Centivo builds employer-focused, primary care-centered health plans that combine an in-house virtual primary care practice (Centivo Care), direct contracts with accountable care organizations (ACOs) in 18 major markets, and a tech-enabled member engagement and plan administration platform. The company says its model can lower total cost of care by 30% or more, typically saves employers 15% or more, and increased utilization of primary and specialty care. In 2023 Centivo’s health plans achieved a 71% reduction in member out-of-pocket costs compared to the plans they replaced, and the company says its approach reduces annual employee out-of-pocket costs by nearly $1,200. Following Centivo’s acquisition of virtual-first medical provider Eden Health in May, the company expanded its PCMH-certified virtual primary care capabilities and integrated behavioral health into its platform. Centivo serves Americans in all 50 states across a diverse set of industries and plans to use recent capital to enhance and scale its product and technology and forge new strategic partnerships with health systems. Its stated mission is to bring affordable, high-quality healthcare to working families by curbing inefficiency and waste in employer-sponsored plans. Centivo offers health plans for self-insured employers anchored around relationships with accountable care providers and a primary-care-centered clinical model. Its plan designs include free adult and pediatric primary care for all visits, no deductibles, predictable copays for non-primary care, and integrated virtual primary care. Centivo says employers typically save 15–30% annually versus traditional insurance and that members’ medical and pharmacy out-of-pocket costs average under $350 per person per year. The company reports primary care utilization has increased by more than 30% while quality and member satisfaction have strengthened. Centivo serves employers ranging from 51 employees to Fortune 500 companies and has a market presence in 13 states. The company launched in 2019 and is pursuing rapid growth and expansion amid increased employer demand. Centivo is a Buffalo, NY-based health plan company led by CEO Ashok Subramanian. Its core product is a health plan anchored around providers of value-based care for self-funded employers. The company serves employer clients ranging in size from 100 employees to Fortune 500 companies. It recently launched a fully integrated virtual primary care-centered health plan in Florida. Centivo plans to use new funding for growth, expansion and development of products and services, including its virtual primary care-centered plan. By the end of 2022 the company’s health plan will be available in half of the top 20 metropolitan areas in the country, and it has a new strategic distribution arrangement with the Business Health Care Group in eastern Wisconsin. Centivo provides a benefits solution built for self-funded employers, offering affordable and predictable costs, a technology-driven member experience, and a range of benefit options including traditional and proprietary networks. The company develops high-value networks in partnership with local healthcare providers and uses data analytics to refine networks and direct members to appropriate providers. Members receive a primary care–centered model with expanded access and fully integrated virtual care. Provider partners include health systems such as Mount Sinai Health System, Orlando Health, Scripps Health, and UCLA Health, as well as independent practices. Centivo’s solution is available to mid-sized and large employers in New York, New Jersey, Connecticut, Southern California, Florida, and North Carolina, with plans to expand to additional markets in 2021. The company is led by CEO and co-founder Ashok Subramanian and has offices in Stamford, CT; Buffalo, NY; and New York, NY. Centivo is a New York City–based, new type of self-funded health plan built specifically for employers and their employees and families. Led by CEO and co-founder Ashok Subramanian, the company serves as a health plan or third-party administrator and partners closely with local health plans and TPAs to enhance offerings. Its model centers on an innovative primary care–centered network focused on outcomes, a dynamic benefit design that rewards members for high-value care and adherence, and a digital technology platform and concierge support to improve care and experience. Centivo is launching its product for the 2019 plan year, focusing on employers with employees in New York, New Jersey, Connecticut, and select other markets. The company plans to deploy capital to build technology and infrastructure, develop local partnerships, and support market launch.

Total raised

$224M

Funding rounds

6

Latest round

Equity

Latest activity

Sep 2024