Acentra Health

Carlyle Group is the majority owner of Acentra Health. The private equity firm acquired CNSI in 2021 and Kepro in 2022, then merged the two companies in September 2023 to create the combined entity. Todd Stottlemyer and the management team hold minority stakes.

Acentra operates as a prime contractor for state Medicaid agencies, providing claims processing, provider enrollment, and program integrity services. The company holds contracts in more than 30 states, with the deepest relationships in Virginia, Illinois, and Hawaii. These contracts are typically awarded through competitive RFPs with five-to-seven-year terms.

Acentra is a government IT contractor, not a venture-scale software company. Its revenue comes from long-term, competitively awarded state and federal contracts with defined scopes of work and renewal cycles. Margins are mid-teens to low-20s, and growth depends on winning re-bids and new state procurements — not user adoption or product-led expansion.

Through its legacy Kepro business, Acentra performs medical necessity reviews, behavioral health prior authorizations, and independent medical reviews for CMS, state agencies, and commercial clients. The clinical network includes registered nurses and board-certified physicians who apply evidence-based criteria. These services are often bundled with the firm's technology platform contracts.

Acentra is a PE-backed platform company — Carlyle's purpose-built vehicle for the government health IT vertical. The firm is not a fund or an investment manager; it is an operating company. Institutional allocators interact with it indirectly, through Carlyle's fund structures or through co-investment vehicles that held CNSI or Kepro before the merger.

The majority of Acentra's revenue is from public-sector contracts — primarily CMS, state Medicaid agencies, and the VA. Kepro also serves commercial insurers and managed care organizations for outsourced utilization review, but the public-payer backbone dominates. The firm is not a direct competitor to Epic, Cerner, or payer-provider interoperability players.

As a government contractor administering Medicaid and Medicare funds, Acentra is subject to two primary risk vectors: contract protests from losing bidders, which can delay implementations, and federal policy shifts that change program scope — such as redetermination surges or new CMS interoperability mandates. State-level procurement laws and minority-business subcontracting rules also shape contract terms.