CareCentrix
Vendor Review for Medicaid Vendor Partner Readiness
- Overall Assessment
- Basic Info
- Relevant Leadership Experience
- Brand Perception
- Clarity of Value Proposition
- Scalability
- Funding Model
Overall Assessment
Summary
- Limited/no Medicaid experience across leadership team. Strong healthcare experience.
- Strong brand recognition. 2 issues being litigated related to upcoding and data breach.
- Internal reviews show healthy culture
- Focused and clear value prop
- Staffing analysis shows positioning for growth
Scoring

Composite

Leadership Medicaid Experience

Scalability

Brand Perception
Category
Services>Business process outsourcing
What they do
Business process outsourcing for plans for home health benefits.

current vendor logo (for identification purposes only)
Self-stated value proposition
CareCentrix works with payers to help their members age and heal where they most want to be — at home. We manage the entire continuum of integrated post-acute care, including the transitions to and from skilled nursing facility (SNFs), durable medical equipment (DME), home nursing, home infusion and home sleep testing. Guiding care to the home is the best way to bend the cost curve in health care.
CareCentrix manages networks of durable medical equipment vendors, home health care nurses, physical therapists, and infusion nurses. We also have a sleep management business.
Founded
1996
Annual Revenues
Estimated @ $1B
# employees
Estimated @ 2,500
Points Possible: 212
Points Earned: 66

click to enlarge
Role | | |
---|---|---|
CEO | ![]() John Driscoll | Click for Bio (self-reported)John Driscoll brings more than 25 years of health care experience to CareCentrix. Prior to CareCentrix, John served as President at Castlight Health, a healthcare technology company. Previously, John served as Group President for new markets at Medco (a $70 billion Pharmacy Benefit Manager). He led product development for employer and health plan clients. During his years at Medco, John was part of the senior management team that spun Medco out of Merck, building an enterprise that was named as the most admired company in healthcare services by Fortune. He was responsible for Medco’s entry into Medicare, growing the business from start-up to $20 billion in annual revenue. John also led Medco’s acquisitions and investments, investing over $10 billion in capital in high-growth companies, including specialty pharmacy Accredo Health. During John’s tenure, he was also in charge of Retail network contracting, Medco’s data products, Medco International, and Medco’s specialty pharmacy business. John founded and chaired the Surescripts ePrescribing Network, building the first cross-industry collaborative with competing Retail, PBM, and Health Plans cooperating to revolutionize e-prescribing. Surescripts has grown from servicing under 50 million prescriptions in 2005, to over 1 billion prescriptions today. John also served as an Advisor to Oak Investment Partners. He was a member of the executive team at Oxford Health Plans, serving as Corporate Vice President for government programs. At Oxford Health Plans, he built and led the Medicare & Medicaid business, from start-up to over $1.3 billion in annual revenue. During his time at Oxford, the company was one of the fastest growing companies in the U.S. and was widely recognized as one of the most innovative companies in healthcare. John was selected by the White House for its Entrepreneurs in Residence program in 2011 to advise the FDA on new paths for innovation. He has published articles in Los Angeles Times and Time Magazine. John has a B.A. and M.B.A. from Harvard University, and was a resident tutor at Winthrop House. John also holds an MPhil from Cambridge University in England. He chairs the Truman National Security Project, and served as a captain in the U.S. Army Reserve. He serves as a Board Member for the Alliance for Hunger and the Press Ganey Corporation, and previously served on the Board of Outward Bound, Hurricane Island Outward Bound School, and the Domus Foundation. |
Operations Executive | ![]() Laizer Kornwasser | Click for Bio (self-reported)Laizer Kornwasser brings more than 20 years of executive experience to CareCentrix. As President and Chief Operating Officer, he is responsible for driving operational excellence and business strategy. Prior to CareCentrix, Laizer was a professor of management at the Sy Syms School of business at Yeshiva University, and has held executive leadership positions in investment banking and Fortune 50 companies, including having served as the Senior Vice President of Consumer Solutions and Retail Markets at Medco. He holds a MBA from Harvard Business School and a BS in Accounting from Yeshiva University’s Sy Syms School of Business. |
Information Systems Executive | ![]() Kimberly Paul | Click for Bio (self-reported)Kimberly Paul is a proven Technology Executive who brings more than 20 years experience to CareCentrix. Kimberly has expertise in software development, technology operations, and transformation spanning Series A startups to Fortune 50 companies. Prior to CareCentrix Kimberly was the CTO of Advanced Practice Strategies, a health technology company. While at APS she was responsible for the maturation and modernization of the technology stack and division. Prior roles include EVP, CIO at Neocare Solutions and Head of Application Development at Aetna. Her SaaS solutions have directly contributed over 10x top line growth with nominal operating margins. She has successfully exited multiple high growth companies and has been recognized nationally for her leadership. Kimberly holds a BA from the Johns Hopkins University. |
Sales Executive | ![]() Steve Wogen | Click for Bio (self-reported)Steve Wogen brings more than 25 years of experience in healthcare leadership to CareCentrix. As Chief Growth Officer, he is responsible for growth strategy, medical economics, Sales, and Marketing. Steve comes to CareCentrix from Express Scripts, formerly Medco Health Solutions, where he was the SVP/GM for Prescription Drug Plan and Retiree Solutions, and led the integration of the companies’ retiree business lines. He led the launch of Medco’s Prescription Drug Plan and employer sponsored retiree products, which he grew to a $4 Billion business; became CFO of the Retiree Division and directed the cross-functional team responsible for launch of Medco’s Medicaid strategy and operational model. Previously, Steve was Regional Director of Medical Economics at Cigna. Steve holds a bachelor’s degree in economics and medical ethics from Davidson College in Davidson, NC, and a master’s in health administration from the Medical College of Virginia, in Richmond, VA. He has published and presented his work on electronic prescribing, the value of pharmaceuticals in care management, Medicare Part D and efficiency in healthcare delivery. |
Product/Solution Executive | ![]() Susan Blackburn | Click for Bio (self-reported)Senior Health Care Executive with expertise in strategic product design and development for new and emerging markets, merger integration leadership and change management resulting from health care legislation and regulation. Well versed in the design and development of benefit management products/services, the delivery of clinical and financial analytics, client consultative service and the dynamic change and impact of Federal and State government health programs. |
Finance Executive | ![]() Steve Horowitz | Click for Bio (self-reported)As Chief Financial Officer, Steve Horowitz directs all of CareCentrix’s financial activities, including financial planning, accounting and financial reporting. Prior to joining CareCentrix, Steve was the Vice President of business planning for Medco Health Solutions, a Fortune 50 pharmacy benefit manager. In this role, Steve was the CFO for three key U.S.-based divisions as well as all international markets, which together generated over $2 billion in annual revenue. Previously, Steve held the position of controller at National Medical Health Card Systems, a pharmacy benefit manager, and at The Fantastic Corporation, a global broadband multimedia corporation. Earlier, Steve was CFO at the Mount Vernon Neighborhood Health Center. Steve received his MBA from Adelphi University and earned his BS in business management from Cornell University. He is a licensed CPA, as well as a member of the American Institute of Certified Public Accountants. |
Points possible: 95
Points earned: 70

Analyst Notes
- Existing Medicaid client base
- Market interest and recognition is broad outside of investment community
- There are some high profile upcoding issues related to a lawsuit involving CareCentrix Cigna filed in 2017. Also a lawsuit in KS related to a data breach.
- Indeed/Glassdoor reviews are robust and overall rated favorably for company culture and confidence in leadership.
Points possible: 60
Points earned: 50

Analyst Notes
- Clear focus on managing all stages of the path to home care
- Success is described in relation to utilization management, reduced claims costs.
- Focus on HCBS / LTC limits use of buzzwords in messaging.
- Does not appear to tailor solutions to Medicaid vs other LOBs based on messaging.
Points possible: 50
Points earned: 50

Analyst Notes
- Extensive current client base and significant ongoing annual revenues
- Mid level operations and product teams rated with extensive experience
- Recent hiring trends suggest increasing operational readiness for growth
Analyst Notes
Ownership model
Private equity
Stage
Late stage
Trend in funding rounds
Only 1 round
Major investors
Summit Partners