridors and retroactive adjustments, which is a form of co-development around risk sharing, aiming for a 10% mature margin on these Performance Suite deals. These new signings alone are anticipated to contribute over $550 million in new 2026 revenue at maturity.

Industry conferences and thought leadership to build brand defintely.

While specific conference spending isn't public, the company's consistent communication around its AI advancements and contract wins serves as thought leadership. The focus on AI efficiency improvements and the transition to enhanced contract structures are the key messages driving brand perception in the market.

• Secured 13 new revenue agreements in 2025.
• Full-year 2025 revenue guidance is between $1.87 billion and $1.88 billion.
• Expected 2026 revenue under contract is approximately $2.5 billion.
• AI efficiency improvements are being realized in operational projects.

Evolent Health, Inc. (EVH) - Canvas Business Model: Customer Segments

You're looking at the core client base for Evolent Health, Inc. (EVH) as of late 2025. These are the organizations that pay for their specialty condition management and value-based care solutions. Honestly, the numbers show a focus on scale and deep penetration within existing large relationships.

• - Large national and regional health insurance payers.
• - Government-sponsored plans (Medicaid and Medicare Advantage).
• - Commercial health plans and exchanges.
• - Provider-sponsored health plans and Accountable Care Organizations (ACOs).

Evolent Health, Inc. serves over 120 health plans across all 50 states as of May 2025. The company manages 84.8 million product lives on its platform, with total lives reaching 84,778 thousand in the first quarter of 2025.

The customer segments are detailed below, showing the mix of business and recent wins:

Growth in the customer base is driven by new agreements. Evolent Health, Inc. signed 13 new contracts in 2025 as of the third quarter. These new agreements are expected to add approximately 1 million new lives to the platform and generate about $10 million in annualized specialty technology and services revenue.

The focus on high-cost specialties like oncology is clear from the deal flow. For instance, one Q3 2025 contract with a Blue Cross plan to launch the Performance suite for oncology covers more than 650,000 members and is expected to contribute north of $500 million in revenue annually.

You can see the mix of business is dynamic, with the Performance Suite segment seeing lower PMPM fees sequentially in Q1 2025, moving from $21.19 to $15.57 year-over-year for that segment.

Evolent Health, Inc. (EVH) - Canvas Business Model: Cost Structure

When you look at the Cost Structure for Evolent Health, Inc. (EVH), you see where the bulk of their revenue is consumed, which is typical for a high-touch, technology-enabled service provider in healthcare. It's all about service delivery and platform investment right now.

The most significant outflow in the third quarter of 2025 was the Cost of Revenue, hitting $379.76 million for the three months ended September 30, 2025. This number directly reflects the cost of delivering their care management and administrative services to their growing member base.

Next up are the overheads, specifically the Selling, General, and Administrative (SG&A) expenses. For Q3 2025, these came in at $77.59 million. Honestly, you need to watch this line item closely because disproportionate growth here can really eat into operating leverage, even if revenue is climbing. For context on the scale of these core costs, here's a quick look at the major Q3 2025 expense categories:

Then there's the capital structure cost. Evolent Health, Inc. is carrying significant leverage, with long-term debt reported at over $1.05 billion as of September 30, 2025. This level of debt means the interest expense is a persistent drag, which is why management is focused on deleveraging. They expect the planned sale of Evolent Care Partners to close by year-end 2025, with proceeds earmarked to pay down $100 million in senior debt to help manage that interest cost.

Platform enhancement requires heavy investment, which shows up in technology and software development costs. You'll see this reflected in two ways. First, the company reiterated its expectation to deploy approximately $35 million in cash for capitalized software development during the full year 2025. Second, looking at the year-to-date spend, investments in internal-use software and fixed assets increased 41% Year-over-Year to $26.3 million in the first nine months of 2025. That's aggressive spending to support future scale.

Finally, the variable cost tied to performance-based contracts-the actual medical costs-is managed through contract design. While a specific dollar amount for medical costs isn't broken out separately in the headline results, the rising medical costs impacting health plans are what drive demand for their solutions. Evolent Health, Inc. is mitigating this risk by structuring new Performance Suite deals with enhanced protections like risk corridors and retroactive adjustments for prevalence and case mix, aiming for more predictable margins.

You should track the margin performance on the Performance Suite, as that's where the medical cost risk is most direct. Management is targeting a ~10% mature margin for these contracts, accepting a slightly lower upside for lower volatility.

Finance: draft the projected 2026 interest expense based on the $100M debt paydown by end of year.

Evolent Health, Inc. (EVH) - Canvas Business Model: Revenue Streams

You're looking at how Evolent Health, Inc. (EVH) brings in money, which is key to understanding their financial health as we approach the end of 2025. The revenue streams are built around their specialty condition management solutions, blending fixed fees with performance-based arrangements.

The top-line expectation for the full year ending December 31, 2025, is a revenue guidance between $1.87 billion and $1.88 billion, this figure incorporates the impact of the ECP divestiture. This is the clearest overall financial marker for the year.

Evolent Health, Inc. structures its income across several distinct product suites, each with a different monetization method:

• - Performance Suite revenue (value-based care/risk-sharing model).
• - Specialty Technology and Services Suite fees (per-member-per-month or PMPM).
• - Revenue from Administrative Services and Case-based fees.
• - Proceeds from the ECP divestiture of up to $113 million for debt paydown.

The Performance Suite revenue stream is rooted in a risk-based model, covering solutions for oncology, cardiology, and the former Evolent Care Partners segment. This is the capitation-based portion of their business, meaning Evolent Health, Inc. takes on some of the financial risk in exchange for potential upside.

For the fee-based offerings, the Specialty Technology and Services Suite generates revenue primarily through a per-member-per-month (PMPM) fee structure. This suite covers fee-based solutions across specialties like oncology, cardiology, and musculoskeletal care for members on the platform under Administrative Services Organization (ASO) arrangements.

The remaining core revenue components include:

• Administrative Services: This stream is also calculated using an Average PMPM fee based on the Administrative Services Lives on Platform.
• Case-based fees: Revenue here is tied to specific programs, such as surgery management and advanced care planning, calculated by Revenue per Case.

To give you a sense of the unit economics, though based on older data, the structure involves different PMPM rates across services. For instance, in Q1 2023, the Performance Suite Average PMPM was $24.66, the Specialty Technology and Services Suite Average PMPM was $0.36, and the Administrative Services Average PMPM was $14.91.

A significant, non-recurring financial event impacting the balance sheet is the strategic divestiture of Evolent Care Partners (ECP). The total transaction value is up to $113 million in cash. The structure of this cash is $100 million at closing, with the remainder contingent on final Medicare Shared Savings Program performance for 2025, payable in Fall 2026. Evolent Health, Inc. plans to use all net proceeds to repay borrowings on its senior credit facility, which is expected to reduce annual interest expense by approximately $10 million.

Here's a breakdown of the ECP Divestiture Proceeds Allocation:

The company is clearly focused on its core specialty business, using the ECP proceeds to accelerate deleveraging and improve cash flow by more than $7 million annually, net of ECP's reduced cash generation.