Genuine Health Group

What Genuine Health Group does

Genuine Health Group is a physician-owned management services organization (MSO) headquartered in Coral Gables, Florida, that enables independent primary care providers to transition from fee-for-service reimbursement to value-based care. Founded in 2016-2017 by Joe Caruncho and Dr. Orlando Lopez-Fernandez, Jr. (who previously built and sold Medicare Advantage plan Preferred Care Partners to UnitedHealth Group in 2012), the company recruits and supports affiliated PCPs across ACO structures and full-risk arrangements. As of 2025 it manages care for 60,000+ Medicare beneficiaries through 400+ affiliated providers across five states (Florida primary, plus Texas, South Carolina, Georgia, and Alabama), reporting roughly $800M in annual premium revenue.

The business operates a platform-plus-services model spanning three revenue mechanics: ACO shared savings under the Medicare Shared Savings Program (MSSP) and the ACO REACH model via its Genuine Health Direct subsidiary (one of only 53 CMS-approved Direct Contracting Entities); MSO management fees for administrative, coding, quality, and analytics support (notably expanded UnitedHealthcare contracts); and capitated, full-risk Medicare Advantage agreements operated through acquired provider organizations such as Premier Care Associates and PreventiMed. Its core technology is the proprietary Genuine Insights analytics platform, which delivers real-time performance dashboards, care-coordination, risk-adjustment and administrative decision-support to affiliated practices, complemented by a companion mobile app for transmitting patient information to contracted clinicians. Clinical programs including Genuine Health At Home, Chronic Care Management, Transition Care Management, and Health Equity/social-worker initiatives target readmission reduction and chronic-disease outcomes.

Go-to-market is a domestic, sales-led field motion: a Growth and Retention team directly recruits independent practices into ACO and MSO contracts through practice assessment, custom game-planning, and negotiation. Pricing is not publicly disclosed and is negotiated per partnership. The company is privately held, financed initially by ~$14M of founder capital and subsequently by a $160M growth investment from Crestline Investors in September 2021, which funded a 2021-2022 acquisition program (PreventiMed, Premier Care Associates, ACMG) that added 20,000+ Medicare patients and pushed annualized revenue above $750M.

Name

Genuine Health Group

Legal name

Genuine Health Group, LLC

Website

https://genuinehealthgroup.com

Company type

Private

Founded year

2017

Operating status

Operating

Headcount range

11–50 employees

Short description

Physician-owned management services organization enabling independent primary care providers to shift to value-based care, operating MSSP and ACO REACH ACOs, an MSO, and full-risk Medicare Advantage contracts for 60,000+ Medicare beneficiaries across five U.S. states.

Ownership category

akta.pro rank

Product category

Value-Based Care Management Services

NAICS

Offices of Physicians (except Mental Health Specialists) (621111), Home Health Care Services (621610), Offices of Physicians (62111)

SIC

Services-Offices & Clinics Of Doctors Of Medicine (8011), Services-Health Services (8000)

akta.pro primary industry

Primary Care Networks, Groups & MSOs (HLAFAGAE)

akta.pro secondary industry

Hospital Shared Services, GPOs & System Support Organizations (HLAFAAAO)

Keywords

• Value-based care services
• Accountable care organization
• Physician enablement services
• Medicare risk management
• Healthcare management services

Headquarters

HQ city

Coral Gables

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Others

Revenue model

1. ACO Shared Savings: Genuine Health Group operates Accountable Care Organizations (ACOs) under the Medicare Shared Savings Program (MSSP) and ACO REACH model. The company shares in savings generated when its affiliated physicians deliver care below Medicare benchmarks while meeting quality thresholds. Genuine Health Direct (the ACO REACH/DCE entity) achieved $16.3M in gross savings in 2022, placing in the top 25% of all ACO REACH programs. Total 2022 savings across all ACO models reached $32.2 million.
2. MSO Management Fees: Genuine Health Group provides Management Services Organization (MSO) infrastructure to physician practices, including administrative, coding, quality, and analytics support, in exchange for management fees. MSO contracts with UnitedHealthcare have been expanded throughout Florida and other states.
3. Medicare Advantage Full-Risk Agreements: Genuine Health Group acquires and operates provider organizations that enter into full-risk agreements with Medicare Advantage plans. These include Premier Care Associates (more than 4,500 Medicare patients, $56M annual revenue) and PreventiMed ($43M annualized revenue). Revenue flows from capitated payments under these at-risk arrangements.

Go-to-market motion1 record

Distribution channels2 records

Marketing channels6 records

Core offering

Genuine Health Group is a physician-owned management services organization that helps independent primary care physicians transition from fee-for-service to value-based care. It operates Accountable Care Organizations (ACO REACH/Genuine Health Direct, MSSP), a Management Services Organization (MSO), and the Genuine Insights analytics platform to deliver care coordination, risk adjustment, quality reporting, and clinical programs to affiliated providers managing Medicare Advantage and Traditional Medicare patients.

Product overview

Genuine Health Group is a physician enablement platform that assists primary care providers in transitioning to value-based care. The company operates a platform-plus-services model centered around its ACO entities (Genuine Health Direct/ACO REACH and MSSP ACOs), a Management Services Organization (MSO), and the Genuine Insights™ analytics platform. Key clinical programs include Genuine Health at Home for chronic disease and post-discharge patients, Chronic Care Management, Transition Care Management, and Health Equity initiatives. The company manages care for Medicare Advantage and Traditional Medicare patients through a network of affiliated primary care physicians, leveraging real-time analytics and care coordination to deliver better outcomes while reducing costs.

Differentiator

Problem solved

Functional benefit

Brands

• Genuine Health Direct: Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) entity; one of only 53 Direct Contracting Entities approved by CMS in the United States.
• Genuine Insights
• Genuine Health At Home

Products and services

• Genuine Health Direct (ACO REACH) An Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) entity designed to improve patient care and accessibility while reducing healthcare costs. It is one of only 53 ACO REACH programs approved by Medicare in the United States. Genuine Health Direct achieved top 25% national ranking with $16.3M in gross savings and 100% CMS quality score in 2022.
• Genuine Health At Home An in-home care and support program for Medicare patients with chronic diseases and those transitioning from inpatient treatment to home environments. Delivered through allied professionals and physicians, it focuses on medication adherence, post-discharge follow-up, home safety evaluations, and patient engagement to reduce hospital readmissions.
• Genuine Insights Mobile App A mobile application designed for transmitting patient health care information to selected clinicians who have a contractual relationship with Genuine Health Group. The app is used to confirm user acknowledgment of notifications and review transmitted patient health care information.
• Genuine Insights Analytics Platform A proprietary analytics and reporting platform that provides real-time data, performance dashboards, and decision-support tools for affiliated physicians to manage care coordination, risk assessments, and administrative workflows across 60,000+ Medicare lives.
• Management Services Organization (MSO) A management services organization designed to help independent physicians succeed by providing operational support, administrative services, and infrastructure for value-based care delivery, including coding, quality reporting, and analytics support in exchange for management fees.
• Medicare Advantage Solutions Solutions designed to help primary care providers manage Medicare Advantage patients, including support for transitioning to value-based care models and collaborating with Medicare Advantage health plans. Includes full-risk capitated arrangements through acquired provider organizations (Premier Care Associates, PreventiMed, ACMG).
• Traditional Medicare Solutions Solutions for providers managing patients with traditional fee-for-service Medicare, including participation in the Medicare Shared Savings Program (MSSP) and Direct Contracting Entity (DCE/ACO REACH) models to deliver disease prevention, improved access to care, and medication adherence.
• Accountable Care Organization (ACO) Services Accountable Care Organizations operated by Genuine Health Group that manage care delivery for patients with traditional fee-for-service Medicare, focusing on disease prevention, improved access to care, medication adherence, and shared savings distribution. Includes MSSP ACO and ACO REACH programs (Genuine Health Direct).

Quantifiable outcome

• $32.2 million in Medicare savings generated across ACO models in 2022
• +5 more outcomes

Named customers4 records

Segments3 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature4 records

Partnerships

Six partnerships are on record, tiered core and minor.

• UnitedHealthcare (UHC)coreOthersUnitedHealthcare is both a strategic partner and a payer for Genuine Health Group. The company has expanded MSO contracts with UnitedHealthcare throughout Florida and other states. Roger Rodriguez, Genuine Health's CEO, previously served as the most senior executive in charge of UnitedHealthcare's Medicare and retirement business for Florida and the Southeast. Genuine Health also invests in UHC wellness programs (Real Appeal, Quit for Life, UHC Rewards) for its own employees, and UHC provides programs and resources for employee health and wellness.
• Holland & KnightminorOthersHolland & Knight served as legal representative for Premier Care Associates in its acquisition by Genuine Health Group in February 2022.
• Cozen O'ConnorminorOthersCozen O'Connor served as legal advisor to Genuine Health Group for the Premier Care Associates acquisition (February 2022) and previously as legal advisor in connection with the $160 million Crestline investment.
• LazardminorOthersLazard served as financial advisor to Genuine Health Group in connection with the $160 million investment from Crestline Investors in September 2021.
• PAAST (accounting firm)minorOthersPAAST served as accounting and financial/tax advisor to Genuine Health Group in connection with the $160 million Crestline investment.
• Alston & Bird LLPminorOthersAlston & Bird LLP served as legal advisor to Crestline Investors in connection with the $160 million investment in Genuine Health Group.

Scale indicators12 records

Recent moves6 records

Expansion highlights6 records

Direct peers

• Cano Health: Public (formerly) primary care operator focused on seniors with capitated Medicare Advantage contracts, strong Florida footprint overlapping Genuine Health's home market. Direct competitor for capitated senior PCP lives in Florida and Texas.
• Astrana Health (formerly Apollo Medical Holdings): Physician-centric, value-based MSO and ACO operator focused on Medicare Advantage and ACO REACH populations. Closest pure-play MSO peer and direct comparison for Genuine Health's network/IPC/MSO stack.
• Privia Health Group: Public physician enablement company that partners with independent PCPs and specialists on value-based care contracts, including ACOs. Most direct comparable on the MSO/physician-enablement model with multi-payer risk arrangements.
• Oak Street Health (CVS Health): Senior-focused primary care operator on full-risk Medicare Advantage capitation, now a CVS Health subsidiary. Comparable as a direct competitor for Medicare PCP risk lives and adjacent on VBC primary care delivery.
• VillageMD (Walgreens Boots Alliance): Primary care platform owned by Walgreens that partners with and acquires physician groups to deliver value-based care, including via Village Medical and Summit Health. Comparable PCP-enablement and risk-sharing model with capital from a strategic parent.
• P3 Health Partners: Public Medicare-focused VBC management company that contracts with PCPs and IPAs in ACO REACH and MA risk arrangements. Direct competitor for global-risk PCP lives with overlapping ACO and capitation models.
• Agilon Health: Public VBC enablement platform that contracts with independent primary care physicians to manage Medicare Advantage and ACO REACH lives. Directly comparable on global-risk PCP enablement and shared-savings economics.

Broad incumbents

• CareMore Health (Elevance Health): Multidisciplinary senior care delivery subsidiary of Elevance Health operating in value-based Medicare and MA. Comparable at a category level as a payer-affiliated senior VBC delivery entity, though larger and broader in scope.
• One Medical (Amazon): Membership-based primary care platform owned by Amazon with VBC contracts, including senior populations via Iora Health. Adjacent primary care enablement competitor with broader payer mix and capital backing.
• CenterWell Senior Primary Care (Humana): Humana-owned senior-focused primary care chain taking full-risk Medicare Advantage capitation. Operates at much larger scale and competes for the same senior PCP lives, especially in Florida where Humana is a leading MA payer.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks5 records

Key highlights7 records

Customer concentration

• Facebookfacebook.com/GenuineHealthGroup
• LinkedInlinkedin.com/company/genuinehealthgroup
• Instagraminstagram.com/genuinehealthgroup
• Xx.com/GenuineHealthUS

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles11 records

Subsidiaries5 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A2 records

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Genuine Health Group