Evolent Health, Inc. (EVH) SEC Filings & Earnings Calls

Medical expense ratio increased sharply to 95.3% from 80.0%, indicating significant cost pressure

“Medical Expense Ratio 95.3% vs 80.0%”

Adjusted EBITDA declined year-over-year despite revenue growth, reflecting margin compression

“Adjusted EBITDA $28.1M vs $37.5M; margin 4.3% vs 8.5%”

Medicaid and client-specific membership attrition headwinds continue

“Despite significant continued industry headwinds from Medicaid and other client specific membership attrition” · word for word

Customer concentration risk

“Highmark 21.8% ... Molina Healthcare, Inc. 22.2% ... Cook County Health and Hospitals System 12.2% ... Aetna 14.4%” · word for word

Medicaid/Exchange membership attrition

“During the quarter ended June 30, 2026, our customers reported membership declines in Medicaid and Health Exchanges consistent with our expectations.” · word for word

Medical expense ratio pressure

“MER 95.3 % ... 80.0 %” · word for word

DOJ investigation

“On August 12, 2025, the Company received a Civil Investigative Demand ('CID') from the Department of Justice pursuant to a False Claims Act investigation” · word for word

High leverage and interest rate risk

“For every 1% increase in SOFR, the Company would record additional interest expense of $3.5 million per annum.” · word for word

Medical cost inflation: medical expense ratio surged to 93.3% from 68% YoY; underwriting profitability at risk.

“Medical Expense Ratio 93.3% vs 68.0% in prior year.”

Adjusted EBITDA decline: down 40% YoY despite revenue growth; cost structure under pressure.

“Adjusted EBITDA $22,067 vs $36,860 in prior year.”

Operating Loss and Negative Cash Flow

“Operating loss $(10,599) $(1,622); Net cash and restricted cash (used in) provided by operating activities $(984) $4,565”

Commercial Revenue Decline

“Commercial and other $115,322 $180,207 (down 36% YoY)”

Customer Concentration

“Aetna, Cook County, Florida Blue, Molina each >10% of accounts receivable or revenue”

Elevated Medical Cost Trend

“Nationwide during 2025, health plans saw a rapid increase in medical expenses for oncology and other specialty areas that significantly exceeded historical norms.” · word for word

Healthcare Policy Change Impact

“Additionally, changes to healthcare policy included in the One Big Beautiful Bill (OBBB) negatively impacted the number of lives we managed and thus reduced Adjusted EBITDA expectations for 2026.” · word for word

Stock Price Decline / Shareholder Value Destruction

“The decision by the Compensation Committee to apply negative discretion was based on the softening in the projected Adjusted EBITDA outlook for 2026, as discussed on the Company’s Q4 2025 earnings call, higher than expected net leverage exiting 2025, as well as the desire to bolster alignment with shareholders during a year in which the stock price declined ” · word for word

Partner concentration

“Our four largest partners in terms of revenue, Molina Healthcare, Inc. (“Molina”), Cook County Health and Hospitals System, Florida Blue and Centene Corporation comprised 25.7%, 16.4%, 14.2% and 12.2%, respectively, of our revenue for the year ended December 31, 2025.” · word for word

Contract termination risk

“many of our specialty contracts, following an initial term, are terminable without cause by the customer or Evolent either upon the giving of requisite notice and the passage of a specified period of time (typically between 30 and 180 days)” · word for word

Regulatory risk from AI use

“An emerging trend is intensified scrutiny by state and federal authorities with respect to the use of AI, particularly any AI systems used in utilization management.” · word for word

Medicaid enrollment volatility

“Medicaid and exchange enrollment is impacted, and may fluctuate, based on a variety of factors. These include continuous enrollment requirements instituted during the COVID-19 public health emergency (the “PHE”) in 2021 under which Medicaid enrollment grew, and the resumption of Medicaid eligibility redeterminations, or “unwinding,” that began in 2023 at the” · word for word

GAAP net loss due to impairment; adjusted EBITDA positive but margin pressure from contract reserving.

“Net loss attributable to common shareholders of Evolent Health, Inc. $ (429,131); Net loss margin (91.6)%.” · word for word

Health plan customer membership decreases in Exchange products impacting first half 2026.

“The addition of $900 million in new Performance Suite revenue in 2026, as well as the impact of significant health plan customer membership decreases in their Exchange products, create an impact on Adjusted EBITDA in the first half of the year.” · word for word

Integration risk from acquisition.

“Acquisition of Privia Management Company; integration details not disclosed.”

No material risks identified; board change routine.

“Director retirement not due to disagreement; new director appointed.”

Customer Concentration Risk

“Molina Healthcare, Inc. represented 25.7% of revenue for Q3 2025; Cook County Health and Hospitals System 17.6%; Florida Blue Medicare, Inc. 14.4%; Centene Corporation 13.8%.”

Regulatory Risk - OBBBA

“The OBBBA also makes significant changes to the Medicaid, Medicare and ACA Health Exchanges... The effect of these changes could result in reductions in members covered by partners’ health care plans.” · word for word

DOJ Investigation

“On August 12, 2025, the Company received a Civil Investigative Demand ('CID') from the Department of Justice pursuant to a False Claims Act investigation concerning allegations that a former customer... may have submitted... unsupported diagnosis codes in connection with Medicare Advantage beneficiaries.” · word for word

Medical Cost Trend Risk

“Our results for the first three quarters of 2025 were also impacted by growth in medical claims cost that continued to grow faster than our historical averages.” · word for word

Leverage and Interest Rate Risk

“We have $1,085.0 million of principal amount of indebtedness outstanding as of September 30, 2025. For every 1% increase in SOFR, the Company would record additional interest expense of $4.53 million per annum.” · word for word

Revenue decline of 22.8% YoY due to business mix shift; net loss persists though improving.

“Revenue $479.5M vs $621.4M in Q3 2024; net loss $26.9M.”

CFO transition could cause short-term disruption, but new CFO has strong credentials.

“CFO change effective Jan 1, 2026; Mario Ramos appointed.”