WASHINGTON, June 6, 2018 /PRNewswire/ -- Evolent Health
(NYSE: EVH) announced today that its partners, Nicklaus Children's
Health System and Baptist Health Care, have been notified by the
Florida Agency for Health Care Administration (AHCA) of its intent
to award a contract to Miami Children's Health Plan (an affiliate
of Nicklaus Children's Health System) and Lighthouse Health Plan
(an affiliate of Baptist Health Care) to provide physical and
behavioral health care services through Florida's Statewide Medicaid Managed Care
(SMMC) program.
With AHCA's recent state Medicaid contract award to Best Care
Assurance, LLC (an affiliate of another Evolent partner, Lee
Health), Evolent expects to provide health plan administration and
operational services for three health plans and five regions across
Florida:
- Miami Children's Health Plan (an affiliate of Nicklaus
Children's Health System) intends to offer a Managed Medical
Assistance (MMA) plan to Medicaid beneficiaries living in Region 9
and Region 11, which include Miami-Dade and Palm
Beach counties. These regions cover more than 700,000
beneficiaries in Florida's MMA
program.
- Lighthouse Health Plan (an affiliate of Baptist Health
Care) intends to offer a Managed Medical Assistance plan to
Medicaid beneficiaries living in Region 1, and it will also have
the right to enroll and serve members in Region 2. These regions
comprise the northwest Florida
Panhandle and cover more than 200,000 beneficiaries in
Florida's MMA program.
- Best Care Assurance, LLC (an affiliate of Lee Health)
intends to offer a Managed Medical Assistance plan to Medicaid
beneficiaries living in Region 8, which includes seven counties in
southwest Florida covering
approximately 200,000 eligible beneficiaries in Florida's MMA program.
"Launching a Medicaid plan focused on supporting the most
vulnerable members of our community is a mission near and dear to
our hearts," said Nicklaus Children's Health System Chief Executive
Officer M. Narendra Kini, M.D., MHA.
"Together with our strategic value-based care partner, Evolent
Health, we have an exceptional opportunity to make a far-reaching,
positive impact in the greater Miami area. We look forward to leveraging
Evolent's robust health plan services, value-based care platform
and population health programs to serve the needs of our community
and drive better care at a lower cost."
"We are thrilled to launch Lighthouse Health Plan, a critical
component of our value-based care strategy and mission to support
the full spectrum of health care needs in northwest Florida," said Baptist Health Care Chief
Financial Officer Michael Gleason.
"Evolent's proven Medicaid expertise and comprehensive platform
will be essential to proactively addressing health care needs and
providing Medicaid beneficiaries with high-quality health care and
services."
"By partnering with three leading systems in major markets,
including Miami-Dade, Palm Beach, Fort
Myers, Pensacola and
Tallahassee, we are
well-positioned to help drive transformative health care change in
Florida—the fourth largest Medicaid population in the United States," said Evolent Health Chief
Executive Officer Frank Williams.
"We are excited and honored to work closely with our partners,
state regulators and other key stakeholders to launch and support
health plans that will help meet the unique needs of Medicaid
beneficiaries across the region."
Evolent's Medicaid Center of Excellence (MCOE) will provide
Evolent's partners with Identifi℠, Evolent's population health
performance management platform, clinical and operational
capabilities and health plan administrative support—including
claims management, member and call center services. The Medicaid
Center of Excellence offers a model for states across the nation to
implement provider-sponsored, community-based Medicaid health plans
in their communities.
Each of the five-year health plan awards with ACHA are subject
to regulatory approval and successful completion of a readiness
review. Evolent's partnership agreements are commensurate with the
term of the ACHA contract awards and are comprised of an
implementation component and a per member per month fee based on
plan enrollment. Evolent will also own a minority stake in
Lighthouse and Miami Children's Health Plans as part of this
arrangement. Implementation work is anticipated to commence
immediately with the formal health plan launch expected to commence
in late 2018 or early 2019.
Certain statements made in this press release and in other
written or oral statements made by us or on our behalf are
"forward-looking statements" within the meaning of the Private
Securities Litigation Reform Act of 1995 ("PSLRA"). A
forward-looking statement is a statement that is not a historical
fact and, without limitation, includes any statement that may
predict, forecast, indicate or imply future results, performance or
achievements, and may contain words like: "believe," "anticipate,"
"expect," "estimate," "aim," "predict," "potential," "continue,"
"plan," "project," "will," "should," "shall," "may," "might" and
other words or phrases with similar meaning in connection with a
discussion of future operating or financial performance. In
particular, these include statements relating to services we expect
to provide across Medicaid regions in Florida, future actions, trends in our
businesses, prospective services, future performance or financial
results and the outcome of contingencies, such as legal
proceedings. We claim the protection afforded by the safe
harbor for forward-looking statements provided by the
PSLRA. These statements are only predictions based on our
current expectations and projections about future
events. Forward-looking statements involve risks and
uncertainties that may cause actual results, level of activity,
performance or achievements to differ materially from the results
contained or described in the forward-looking statements, including
that the awards are subject to regulatory approval and readiness
review, and may not be awarded as expected. Although we believe the
expectations reflected in the forward-looking statements are
reasonable, we cannot guarantee future results, level of activity,
performance or achievements. Our Annual Report on Form 10-K
for the fiscal year ended December 31,
2017, Quarterly Report on Form 10-Q for the quarter ended
March 31, 2018 and other documents
filed with the SEC include factors that could affect our businesses
and financial performance. Moreover, we operate in a rapidly
changing and competitive environment. New risk factors emerge
from time to time, and it is not possible for management to predict
all such risk factors. Further, it is not possible to assess the
effect of all risk factors on our businesses or the extent to which
any factor, or combination of factors, may cause actual results to
differ materially from those contained in any forward-looking
statements. Given these risks and uncertainties, investors
should not place undue reliance on forward-looking statements as a
prediction of actual results. In addition, we disclaim any
obligation to update any forward-looking statements to reflect
events or circumstances that occur after the date of this press
release.
About Evolent Health
Evolent Health partners with leading provider organizations to
achieve superior clinical and financial results in value-based
care. With a provider heritage and over 20 years of health plan
administration experience, Evolent operates in more than 30 U.S.
health care markets, actively managing care across Medicare,
Medicaid, commercial and self-funded adult and pediatric
populations. With the experience to drive change, Evolent
confidently stands by a commitment to achieve results. For more
information, visit evolenthealth.com.
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