Acentra Health

Acentra Health

Acentra Health launched in September 2023 as the combination of CNSI, a Medicaid management information systems provider, and Kepro, a utilization review and case management vendor. Carlyle Group engineered the merger and retains a majority stake. Todd Stottlemyer, the former CNSI CEO and a longtime government services executive, became CEO of the combined entity. The firm's heritage traces to state-level health IT contracts that expanded under the Affordable Care Act — processing tens of millions of claims annually for CMS, state Medicaid agencies, and the Veterans Health Administration. The firm operates three core lines: technology solutions for state Medicaid enterprise systems, clinical services including prior authorization and behavioral health peer reviews, and program integrity work that flags waste and abuse in government health spend. Each line is a regulated, contract-driven business with multi-year visibility. Acentra holds prime contracts in more than 30 states, administering Medicaid claims processing in Virginia, Illinois, and Hawaii, among others. It also runs the CMS Beneficiary and Family Centered Care-Quality Improvement Organization for multiple regions. The company's clinical network includes registered nurses and physicians who conduct medical necessity reviews under InterQual and MCG criteria. Headcount at formation exceeded 3,500 employees, with primary delivery centers in McLean, Virginia and additional offices in Nashville, Austin, and Hershey, Pennsylvania. Carlyle acquired CNSI in 2021 and Kepro in 2022 before folding them into Acentra. The merger closed in September 2023, with Stottlemyer naming former Kepro CEO Susan Weaver as chief operating officer. The combined entity aims to cross-sell clinical services into the technology client base, a strategy that depends on navigating state procurement cycles. Revenue is estimated in the range of $1.2 billion to $1.5 billion based on predecessor company filings and contract headcounts. Acentra sits at the intersection of private equity and public sector procurement — a structure that invites both scrutiny and stickiness. Unlike most PE-backed health platforms that exit within five to seven years, the government IT vertical rewards long-term hold periods because contracts are deeply embedded in state administrative infrastructure. The company's structural moat is regulatory: replacing an incumbent Medicaid claims processor is costly and politically fraught. That makes Acentra's deal book less about M&A velocity and more about contested re-bids and RFPs — a dynamic that institutional allocators observing government health services track as a proxy for recession resilience.