Health Plans

Better intelligence. Better outcomes.

A clear 360° view of your members strengthens eligibility, retention, outcomes, and risk.

Smarter Member Support

Catch critical gaps before they become setbacks.

By connecting clinical history and health-related social needs with eligibility, Centauri enables a clearer view of each member’s needs so plans can reach them sooner, coordinate care and coverage, and provide timely support that improves access to benefits and continuity of care, while reducing churn.

How Centauri Helps

Act early. Shape the outcome.

Centauri helps plans act sooner and in time—across the whole member journey.

  • care

    Bridge gaps. Support members. Improve performance.

    When documentation and quality gaps surface too late, plans lose the ability to act before measurement windows close. That affects quality measures, compliance, and accurate reimbursement.

  • outcomes

    Don’t just measure outcomes. Change them.

    Timely outreach and stronger coordination improve continuity for members while supporting better quality performance, stronger star ratings, and HEDIS® results, and lower avoidable cost over time.

  • Risk Adjustment

    Accurate reimbursement for the risk you're truly managing.

    Get a more complete picture of member risk. Identify documentation and care gaps earlier, connect supporting clinical information, and help ensure member risk is represented accurately and supported by the medical record.

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Solutions for Health Plans

  • Member Benefits

    Identify members likely to qualify for Supplemental Security Income (SSI), Social Security Disability Insurance (SSDI), Long-Term Services and Support Waiver Programs (LTSS), and Medicaid benefits, then support them through the steps needed to access and retain those benefits, as well as connect them to community resources related to the Social Determinants of Health.

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  • Risk Adjustment

    Identify care and documentation gaps across Medicare Advantage, Affordable Care Act (ACA), and Medicaid through automated retrospective and prospective retrieval and coding to improve risk accuracy, receive accurate reimbursement, and reduce audit exposure.

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  • Quality Optimization

    Build a clearer view of each member’s clinical needs—then activate timely insights for provider engagement and member support to close gaps and improve quality performance.

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  • Care Management

    Surface member risks earlier—then coordinate outreach, support, and care team action to prevent gaps, improve continuity, and help members stay connected through critical transitions.

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Proven at Scale

ROI that compounds over time.

Health plan performance improves when action happens early and consistently. With Centauri, your teams can move quickly across risk, quality, and benefit activation in the moment that matters. That drives return on investment through member retention, losses avoided, and revenue captured.

With sustained performance across more than 60 million members and a ~99% client retention rate, value compounds year over year.

  • 60M People served nationwide
  • 100+ Health plans served
  • 10-20x Return on investment

Built for regulated environments, Centauri’s platform is HITRUST-certified, audit-ready, and designed to support accurate submissions, defensible documentation, and compliance confidence at every step—so performance holds up not just in the market, but under scrutiny.

See what connected healthcare can do.

Clarity in the moments that matter—so healthcare teams can move faster, work together, and drive better outcomes.

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