Evolent Health Services

Excelling at State Readiness

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Excellence in Action Excelling at State Readiness With our Medicaid partner facing an unexpected review by state authorities, Evolent Health Services rose to the occasion with nimbleness, subject-matter expertise and an "all-in" response. THE CHALLENGE State regulators conduct readiness reviews of managed Medicaid plans to ensure tight oversight and identify weak spots. While plans typically have long lead times to prepare for these assessments, one of our partners recently found itself facing an unanticipated readiness review. Together, Evolent Health Services and the plan faced an uphill battle against an ever-changing review process. Unpredictable testing scenarios kept our organizations on our toes, as did frequently changing requirements, targets and timelines. Often, our organizations had fewer than three days to turn around state requests during the busy winter holiday period. The state's multi-phased assessment, which scrutinized the entire operation, included: • Desktop materials review • Workflow deep dives • Contract review • System demonstrations • File exchanges • Historical data dumps THE EVOLENT WAY: "GET STUFF DONE" To help our Medicaid plan partner ace its readiness review in record time, our teams came together, committed to keep the plan in business. At times this meant staffing the response around the clock, including weekends and over holidays, to respond to the state's unexpected requests and shifting deadlines. We rose to the challenge by tackling the issues head on with Evolent's "Get Stuff Done," or GSD, approach. Our GSD philosophy prizes flexibility, nimbleness and action, and it enabled us to quickly make operational adjustments to meet changing requirements. For example, at the state's request, we increased member service hours and provided additional reporting to meet the state's needs and ensure the plan's ongoing smooth operations supported by Evolent. evolenthealthservices.com

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