Centauri Health Solutions
- Company typePrivate
- Founded2014
- HeadquartersScottsdale, United States
- Headcount101–250
- GTM typeB2B
- OfferingSoftware
Centauri Health Solutions firmographics
Firmographics- Name
- Centauri Health Solutions
- Legal name
- Centauri Health Solutions, Inc.
- Website
- https://centaurihs.com
- Company type
- Private
- Founded year
- 2014
- Operating status
- Operating
- Headcount range
- 101–250 employees
- Ownership category
- akta.pro rank
Centauri Health Solutions industry classification
Industry- Product category
- Healthcare Data Analytics and Interoperability
- SIC
- Services-Health Services (8000), Hospital & Medical Service Plans (6324)
- akta.pro primary industry
- Chronic Condition Virtual Care & Disease Management (Payer-Sponsored) (HLALACAE)
- akta.pro secondary industry
- Employer/Member Engagement Platforms for Provider-Sponsored Plans (HLACAEAM)
Keywords
Where Centauri Health Solutions is headquartered
LocationHeadquarters
- HQ city
- Scottsdale
- HQ country
- United States
- HQ region
- North America
Offices4 records
Markets served
Centauri Health Solutions business model
Business model- GTM type
- B2B
- Offering type
- Software
- Cost components
- Personnel, Technology or R&D, Operations, Marketing or Sales, Infrastructure
Revenue model
- Health Plan Solutions: Technology-enabled services and SaaS solutions sold to Medicare Advantage and Medicaid health plans, including risk adjustment, quality optimization, benefit eligibility/enrollment, and clinical data exchange. Revenue is generated through a combination of service fees and software platform subscriptions, with outcomes-based dynamics tied to client performance metrics.
- Hospital/Health System Solutions: Revenue cycle optimization services for hospitals and health systems including eligibility/enrollment, out-of-state Medicaid billing, pricing analytics, charge accuracy, denials intelligence, referral management, and clinical data exchange. Delivered via SaaS model and professional services engagements.
Go-to-market motion1 record
Distribution channels2 records
Marketing channels7 records
Centauri Health Solutions product offering
Product offeringCore offering
Centauri Health Solutions is a healthcare technology company that delivers integrated SaaS platforms and technology-enabled services to U.S. health plans and health systems. Its core offerings span benefit eligibility/enrollment and retention, intelligent risk adjustment, HEDIS/Stars quality optimization, care coordination via real-time ADT notifications, and nationwide clinical data exchange through QHIN-enabled networks. Solutions are sold as standalone products (e.g., Best Benefits, PremiumAssist, SES Notify, Precise) and as an integrated suite covering 60M+ members across 60+ health plans.
Product overview
Centauri Health Solutions is a healthcare technology platform company offering integrated solutions for U.S. health plans and health systems. The portfolio operates as a platform-plus-modules architecture combining eligibility/enrollment, risk adjustment, quality optimization, care coordination, and clinical data exchange. Core products include Best Benefits (SSI/SSDI enrollment), PremiumAssist (dual eligible enrollment), Member Insights (dual member engagement), and Medicaid Retention for benefit activation; Intelligent Risk Adjustment and Quality Optimization/Precise® (HEDIS engine) for risk and quality; SES Notify (ADT notifications) and MedAllies QHIN (clinical data network) for care coordination and interoperability. Additional offerings span Stars Quality Solution, SDOH, Revenue Cycle Analytics, and referral management. The company serves 60+ health plans including all top 10 U.S. health plans, 60M+ members, and 1,000+ hospitals/5,000+ ambulatory organizations.
Differentiator
Problem solved
Functional benefit
Brands
- Secure Exchange Solutions (SES): Clinical data exchange platform providing ADT notifications, physician connectivity, and interoperability solutions. SES Notify ranked #1 in 2026 Best in KLAS for ADT Notifications.
- SES Notify
- Best Benefits
- PremiumAssist
- Member Insights
- MedAllies
- Precise
Products and services
- Intelligent Risk Adjustment Risk adjustment solution providing digital-first medical record retrieval, focused manual retrieval, and coding for accurate HCC documentation, enabling Medicare Advantage and Medicaid health plans to capture capitation revenue.
- Quality Optimization / Precise HEDIS management and reporting solution with NCQA certification continuously since 2006, covering 81+ measures with systematic sampling and survey integration to support Star Ratings improvement for Medicare Advantage and Medicaid health plans.
- SES Notify Real-time admission, discharge, and transfer (ADT) notification platform ranked #1 in the 2026 Best in KLAS, enabling care teams to receive alerts via Direct Secure Messaging and EHR integration for care coordination.
- Best Benefits SSI/SSDI eligibility and enrollment solution for Medicaid Managed Care Plans that identifies eligible members, conducts outreach, and drives disability benefit enrollment with approval rates 30-50% higher than national SSA averages.
- PremiumAssist Dual-eligible outreach, enrollment, and redetermination services for Medicare Advantage Plans and Dual Special Needs Plans, with proactive retention strategies that reduce Medicaid fall-off length by half.
- Member Insights AI-driven member engagement solution for dual-eligible Medicare Advantage members combining compassionate outreach, real-time ADT event monitoring, SDOH assessments, and referral coordination to drive retention and care coordination.
- Medicaid Retention Post-PHE recertification and retention solution helping health plans navigate Medicaid redeterminations with compassionate outreach, state-specific eligibility assessments, and retention workflows.
- Clinical Data Network / MedAllies QHIN Qualified Health Information Network (QHIN) connecting 300M+ participants through Carequality, CommonWell, eHealth Exchange, and MedAllies QHIN-enabled networks, providing nationwide clinical data exchange infrastructure supporting TEFCA participation.
- Revenue Cycle Analytics (RCA) Hospital revenue cycle optimization SaaS platform including Pricing Analytics, Charge Accuracy, Denials Intelligence, and Price Transparency, serving 120+ hospital clients.
Quantifiable outcome
- Best Benefits program reveals $2.3 billion annually in health plan revenue and member payments/resources.
- +4 more outcomes
Companies that use Centauri Health Solutions
Customer profileNamed customers3 records
Segments3 records
Ideal customer profiles2 records
Centauri Health Solutions technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
AI capability7 records
Feature8 records
Centauri Health Solutions partnerships and signals
Strategic signalPartnerships
Three partnerships are on record, tiered minor and core.
- Elevate Patient Financial SolutionsminorElevatePFS completed the acquisition of Centauri Health Solutions' Health Systems Services division in February 2026, expanding its revenue cycle management capabilities to include Medicaid and disability enrollment services and out-of-state billing.
- MedAlliescoreCentauri acquired MedAllies in April 2025, adding a Qualified Health Information Network (QHIN) and HISP infrastructure. The acquisition added 1,000 hospitals, 5,000 ambulatory organizations, and 125,000 healthcare providers to Centauri's national clinical exchange network.
- Secure Exchange Solutions (SES)coreCentauri acquired Secure Exchange Solutions in December 2021, expanding clinical data exchange capabilities and physician connectivity. SES is a Rockville, Maryland-based health IT provider focused on clinical data exchange. SES Notify became a #1 KLAS-ranked ADT notification platform.
Scale indicators13 records
Recent moves6 records
Expansion highlights6 records
Centauri Health Solutions competitors and assessment
Company assessmentBroad incumbents
- Optum (UnitedHealth Group): Largest healthcare technology and services platform globally, providing risk adjustment, quality, care coordination, and clinical data analytics to payers and providers. Operates a much broader portfolio than Centauri, including OptumInsight (formerly Change Healthcare), OptumRx, and OptumHealth, making it the dominant incumbent against which Centauri competes in payer analytics.
- Change Healthcare (OptumInsight): Major healthcare technology company (now part of Optum following 2022 acquisition) providing revenue cycle, clinical data exchange, payer-provider connectivity, and analytics. Overlaps with Centauri's hospital revenue cycle and clinical data exchange products at much larger scale.
- Cognizant (Healthcare Business): Global IT services firm with a sizable healthcare practice delivering payer consulting, risk adjustment, quality, and digital transformation services. Competes for similar enterprise payer B2B services budgets as Centauri but from a consultancy/outsourcing model.
- Merative (formerly Truven Health Analytics): Healthcare analytics company (owned by Francisco Partners) providing outcomes research, payer analytics, risk and quality solutions for health plans and providers. Comparable payer-analytics and quality/risk product set with broader outcomes research capabilities.
Direct peers
- Cotiviti: Private-equity-backed (Veritas Capital) healthcare analytics company providing payment integrity, risk adjustment, quality (Stars/HEDIS), and clinical data exchange solutions to health plans. Closest direct peer to Centauri in payer risk adjustment and quality optimization.
- Inovalon: Healthcare data analytics platform serving health plans and providers with risk adjustment, quality, provider engagement, and clinical data exchange products. Highly comparable to Centauri on payer-facing risk adjustment and quality workflow.
- Edifecs: Healthcare data interoperability and analytics company specializing in payer-provider data exchange, risk adjustment analytics, and value-based care enablement. Directly comparable technology stack and customer base to Centauri's interoperability and risk adjustment business.
- EXL Health (EXL Service): Analytics and digital solutions division of EXL Service providing risk adjustment, care management, and population health analytics for health plans. Similar payer-services-and-analytics business model competing for similar payer budgets.
Emerging players
- Health Catalyst: Public health system-focused data and analytics platform providing population health, quality, and revenue cycle analytics. Historically more provider-side than Centauri but increasingly overlapping in payer-provider data exchange.
- Persivia: Population health management and risk adjustment analytics company serving health plans, ACOs, and providers. Competes with Centauri in risk adjustment and population health segments at smaller scale.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat5 records
Key risks5 records
Key highlights7 records
Customer concentration
Centauri Health Solutions social profiles
Digital presenceCentauri Health Solutions compliance and trust
Trust signalCompliance6 records
Centauri Health Solutions financial estimates
Financial estimateRevenue estimate
Valuation estimate
Centauri Health Solutions leadership team
Management profileNumber of profiles
Profiles15 records
Centauri Health Solutions subsidiaries and ownership
Company hierarchySubsidiaries8 records
Centauri Health Solutions funding detail
Funding detailFunding overview
Funding rounds3 records
Investors2 records
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Centauri Health Solutions M&A and investment
M&A and investmentM&A10 records
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Centauri Health Solutions
What does Centauri Health Solutions do?
Centauri Health Solutions is a healthcare technology company that delivers integrated SaaS platforms and technology-enabled services to U.S. health plans and health systems. Its core offerings span benefit eligibility/enrollment and retention, intelligent risk adjustment, HEDIS/Stars quality optimization, care coordination via real-time ADT notifications, and nationwide clinical data exchange through QHIN-enabled networks. Solutions are sold as standalone products (e.g., Best Benefits, PremiumAssist, SES Notify, Precise) and as an integrated suite covering 60M+ members across 60+ health plans.
Is Centauri Health Solutions a public or private company?
Centauri Health Solutions is a private company. It is classified as private equity controlled and is currently operating.
When was Centauri Health Solutions founded?
Centauri Health Solutions was founded in 2014. It employs 101 to 250 people.
Where is Centauri Health Solutions based?
Centauri Health Solutions is headquartered in Scottsdale, United States, in the North America region.
How does Centauri Health Solutions make money?
Two revenue lines are on record. Health Plan Solutions are the primary driver. The others are hospital/Health System Solutions.
Who are Centauri Health Solutions's main competitors?
Broad incumbents on record are Optum (UnitedHealth Group), Change Healthcare (OptumInsight), Cognizant (Healthcare Business) and Merative (formerly Truven Health Analytics). Direct peers are Cotiviti, Inovalon, Edifecs and EXL Health (EXL Service). Emerging players are Health Catalyst and Persivia.
Does Centauri Health Solutions have an API?
No public API is recorded for Centauri Health Solutions.
What industry is Centauri Health Solutions in?
Centauri Health Solutions's product category is Healthcare Data Analytics and Interoperability. Its primary akta.pro industry code is HLALACAE, Chronic Condition Virtual Care & Disease Management (Payer-Sponsored), with a secondary code of HLACAEAM, Employer/Member Engagement Platforms for Provider-Sponsored Plans. Its SIC code is 8000.