Evolent Health, Inc. (NYSE:EVH) Q2 2023 Earnings Call Transcript

Seth Blackley: Yes. Look, I think the way I would answer it in general is that I’d say we’re certainly on track for that $300 million overall and the $50 million piece of that, which is around new business. And I think this quarter helps a lot. Even the ones that are not technically new operating agreements that are cross sales help a lot because even though they may not be huge in and of themselves is really high flow through on these. So I think what we were attempting to communicate in the tone and certainly in this answer is that we feel like we’re certainly on plan for the $300 million.

Sean Dodge: Okay, great. And then in the Performance Suite, you mentioned now seeing any indication of higher cost trends in your data. Can you give us just a quick refresher on if you were to see some type of spike or elevated trajectory. Do you have some contractual levers available to you? How often are you able to reprice those? Kind of what kind of protections I guess do you have if you were to see things start to pick up?

John Johnson: Yes. Sean, it’s John and I’ll take that one. I would think of this in two ways. The first and it’s an important distinction in our risk-bearing business versus a broad-based MCO or a risk-bearing provider, where nearly everything that we take risk on in the Performance Suites is pre-auth. And so we have very good visibility into those auth rates and the likely impact, right, in future claims. So that’s the first thing that I’d say is we would generally speaking be able to know or see that earlier than we would if we were just waiting for claims completion. The second piece, as we think about how we contract for this business, we will typically include things like a corridor around, say, cancer prevalence.

And so if prevalence in a population moves up or down outside of that corridor, then the parties will come back to the table and adjust the rate accordingly. So that’s an important part of the model. And I think it’s also important to recall that we can have some visibility into that potentially happening before we see it in the claims.

Sean Dodge: Okay. That’s super helpful. Thanks again.

Operator: The next question comes from Ryan Daniels with William Blair. Please go ahead.

Ryan Daniels: Yes, guys, thanks for taking the questions. Wanted to start with a little bit on the pipeline as it relates specifically to the potential for more Medicare business, which I think is a little under a third of your book today. So Seth, you talked about some of the pressures that some might be facing there with increased surgical utilization, and then we have the lower MA rates and risk adjustment pressures for 2024. And I’m curious if that is accelerating the pipeline as more and more payers are turning to you to help them manage their MLR, what could be kind of a more challenging outlook for 2024 and 2025?

Seth Blackley: Hey, Ryan, the answer is yes. It is moving the pipeline in a good way for us. And I think the – it is the general pressure on MLR around utilization. I think the risk adjustment piece is maybe equally important in the sense that I do think that lever has been reduced a little bit. And so I was talking to one of our customers a couple months ago and he said exactly that, which is, we’re going to have to attack utilization a little bit more aggressively without that lever or with that lever being a little bit reduced, right? So I think the answer is yes, we’re seeing it as we said in the script today, it’s feeling positive in the pipeline, and I think the combination of that pressure, but also the broader set of solutions that we can offer Tech Services model, Performance Suite model, multiple lines of business, multiple specialties gives us a lot of different ways to create win-win partnerships with our clients and prospects.