Acentra Health
Acentra Health is a Carlyle-backed government healthcare technology and clinical services firm serving CMS and 34 state Medicaid programs via proprietary platforms (evoBrix X MMIS, Atrezzo care management) and BFCC-QIO contracts spanning 29 states and 77M+ beneficiaries.
- Company typePrivate
- Founded2023
- HeadquartersMclean, United States
- Headcount1,001–5,000
- GTM typeB2B
- OfferingServices
What Acentra Health does
Acentra Health is a private, Carlyle-backed provider of clinical services and healthcare technology to U.S. federal and state government healthcare agencies, formed in 2023 through the merger of CNSI (healthcare technology) and KEPRO (clinical services), which together brought more than 60 years of public-sector health experience. The company serves as a prime contractor to the Centers for Medicare & Medicaid Services and 34 state Medicaid programs, including as the Beneficiary and Family Centered Care-Quality Improvement Organization (BFCC-QIO) for Medicare beneficiaries across 29 states — the largest geographic footprint of any CMS-contracted partner in the program.
The company's offerings center on three proprietary technology platforms: evoBrix X, a cloud-based modular Medicaid Management Information System (MMIS) for high-volume claims and encounter processing; Atrezzo, a configurable care management platform for utilization management, care coordination, and population health; and eCAMS HCE, a clinical assessment platform supporting eligibility determinations such as PASRR and Level of Care assessments. These platforms underpin a portfolio of service modules covering provider enrollment and screening, claims adjudication, behavioral health and clinical eligibility assessments, carceral care, pharmacy management, and quality and compliance oversight, with AI-enabled tooling (SmartDoc and Agentic AI Workflows) layered on to automate prior-authorization review and medical coding.
Acentra Health generates revenue primarily through multi-year government contracts awarded via competitive procurement, typically structured as five-year base terms plus option years, with pricing negotiated per contract (not publicly disclosed). Notable contracts include a $298 million CMS BFCC-QIO renewal (September 2024), a $113 million Virginia DMAS utilization management and behavioral health contract, a $56.9 million North Carolina CIAE contract with up to $41.9 million in extensions, and additional work for agencies in Florida, West Virginia, Arizona, Hawaii, Wyoming, Oregon, the U.S. Department of Veterans Affairs, and the Georgia Department of Education. The company employs more than 1,500 people across approximately 20 U.S. offices and is led by CEO Todd Stottlemyer.
Acentra Health firmographics
Firmographics- Name
- Acentra Health
- Legal name
- Acentra Health, LLC
- Website
- https://acentra.com
- Company type
- Private
- Founded year
- 2023
- Operating status
- Operating
- Headcount range
- 1,001–5,000 employees
- Short description
- Acentra Health is a Carlyle-backed government healthcare technology and clinical services firm serving CMS and 34 state Medicaid programs via proprietary platforms (evoBrix X MMIS, Atrezzo care management) and BFCC-QIO contracts spanning 29 states and 77M+ beneficiaries.
- Ownership category
- akta.pro rank
Acentra Health industry classification
Industry- Product category
- Government Healthcare Technology and Services
- NAICS
- Administration of Public Health Programs (923120), Services for the Elderly and Persons with Disabilities (624120), Health and Welfare Funds (525120)
- SIC
- Hospital & Medical Service Plans (6324), Services-Prepackaged Software (7372)
- akta.pro primary industry
- Medicare Quality, Risk Adjustment & Stars Analytics/Services (FSAIAGAJ)
- akta.pro secondary industry
- MA Chronic Condition Management & Supplemental Benefits (SSBCI) (HLAEACAI)
Keywords
Where Acentra Health is headquartered
LocationHeadquarters
- HQ city
- Mclean
- HQ country
- United States
- HQ region
- North America
Offices2 records
Markets served
Acentra Health business model
Business model- GTM type
- B2B
- Offering type
- Services
- Cost components
- Personnel, Technology or R&D, Operations, Infrastructure, Marketing or Sales
Revenue model
- Government Healthcare Contracts: Multi-year contracts with federal and state government agencies for healthcare technology and services. Contracts typically span 5 years base plus option periods. Revenue derived from service fees under negotiated contract terms. Major contracts include BFCC-QIO services for Medicare beneficiaries, Medicaid MMIS implementation and operation, and care management services for state Medicaid programs.
- Clinical Services & Solutions: Fee-for-service and per-member arrangements for clinical assessment, eligibility determination, utilization management, and care coordination services provided to government healthcare programs.
- Employee Assistance Program (EAP): Acquired EAP Consultants LLC in January 2024 to strengthen employee assistance program offerings for government and commercial clients.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Other | Multi-year contract | Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) services |
| Other | Multi-year contract | Comprehensive Independent Assessment Entity for North Carolina Medicaid |
| Other | Multi-year contract | Virginia Medicaid Utilization Management and Behavioral Health Services |
Go-to-market motion1 record
Distribution channels4 records
Marketing channels8 records
Acentra Health product offering
Product offeringCore offering
Acentra Health provides healthcare technology platforms and clinical services to federal and state government healthcare agencies. Its core offerings center on proprietary technology platforms (evoBrix X MMIS, Atrezzo care management, eCAMS HCE clinical assessment) combined with clinical services including utilization management, behavioral health assessments, PASRR evaluations, quality oversight, and employee assistance programs. The company serves as a CMS-designated BFCC-QIO for Medicare beneficiaries across 29 states and holds 34 state Medicaid contracts.
Product overview
Acentra Health offers a technology platform-based portfolio of healthcare solutions for government healthcare agencies, centered on three proprietary technology platforms: the Atrezzo care management platform, the evoBrix X Medicaid Management Information System (MMIS), and the eCAMS HCE clinical assessment platform. These platforms deliver services including Provider Engagement (enrollment, screening, credentialing), Claims Processing & Adjudication, Clinical Eligibility assessments (Level of Care, PASRR, Behavioral Health), Care Management (Utilization Management, Carceral Care, Care Coordination, Pharmacy Management, EAP), and Quality & Compliance Oversight. The solutions serve federal and state government healthcare programs including Medicare, Medicaid, and behavioral health services across 34+ state contracts. The company operates as a CMS-designated Quality Improvement Organization (QIO) serving Medicare beneficiaries across 29 states.
Differentiator
Problem solved
Functional benefit
Brands
- Atrezzo: Care management platform integrating essential care management features within a modular, configurable solution.
- evoBrix X
- eCAMS HCE
- NCLIFTSS
Products and services
- Atrezzo Care management platform that integrates essential care management features within a modular, configurable solution to enhance care team coordination and drive better care and improved outcomes. Supports utilization management, behavioral health services, and case management.
- evoBrix X Configurable, modular Medicaid Management Information System (MMIS) platform for high-volume claims and encounter processing, management, and reporting. Ensures payment cycles are not missed with rapid integration, implementation, and deployment options.
- eCAMS HCE Healthcare technology platform supporting clinical assessment and evaluation processes for government healthcare programs.
- Provider Engagement Services Digital solution for provider enrollment, screening, and credentialing including online configurable rules-driven enrollment applications and automated workflows ensuring program adherence to state and federal requirements.
- Claims Processing & Adjudication High-volume claims and encounter processing through configurable MMIS platform, ensuring payment cycle continuity with rapid integration and deployment options.
- Level of Care Assessments Clinical assessments determining appropriate care settings for patients, improving outcomes for beneficiaries with high-risk, high-cost concerns through comprehensive health overviews.
- Preadmission Screening & Resident Review (PASRR) Federally required screening and evaluation services for individuals prior to admission into Medicaid-certified nursing facilities, ensuring appropriate placement and access to needed services.
- Behavioral Health Needs Assessment Comprehensive behavioral health evaluations to identify appropriate care delivery and settings for patients with mental health concerns.
- Utilization Management Service authorization management for inpatient and outpatient medical and behavioral health services, including residential treatment and community mental health rehabilitation.
- Employee Assistance Program (EAP) Employee wellness and productivity programs providing short-term counseling, support services, and connections to long-term treatment options for beneficiaries.
- Quality & Compliance Oversight Services including CMS Waiver Support, Standard of Care Review, Managed Care Oversight, External Quality Review, and Appeals & Grievances to ensure regulatory compliance and care quality.
- Data Analytics Analytics and Machine Learning solutions transforming healthcare administration by optimizing clinical and administrative workflows, identifying fraud, and addressing population health risks through data-driven insights.
Quantifiable outcome
- 30% reduction in medical coder effort through agentic AI workflows
- +5 more outcomes
Companies that use Acentra Health
Customer profileNamed customers10 records
Segments4 records
Ideal customer profiles3 records
Acentra Health technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
AI capability8 records
Feature5 records
Acentra Health partnerships and signals
Strategic signalScale indicators10 records
Recent moves7 records
Expansion highlights3 records
Acentra Health competitors and assessment
Company assessmentDirect peers
- NTT DATA: NTT DATA is a major systems integrator delivering state Medicaid systems (MMIS), data analytics, and federal healthcare IT solutions. It competes on similar state Medicaid modernization RFPs that Acentra Health pursues.
- Gainwell Technologies: Gainwell Technologies is a leading provider of Medicaid Management Information Systems (MMIS), claims processing, and analytics for state Medicaid agencies. It is the most direct competitor to Acentra Health's evoBrix X MMIS platform and state Medicaid services franchise.
- Maximus: Maximus provides operational and clinical services, including clinical assessments, care management, and quality oversight, to federal and state government health programs. It directly competes with Acentra Health on state Medicaid assessment and utilization management contracts.
- Conduent: Conduent provides government healthcare services including Medicaid eligibility, claims processing, and member services across multiple states. It is a direct competitor in state Medicaid operations and benefits administration RFPs.
- ICF International: ICF delivers analytics, program implementation, and clinical advisory services to federal and state health agencies. It is a comparable competitor in health informatics, quality measurement, and CMS program support work.
Broad incumbents
- Modivcare: Modivcare provides non-emergency medical transportation and personal care services to Medicaid managed care plans and state agencies. It overlaps with Acentra Health in serving government-funded priority populations through state Medicaid programs.
- Optum (UnitedHealth Group): Optum is the health services arm of UnitedHealth Group, providing government healthcare services, analytics, and care management at massive scale. It competes with Acentra Health across state Medicaid, Medicare, and federal healthcare engagements with a much broader portfolio.
- DXC Technology: DXC Technology delivers federal and state government IT modernization services including healthcare and human services. It pursues similar large-scale government healthcare technology contracts as Acentra Health.
- Cognizant Government Services: Cognizant provides large-scale digital transformation and IT services to federal and state health agencies. It competes for multi-million-dollar government healthcare technology contracts with broader scale and delivery capabilities than Acentra Health.
Emerging players
- HealthEdge: HealthEdge provides core administrative processing systems (claims, benefits, care management) to health plans including government-sponsored plans. It competes in adjacent technology layers to Acentra Health's evoBrix X and Atrezzo platforms.
Market position
Strengths4 records
Weaknesses4 records
Competitive moat7 records
Key risks5 records
Key highlights6 records
Customer concentration
Acentra Health social profiles
Digital presenceAcentra Health compliance and trust
Trust signalCompliance9 records
Acentra Health financial estimates
Financial estimateRevenue estimate
Valuation estimate
Acentra Health leadership team
Management profileNumber of profiles
Profiles2 records
Acentra Health subsidiaries and ownership
Company hierarchySubsidiaries1 record
Acentra Health funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Acentra Health M&A and investment
M&A and investmentM&A4 records
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Acentra Health
What does Acentra Health do?
Acentra Health provides healthcare technology platforms and clinical services to federal and state government healthcare agencies. Its core offerings center on proprietary technology platforms (evoBrix X MMIS, Atrezzo care management, eCAMS HCE clinical assessment) combined with clinical services including utilization management, behavioral health assessments, PASRR evaluations, quality oversight, and employee assistance programs. The company serves as a CMS-designated BFCC-QIO for Medicare beneficiaries across 29 states and holds 34 state Medicaid contracts.
Is Acentra Health a public or private company?
Acentra Health is a private company. It is classified as private equity controlled and is currently operating.
When was Acentra Health founded?
Acentra Health was founded in 2023. It employs 1,001 to 5,000 people.
Where is Acentra Health based?
Acentra Health is headquartered in Mclean, United States, in the North America region.
How does Acentra Health make money?
Three revenue lines are on record. Government Healthcare Contracts are the primary driver. The others are clinical Services & Solutions and employee Assistance Program (EAP).
Who are Acentra Health's main competitors?
Direct peers on record are NTT DATA, Gainwell Technologies, Maximus, Conduent and ICF International. Broad incumbents are Modivcare, Optum (UnitedHealth Group), DXC Technology and Cognizant Government Services. HealthEdge is listed as an emerging player.
Does Acentra Health have an API?
No public API is recorded for Acentra Health.
What industry is Acentra Health in?
Acentra Health's product category is Government Healthcare Technology and Services. Its primary akta.pro industry code is FSAIAGAJ, Medicare Quality, Risk Adjustment & Stars Analytics/Services, with a secondary code of HLAEACAI, MA Chronic Condition Management & Supplemental Benefits (SSBCI). Its NAICS code is 923120 and its SIC code is 6324.