Total Health Plan Management, Evolved.
Healthcare today is archaic, reactionary, and ritualized.
At Evolve, these days are over.
Why Traditional Healthcare Fails.
Year after year, the ritual repeats:
You're presented with renewal options. Premiums have jumped again with no clear explanation why.
You ask for claims data to understand what's driving costs... and the response is vague at best.
You're told cost management solutions exist, but they barely touch the high-cost claims that actually drive your increases.
So you accept another unjustifiable increase and move on.
Until next year, when it happens all over again.
Our Approach
Proactive Risk Management
As risk managers, we take a proactive and controlled approach to self-funded and level-funded health plans. We allow data and strategic analysis to drive solutions.
Through best-in-class TPA services, we build customized health plans with integrated cost containment that produces better benefits, better pricing, and enhancements that employers and employees love.
Evolve Health™
Our Customized Approach Includes Five Key Components:
1
Managed Underwriting Services
Strategic risk assessment and plan design
2
Best-in-Class Third Party Administration
Transparent claims processing and data access
3
High-Performance PPO Networks
Better provider access with better pricing
4
Evolve Rx & Specialty Drug Programs
Pharmacy benefit management for your fastest-growing cost driver
5
Strategic Stop Loss & Insurance Solutions
Risk protection with cost control
Next-Gen Cost Management Solutions
We understand the cost drivers of healthcare and build winning programs with cost management and avoidance in mind.
Our Solutions:
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Third Party Administration (TPA Services)
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Customized Level-Funded & Self-Funded Solutions
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Custom Built Community Health Plans
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Custom Built Association Health Plans
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High-Performance Networks
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Evolve Rx / PBM Carve Out Plans
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Bill Review / Claims Editing
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Medical Case Management
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Diabetes & Medical Infusion Carve Out (MICO) Programs
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Biosimilar Reviews
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Diagnostic Imaging Savings Programs
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Specialty Drug Sourcing Programs
"Evolve Benefits is amazing. Truly an innovative cost containment company that produces real results"
- Pharmaceutical consulting company