Name of Organization/Company: Centivo, New York, NY USA
Category: Health, Wellness and Safety Solution Provider of the Year
Founded in 2017 by industry veteran Ashok Subramanian, Centivo was launched broadly in 2019 to bring lower cost, high-quality health care to the millions of Americans who struggle to afford it. Centivo’s health plan for self-funded employers saves mid to large companies 15% or more compared to traditional insurers. Employees gain access to transparent, affordable and easy-to-use coverage with no deductibles or coinsurance, free primary care and clear copays. We’re able to remove unnecessary costs by directly negotiating competitive prices with trusted health systems and independent practices, and then having employees coordinate all care through a primary care team whose goals are aligned around health and wellness. As an alternative to traditional carriers or third-party administrators, Centivo offers the technology, network, claims processing, customer support and population health management to fully administer these health benefits.
Centivo has quickly grown to over 150 professionals, servicing almost a dozen markets and partnering with leading providers including Mount Sinai Health System, Orlando Health, MemorialCare, UCLA Health and MercyOne, among others.
Centivo is backed by B Capital Group, Define Ventures, HarbourVest Partners, Nassau Street Ventures, Bain Capital Ventures, Company Ventures, F-Prime Capital, Ingleside Investors and Maverick Ventures as well as various individuals.
Since the beginning of 2020, Centivo’s team has grown by over 90%, we closed on two rounds of funding totaling $85MM, we’ve seen over 300% growth in new customers, and we launched provider networks in several new markets including New York , Southern California, Eastern Wisconsin, Iowa and Florida.
In just three years since its first client launch, Centivo has achieved strong results in cost savings as well as member engagement and healthcare utilization. Employers save an average of 15% and members save an average of 68% on healthcare costs, largely through care redirection and unit cost savings. Centivo sees very high member engagement, with 80% of members selecting a primary care provider, and improved utilization patterns with a 20% increase in primary care visits and a 30% decrease in emergency room visits. While delivering these outcomes, Centivo is experiencing 3x year-over-year revenue growth.
Beyond the numbers, employees value it! “I feel like I can take care of myself and my family without being in debt,” said one member. “I love how straightforward everything is,” said another.
Health coverage is more important than ever, yet ever increasing healthcare costs have far outpaced both inflation and wages. This has left employers desperate to find ways to reduce spending without putting their employees and their families at risk. At the same time, insurance carriers are achieving record breaking profits and outpacing the growth of virtually every stock market index. Something has to change.
Centivo is a new type of health plan anchored around leading providers of value-based care. Centivo’s offering helps self-funded employers provide employees access to benefits in industries that typically have a hard time offering robust health benefits, such as automobile sales, hospitality, retail, etc. The Bureau of Labor Statistics reports that lower-wage workers are 70% less likely to have medical benefits in 2019. In fact, the Bureau of Labor Statistics also reports wage workers in the bottom 10% are paying more on average in contributions to their benefits plan than those in the highest 10%. In many instances, the average worker is unable to afford their healthcare costs under their plans, especially with sky high deductibles and coinsurance of 20% or more. Without a clear picture of healthcare costs, many in this situation leave care to the last minute, which often leads to bigger healthcare issues and higher costs. The Centivo model offers predictable and affordable out-of-pocket costs to encourage members to get care coordinated with their primary care physician, when they need it, rather than avoid care until it’s unavoidable (and much more expensive).
1) Case Study (attached below). This case study highlights the significant behavioral shifts - which lead to significant savings! - realized by the company after using Centivo's plan for some time. This included an increase in primary and preventative care visits and a decrease in emergency room and urgent care visits. It also highlights the success of enrollment and activation at the start of the plan in 2019. Not only did a significant number of employees select Centivo’s plan, but by mid-February, 92% of members who had enrolled were fully activated. This means they had selected a primary care physician and were on their way to enjoying free primary care visits and outlining a plan for healthy living. Even better, people were happy! Enrollment went up almost 50% in the second year as positive buzz spread.: https://vo-general.s3.amazonaws.com/a1ab4161-9c30-4e28-88fc-d6ad384e3fe2/1ed35039-6f53-4b72-976d-ce8cd86ca0ad?AWSAccessKeyId=AKIAJ4PRWO26HAX3IOCA&Expires=1720468657&response-content-disposition=inline%3B%20filename%3D%22Case%20study.pdf%22&response-content-type=application%2Fpdf&Signature=gkYF8UII53ho8sFXUG2LEcA55AE%3D
2) How deductibles contribute to health care inequality and discrimination (see link). This article underscores the importance of access and affordability, both pillars of Centivo’s model, in bringing more equitable health care to underserved populations. Understanding the core of the problem makes for greater-impact solutions, which is why Centivo rebuilt the health care delivery model from the ground up. https://www.benefitspro.com/2020/10/07/how-deductibles-contribute-to-health-care-inequity-and-discrimination/
3) Centivo Secures $34M Series B To Scale Self-funded Employer Health Plan (see link). This is significant because, after just over a year into its full launch, Centivo continues to catch the attention of leading investors including B Capital Group, Define Ventures and HarbourVest Partners.: https://news.crunchbase.com/news/centivo-secures-34m-series-b-to-scale-self-funded-employer-health-plan/