Evolent Health Conference Call Summary Company Overview - **Company**: Evolent Health - **Industry**: Managed Care and Healthcare IT - **Focus Areas**: Specialty care management, particularly in oncology, cardiology, and musculoskeletal conditions [3][4] Key Financial Insights - **Revenue Composition**: Two-thirds of Evolent's revenue is linked to the ACA Marketplace and Medicaid, while about one-third is from Medicare Advantage [6] - **2025 Guidance**: Evolent reiterated its 4Q and 2025 guidance, with adjusted EBITDA expected to be $149 million, including $10 million from an asset being divested [32][33] - **Performance Suite**: Expected to generate about 80% of adjusted EBITDA from tech and services, and 20% from risk-based Performance Suites [19][33] Cost Trends and Utilization - **Cost Trends**: Oncology cost trend is under 11%, while cardiology trends are higher due to benefits rush ahead of premium increases [4] - **Impact on Specialty Cost**: Evolent uses risk pool adjustments to isolate its impact on specialty cost trends, with a growing pipeline of Medicare Advantage business [6][10] Value Creation and Cost Savings - **Evidence-Based Pathways**: Evolent aims to increase adherence to evidence-based care from 65% to about 85%, which reduces costs by ensuring the right treatment is provided initially [9][10] - **Cost Categories**: In oncology, 80% of costs are in therapeutics, with significant savings opportunities in matching therapies to patients. In cardiology, savings come from preventing surgical interventions [12][14] Contractual Protections and Market Dynamics - **Contractual Protections**: Evolent has secured protections around case mix and drug pricing in 90% of contracts, allowing for better risk management [22][24] - **Market Environment**: Health plans are more willing to negotiate favorable terms due to financial pressures, allowing Evolent to secure better contracts [23][25] Future Expectations - **2026 Revenue Outlook**: Evolent expects $750 million in new Performance Suite annual contract value (ACV) with $550 million anticipated to hit in 2026 [29][31] - **EBITDA Expectations**: Minimal EBITDA contribution expected from new contracts in 2026, with a target of reaching a 10% margin by mid to late 2028 [31] Membership and Market Challenges - **Membership Trends**: Declines in Medicaid membership and Medicare Advantage membership are impacting revenue, with expectations of a 40-60% shrinkage in ACA Marketplace revenue [36][42] - **Operational Investments**: Evolent invested $10 million in AI and efficiency improvements to enhance clinical operations and reduce costs [37] Strategic Decisions - **Divestiture of ECP**: Evolent decided to divest its ECP business to focus on its core specialty business, which is expected to grow significantly [49][50] - **Use of Proceeds**: Proceeds from the divestiture will be used to pay down high-interest debt, improving cash flow conversion and targeting a leverage ratio of about 5.5 times by year-end [51][52] Conclusion Evolent Health is strategically positioned in the managed care sector, focusing on specialty care management with a strong emphasis on cost reduction through evidence-based practices. The company is navigating market challenges while securing favorable contractual terms and investing in operational efficiencies to drive future growth.

Financial Data and Key Metrics Changes - Q3 revenue reached $479.5 million, exceeding expectations and at the top of the guidance range, with full-year revenue expected between $1.87 billion and $1.88 billion [3][18] - Adjusted EBITDA for Q3 was $39 million, representing a 23% year-over-year growth [8][19] - The company ended the quarter with $116.7 million in cash and equivalents, and net debt of $910 million [20][22] Business Line Data and Key Metrics Changes - The Performance Suite and Technology and Services Suite contributed to revenue growth, with new contracts expected to add over $550 million in 2026 revenue [4][6] - The specialty Performance Suite care margin was approximately 7%, consistent with year-to-date performance [19] Market Data and Key Metrics Changes - The company anticipates a contraction of approximately 3% in Medicare Advantage membership for 2026, with a significant decline expected in the exchange market [14][15] - Revenue from exchanges this year is around $360 million, split evenly between the Performance Suite and Technology and Services [34][35] Company Strategy and Development Direction - The company is focused on organic growth, margin expansion, and disciplined capital allocation, with a long-term goal to auto-approve over 80% of baseline authorization volume [8][9] - A strategic partnership with American Oncology Network aims to enhance provider alignment and improve cancer care without relying on utilization management [12][24] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the company's ability to capture market share despite a challenging operating environment, particularly in oncology [10][14] - The outlook for 2026 adjusted EBITDA is uncertain due to potential membership declines in key markets, but new contracts are expected to provide significant growth opportunities [15][17] Other Important Information - The company is transitioning its CFO role, with Mario Ramos set to join as the new CFO [24][25] - The divestiture of Evolent Care Partners is expected to close later this year, with proceeds used to reduce debt [9][22] Q&A Session Summary Question: Discussion on new contract wins and peak margins - Management confirmed that all new contracts are under the enhanced performance suite, with a reasonable mature margin target of around 10% [26][27][29] Question: Factors affecting 2026 EBITDA - Key factors include growth, cost structure efficiencies, and membership trends, with membership being the most uncertain variable [30][31][32] Question: MA growth assumptions for enrollment next year - Management noted that if current partners gain market share, it would positively impact revenue, particularly in the Technology and Services Suite [33] Question: Impact of HIX subsidies expiration - Management expressed confidence in pricing for 2026, with protections in contracts to mitigate acuity shifts [34][36] Question: Oncology trends and their progression - Oncology trends have remained stable throughout the year, with a slight increase in utilization noted in exchanges [37] Question: Pipeline pacing and go-live timing - The demand remains significant, and there is potential for new contracts to go live in 2026 [38] Question: Adversity in exchanges and membership impact - The benefits rush is primarily seen in cardiology, with a conservative approach taken for trend acceleration in the exchange line of business [40][41] Question: Product development and oncology navigation solution - The navigation solution is expected to expand into more markets, with a focus on improving care quality and affordability [46][48] Question: Revenue generation from the American Oncology partnership - The partnership aims to improve quality and reduce costs, with potential indirect revenue generation through payer interest [49]

Financial Performance - Revenue reached $479.5 million, reflecting an 8% sequential increase, driven by new launches in Performance Suite and Specialty Tech & Services[6] - Adjusted EBITDA was $39.0 million, a 23% year-over-year growth[6] - The company narrowed its revenue outlook for 2026 to between $1.87 billion and $1.88 billion[6] - Adjusted EBITDA outlook narrowed to between $144 million and $154 million[6] Capital Allocation - Evolent Health had $116.7 million in cash and cash equivalents as of September 30, 2025, with $47.5 million in revolver availability[6] - The company issued $166.8 million of 4.50% 2031 Notes and repaid $167.4 million of 2025 Notes[6] - Evolent repurchased 4.4 million shares of common stock for $40.0 million[6] - Exchanged $175.0 million of Series A Preferred Stock for second lien term loan on similar terms, with interest now tax deductible[6] - Period-end net leverage was 6.7x on LTM Adjusted EBITDA of $136.0 million[6] Business Growth - Announced two new revenue arrangements, one in the Performance Suite and one in the Technology and Services Suite, bringing YTD total to 13, forecasting approximately $2.5 billion for 2026[6]

Core Insights - Evolent Health, Inc. reported strong financial results for Q3 2025, achieving revenue of $479.5 million, which is a decrease from $621.4 million in Q3 2024, but the company is optimistic about future growth with a preliminary revenue forecast of $2.5 billion for 2026 [2][9][14] - The company added two new customer agreements in the quarter, bringing the total for the year to thirteen, and expects to generate over $750 million in new annualized revenue in 2026 [3][4] - Evolent's Adjusted EBITDA for Q3 2025 was $39.0 million, up from $31.8 million in Q3 2024, indicating improved operational efficiency [2][11] Financial Performance - Revenue for the three months ended September 30, 2025, was $479.5 million, down from $621.4 million in the same period last year [9] - The net loss attributable to common shareholders was $26.9 million, an improvement from a loss of $31.2 million in Q3 2024, resulting in a net loss margin of 5.6% compared to 5.0% [9][10] - Adjusted EBITDA increased to $39.0 million with an adjusted EBITDA margin of 8.1%, up from 5.1% in the prior year [2][11] Customer and Market Developments - Evolent signed two new revenue agreements in Q3 2025, contributing to a total of thirteen new contracts for the year [3][4] - A new partnership with a large regional Blues plan will implement Evolent's Performance Suite for Oncology, covering over 650,000 members [5] - The company continues to experience strong demand for its complex specialty care solutions due to rising medical costs impacting health plans [2] Leadership Changes - Mario Ramos has been appointed as the new Chief Financial Officer effective January 1, 2026, bringing extensive experience from CVS Health and WellBe Senior Medical [6][7] - John Johnson will transition to the role of Chief Strategy Officer, and Emily Rafferty will become Executive Vice President, Customer Success [7] Business Outlook - For Q4 2025, Evolent expects revenue to be in the range of $462 million to $472 million, with adjusted EBITDA projected between $30 million and $40 million [13] - The full-year revenue forecast for 2025 is approximately $1.87 billion to $1.88 billion, with adjusted EBITDA expected to be between $144 million and $154 million [14][15]

Financial Data and Key Metrics Changes - Q2 adjusted EBITDA was $37.5 million, in the top half of the range, driven by strong results across technology and services and performance suite models [16] - Q2 revenue was $444 million, $11 million below the midpoint of guidance, primarily due to lower revenue for 2024 and go-live timing issues [19][20] - The company updated its full-year revenue outlook to between $1.85 billion and $1.88 billion [27] Business Line Data and Key Metrics Changes - The performance suite normalized oncology trend was approximately 10.5%, modestly below the initial forecast of 12% [16] - The company achieved four new revenue agreements, bringing the total to 11 new agreements year-to-date [5] - The oncology performance suite offering is expanding to include inpatient or Part A oncology costs, reflecting an addressable market expansion [8] Market Data and Key Metrics Changes - About 25% of Q2 revenue and over 80% of new business announced for 2026 is in Medicare, with expectations of a return to normal macro membership growth [25] - Approximately 10% of Q2 revenue is in the commercial fully insured line of business, expected to remain stable [25] - Medicaid revenue accounted for about 45% of Q2 revenue, with typical annual growth of 2% to 3% expected [25] Company Strategy and Development Direction - The company is focused on organic growth, margin expansion, and capital allocation, with no plans for M&A in the near term [12] - The strategy includes enhancing AI and automation capabilities to improve efficiency and member experience [10] - The company aims to grow adjusted EBITDA at 20% per year despite industry volatility [14] Management's Comments on Operating Environment and Future Outlook - Management noted a challenging operating environment with elevated utilization and lagging premiums [12] - The company expects strong selling conditions in the coming years due to pressures on health plans [8] - Management remains cautiously optimistic about future performance, maintaining a conservative approach to forecasting [9] Other Important Information - The company plans to launch its partnership with Aetna in Q1 2026, targeting 250,000 Medicare Advantage members in Florida [6][7] - The company has a strong late-stage pipeline and anticipates additional growth announcements in the fall [8] Q&A Session Summary Question: Aetna partnership and market density - Management highlighted the significance of the Aetna partnership and its potential for expansion into additional states, with expected margin ramp consistent with typical performance suite margins [29][33] Question: Changes in contract structuring and customer engagement - Management noted that the pipeline has grown to $1 billion, driven by enhanced contract terms and the industry's challenges in managing high-cost specialty categories [35][37] Question: Aetna contract launch timeline - Management expressed confidence in the Aetna contract launch timeframe, emphasizing the importance of having all necessary components in place for a successful rollout [40] Question: Exchange business and ACA risk pools - Management acknowledged the lower margin nature of the exchange business and indicated a focus on protecting downside risks while growing the business [43][45] Question: Performance Suite pipeline and specialty focus - Management indicated that the Performance Suite pipeline is heavily focused on oncology, with a mix of national and regional plans [47][49] Question: Revenue growth expectations for 2026 - Management projected a clear path to exceeding $2.5 billion in revenue for 2026, based on the weighted pipeline and expected go-live timing [53][55]

Financial Performance - Revenue reached $4443 million, which includes a $46 million reduction due to favorable prior year claims development[6] - Adjusted EBITDA was $375 million, placing it in the upper range of expectations, with an adjusted EBITDA margin of 85%[6] - The company reported a net loss attributable to common shareholders of $511 million for Q2 2025, compared to a net loss of $64 million in Q2 2024[6] Growth & Outlook - Evolent announced four new revenue arrangements in Tech & Services and the Performance Suite, bringing the year-to-date total to 11 new arrangements[6] - The company updated the Q1 2026 go-live date for a new relationship with a large national Performance Suite partner to ensure optimal data exchange[6] - The 2025 full-year revenue is projected to be between $185 billion and $188 billion, with adjusted EBITDA between $140 million and $165 million[8] Capital & Liquidity - As of June 30, 2025, Evolent had $1510 million in cash and cash equivalents, along with $625 million in revolver availability[6] - The period-end net leverage stood at 53x based on LTM Adjusted EBITDA of $1288 million[6] - Total debt was reported as $820574 million, with net debt at $686505 million[18]

Core Insights - Evolent Health reported financial results for the second quarter of 2025, highlighting a significant net loss and a decrease in revenue compared to the previous year, but also an increase in adjusted EBITDA and a positive outlook for future growth [1][2][6][10]. Financial Performance - Revenue for the three months ended June 30, 2025, was $444.3 million, down from $647.1 million in the same period of 2024, representing a decrease of approximately 31.3% [6][10]. - The net loss attributable to common shareholders was $51.1 million, compared to a loss of $6.4 million in the prior year, resulting in a net loss margin of 11.5% [6][10]. - Adjusted EBITDA for the quarter was $37.5 million, with an adjusted EBITDA margin of 8.5%, up from 8.0% in the previous year [7][10]. Business Developments - Evolent signed four new revenue agreements in the second quarter, bringing the total for the year to date to 11, indicating strong demand for its services [3][4]. - The company is experiencing a rapidly accelerating pipeline for new business, with expectations to exceed historical growth rates in 2026 [2][10]. Guidance and Outlook - For the third quarter of 2025, Evolent expects revenue to be in the range of $460 million to $480 million and adjusted EBITDA between $34 million and $42 million [9][10]. - The full-year revenue outlook for 2025 has been revised to approximately $1.85 billion to $1.88 billion, with adjusted EBITDA expected to be in the range of $140 million to $165 million [10][11]. Operational Metrics - The average unique members on the platform increased to 40,201, compared to 39,856 in the previous year [6]. - The average PMPM fee for the Performance Suite decreased to $13.76 from $22.30 year-over-year, reflecting changes in service utilization [6][18].

Financial Performance - Revenue for Q1 2025 was $483.6 million, exceeding expectations, but declined by $156 million compared to Q1 2024 due to previously disclosed contracting changes[6] - Adjusted EBITDA for Q1 2025 was $36.9 million, at the high end of expectations, driven by strong execution across all lines of business[6] - The company had $246.5 million in cash and cash equivalents as of March 31, 2025, after generating $4.6 million in cash flow from operations in the quarter[6] - The company drew $200.0 million on its Term Facility and repaid $37.5 million on its Revolving Facility, resulting in a net increase in debt of $162.5 million in Q1 2025[6] - Net Debt to LTM Adjusted EBITDA was 4.1x, with LTM Adjusted EBITDA of $143.2 million[6] Strategic Initiatives and Outlook - The company announced five new revenue agreements, anticipated to contribute approximately $10 million in incremental annualized revenue[6] - The company officially launched the Oncology Navigation Solution within integrated Oncology Condition Management, expecting it to be available to over 300,000 members by the end of May[6] - The company reiterated its full-year 2025 revenue guidance of $2.06 billion to $2.11 billion and Adjusted EBITDA guidance of $135 million to $165 million[7] - The company lowered its Q2 2025 revenue outlook to $440 million - $470 million due to capitation rate true-ups for 2024 launches in Performance Suite, with no impact on bottom line outlook[7] Operational Metrics - Average lives on the Performance Suite platform were 6,486,000 in Q1 2025[12] - Average lives on the Specialty Technology and Services Suite platform were 77,079,000 in Q1 2025[12] - Performance Suite Average PMPM fee was $15.57 in Q1 2025[12]