Centauri Health Solutions

Centauri Health Solutions, established in 2014, provides technology-centric services to optimize variable revenue for health plans and healthcare providers. The company was founded by Adam Miller and Mike McNelis, who now serve as Executive Chairman and CEO, respectively. Miller's extensive background of over 20 years in executive healthcare roles at firms like CVS Caremark, WellCare Health Plans, and UnitedHealth Group informed the company's direction. His experience in Medicare and Medicaid programs, along with healthcare IT, led to the creation of Centauri to address challenges in revenue enhancement and eligibility.

The firm operates in the healthcare technology and services market, serving clients across Medicare, Medicaid, Commercial, and Exchange programs. Its business model centers on deploying a proprietary, private cloud-based software platform combined with data-driven services. This integrated approach helps clients manage complex processes related to government-sponsored healthcare reimbursement. Revenue is generated by providing these technology-enabled analytics and services that address issues like uncompensated care and risk-adjusted revenue for specific patient populations. Centauri's clients include hospitals, health systems, and major health plans nationwide.

The company's core platform integrates data analytics, workflow software, and business intelligence reporting. From this technological base, Centauri offers a suite of services including risk adjustment, quality program support, clinical data exchange, and eligibility and enrollment services for SSI/SSDI, Duals, and Medicaid. For hospitals, the company provides out-of-state Medicaid billing, revenue cycle analytics, and referral management. A key service is its HEDIS® management and reporting engine, which has been continuously certified by the NCQA. Through strategic acquisitions, Centauri has expanded its capabilities, adding services like referral management, revenue cycle analytics, and, most recently, broadening its health data network through the acquisition of MedAllies, a Qualified Health Information Network (QHIN).

Since its founding, the company has achieved significant growth, recognized on the Inc. 5000 and Deloitte Technology Fast 500™ lists. Its growth has been supported by investments from firms like Silversmith Capital Partners, SV Health Investors, and a majority stake acquisition by Abry Partners in 2020. This has enabled a series of strategic acquisitions to build out its service portfolio.

Keywords: healthcare revenue optimization, risk adjustment, quality program management, eligibility and enrollment services, healthcare analytics, revenue cycle management, Medicaid billing, Medicare Advantage, clinical data exchange, health information network, HEDIS certified, healthcare data management, government sponsored healthcare, patient eligibility, hospital financial services, health plan solutions, variable revenue, uncompensated care reduction, provider reimbursement, compassionate outreach