Specialty PBM CarveOut Services

Specialty PBM carve out services and tools that help employers manage specialty drug costs and utilization and improve patient outcomes.
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Archimedes

Archimedes

Reviews pending
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Founded

2016

Employees

0

Funding Summary

Not Provided

Clients Your Size Clients Your Size

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About Archimedes

Specialty drug spend is the single fastest growing healthcare expense. Recognizing the potential clinical value of these drugs, plan sponsors want to provide them to their enrollees—but to maintain an affordable, sustainable benefit in this rapidly changing environment, they must also control costs. To do this, plan sponsors need quantitative information about which strategies work to target drugs to those in need of them and they must minimize use of clinically ineffective therapies and reduce waste. However, the guidance and services provided to plan sponsors to achieve these goals is not always objective or complete.

Recognizing... Show More
VIVIO Health, Inc.

VIVIO Health, Inc.

5.0 (1)
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Min. Group Size

1,000 eligible

Lives Serviced

50,000

Average Cost

Average Cost is Locked

12 RFI Questions Get access to vendor answered question RFIs.

RFI questions number is Locked

23 Specific Questions Specific Questions

Lock

Product Features

✓

Pass-Through, Admin Fee Only Contracts

 ✓

Rebate Administration
✓

No pharmacy profit interest

 ✓

All Specialty Pharmacies Allowed
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Not Provided.

Product Description

VIVIO Specialty Drug Management tackles a core industry problem: specialty drugs are just 2% of prescriptions but drive over 50% of pharmacy spend, and the traditional PBM model is built to push costs... Show More
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ShaRX

ShaRX

Reviews pending
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Founded

2017

Employees

0

Funding Summary

Not Provided

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About ShaRX

SHARx (pronounced “Sharks”) was designed to helpemployees and their dependents affordably access their high cost maintenance and specialty medications.The SHARx program procures these targeted medications for members through alternate access points – many times at $0 cost to the member.
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AscellaHealth LLC

AscellaHealth LLC

Reviews pending
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Founded

2013

Employees

0

Funding Summary

None

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About AscellaHealth LLC

A premier, tech-enabled Specialty Pharmacy and Healthcare Services organization serving Patients, Payers, Life Sciences, and Providers with innovative, cutting-edge clinical programs and services to improve health outcomes and enhance the patient journey.

We are always looking to expand our team with talented individuals, if you are interested in learning more, please send us an email to careers@ascellahealth.com and attach your resume. Show More
Blue Genes

Blue Genes

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Min. Group Size

-

Lives Serviced

-

Average Cost

Average Cost is Locked

12 RFI Questions Get access to vendor answered question RFIs.

RFI questions number is Locked

23 Specific Questions Specific Questions

Lock

Product Features

Not Provided.

Product Description

Specialty Drugs are very costly, and many are deemed not suitable based on a person's genetic profile. Blue Genes Pharmacogenetics program includes over 500 commonly prescribed medications, of which 60 fall into the... Show More
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Payer Matrix

Payer Matrix

Reviews pending
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Min. Group Size

1 eligible

Lives Serviced

1,500,000

Average Cost

Average Cost is Locked

12 RFI Questions Get access to vendor answered question RFIs.

RFI questions number is Locked

23 Specific Questions Specific Questions

Lock

Product Features

✓

Patient Assistance Program (PAP)

 ✓

Manufacturer Assistance Fill-In
✓

Alternative drug sourcing

 ✓

Pass-Through, Admin Fee Only Contracts
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Product Description

Payer Matrix focuses on providing quality care management and advocacy for specialty drugs, providing a substantial cost saving to our clients and members who may not otherwise have this type of discounted access... Show More
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Integrated Prescription Management

Integrated Prescription Management

Reviews pending
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Founded

2009

Employees

0

Funding Summary

Not Provided

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About Integrated Prescription Management

IPM is now part of LucyRx

Integrated Prescription Management (IPM) is a full-service pharmacy benefits manager (PBM) that works with self-funded employer groups, brokers, and TPAs around the country. Known for our high-touch service, insightful analytics, and flexible benefit designs, we take a collaborative approach to controlling costs without compromising care. Show More
OptumRx

OptumRx

5.0 (1)
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Founded

1989

Employees

243

Funding Summary

Not Provided

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About OptumRx

Since our inception in 1989, we have worked closely with our customers to provide high-quality pharmacy care services designed to promote optimized care. We manage over two billion pharmacy claims annually and serve more than 62 million members across a broad spectrum of customers, including public and government entities, health plans, Medicare and Medicaid plan sponsors, employer groups, collective bargaining groups and third-party administrators. We are more than a pharmacy benefit manager—we are a pharmacy care services company focused on driving transformative change and delivering quality holistic care. Show More
Kroger Prescription Plans

Kroger Prescription Plans

Reviews pending
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Product Info

Min. Group Size

50 eligible

Lives Serviced

400,000

Average Cost

Average Cost is Locked

12 RFI Questions Get access to vendor answered question RFIs.

RFI questions number is Locked

23 Specific Questions Specific Questions

Lock

Product Features

✓

Patient Assistance Program (PAP)

 ✓

Manufacturer Assistance Fill-In
✓

Alternative drug sourcing

 ✓

Pass-Through, Admin Fee Only Contracts
Show All Features

Not Provided.

Product Description

Unlike other specialty carve-out programs. Our mission is to be the preferred pharmacy for people undergoing complex medication therapies by optimizing clinical outcomes and providing a high-touch, caring experience. To best support patients,... Show More
Company Overview
ManifestRx

ManifestRx

Reviews pending
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Founded

2021

Employees

0

Funding Summary

Not Provided

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About ManifestRx

ManifestRx strives to provide price transparency and a frictionless pharmacy experience. ManifestRx is removing the barriers, frustration, and confusion associated with third-party contracting and delivering a convenient, simple solution. The family of companies delivers integrated pharmaceutical delivery with Manifest Pharmacy and enterprise pharmacy benefit solutions through ManifestRx.

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MMA Rx Solutions

MMA Rx Solutions

Reviews pending
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Founded

2016

Employees

0

Funding Summary

Not Provided

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About MMA Rx Solutions

MMA Rx Solutions is Marsh & McLennan Agency’s proprietary pharmacy management approach for self-insured clients that lowers prescription unit cost, protects the integrity of pharmacy contracts and helps make employees better pharmacy consumers. 

MMA Rx Solutions is a unique approach in that it is compatible with every PBM and TPA and can enhance carve-in, carve-out or coalition arrangements – whichever best suits the client.

By partnering with MMA Rx Solutions employers gain more visibility into their pharmacy arrangement, a more competitive contract, best-in-class pricing and a more engaged and educated membership."
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PharmPix Corp

PharmPix Corp

Reviews pending
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Founded

2009

Employees

150

Funding Summary

Not Provided

Clients Your Size Clients Your Size

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About PharmPix Corp

Pharmpix is a full service URAC Accredited Pharmacy Benefit Management Company (PBM) with an adaptable business model for distinct pharmacy delivery solutions. We provide services to health plans who manage Medicare, Medicaid and commercial business. Our system and coordinated (PBM) services are also built for large employers/unions and worker’s compensation lines of business. The company is privately held and was organized in 2009 as a corporation. Our headquarters are located in Guaynabo, Puerto Rico.

Our main differentiation among others PBMs are that we operate as a technology focused PBM, serving cost-conscious pharmacy benefit payers and/or administrators... Show More
Sav-Rx Prescription Services

Sav-Rx Prescription Services

Reviews pending
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Founded

1966

Employees

350

Funding Summary

Not Provided

Clients Your Size Clients Your Size

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About Sav-Rx Prescription Services

Sav-Rx Prescription Services, a wholly owned subsidiary of A&A Services, LLC, is the leading provider of lowest net cost Medication Benefit Management for employers and health plans nationwide. Sav-Rx serves millions of lives in all 50 states and Puerto Rico. After 50+ years in business, Sav-Rx remains 100% family-owned and operated, headquartered in Fremont, Nebraska, and anchored in the same community-based, patient-focused values we started with in 1966. Show More
US-Rx Care

US-Rx Care

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Founded

01/2007

Employees

200

Funding Summary

Not Provided

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About US-Rx Care

In contrast to traditional PBM service providers, US-Rx Care operates with full transparency and without any conflicts of interest, backed up by ERISA-defined fiduciary commitments in our service contract. Our fiduciary pharmacy benefits management services deliver unprecedented drug cost savings to self-insured employers, union trusts, and health plans. Typical client savings range from 30%-50% in total drug and administrative cost versus their previous PBM service provider within the first 12 months of US-Rx Care service. Member out-of-pocket costs drop 30% or more also with no change in benefit design. Show More
MedImpact Healthcare Systems, Inc.

MedImpact Healthcare Systems, Inc.

Reviews pending
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Founded

1989

Employees

1,606

Funding Summary

1 Corporate Round

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About MedImpact Healthcare Systems, Inc.

For more than 30 years, MedImpact has been lowering cost, improving care, and delivering better solutions for our clients. Today, we are the largest independent pharmacy benefit solutions company, investing millions of dollars in clinical programs, technology, operations, and analytics to provide clarity, control, and confidence.
Clarity
MedImpact's comprehensive pharmacy benefit solution includes innovative clinical programs and cost analytics with clear information empowering clients and their members in making the best care and cost decisions.
Control
MedImpact provides our capabilities, services, solutions, and products under any service model our clients desire allowing clients control and flexibility... Show More
MedOne Pharmacy Benefit Solutions

MedOne Pharmacy Benefit Solutions

4.0 (1)
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Founded

1999

Employees

80

Funding Summary

Not Provided

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About MedOne Pharmacy Benefit Solutions

MedOne is your key to the pharmacy benefit marketplace. We unlock the most appropriate prescription at the most affordable price for organizations and their health plan members nationwide. The MedOne 100% pass-through model delivers real prescription savings by cutting out the traditional "PBM" middlemen and facilitating direct relationships between health plans and high-performing pharmacies. Once we establish a transparent and aligned marketplace, we partner with organizations to optimize "where" and "what" members fill to reduce pharmacy costs and improve health outcomes.
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Quantum Health

Quantum Health

4.5 (4)
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Founded

1999

Employees

2,100

Funding Summary

None

Clients Your Size Clients Your Size

Clients size is Locked

About Quantum Health

Quantum Health is the leader in healthcare navigation, helping self-funded employers improve the member experience, lower healthcare costs and achieve better health outcomes. Combining AI-powered technology with compassionate Care Coordinators and clinical experts, Quantum Health simplifies the healthcare journey by guiding members to high-quality, cost-effective care while reducing complexity for employers and employees.

Building on more than 26 years of healthcare navigation expertise, Quantum Health expanded its platform through the acquisitions of Embold Health and CirrusMD, adding objective provider quality insights and physician-led virtual care to deliver more connected, personalized healthcare navigation. Today, Quantum Health delivers... Show More
Vivid Clear Rx

Vivid Clear Rx

Reviews pending
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Founded

2020

Employees

0

Funding Summary

Not Provided

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About Vivid Clear Rx

Introducing an Employee-Owned PBM that holds the cultural backbone of its 90-year-old parent company, Hy-Vee, Inc. with a focus on quality, healthy lifestyles and superior customer service.
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Amazon One Medical

Amazon One Medical

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Founded

2007

Employees

3,300

Funding Summary

Not Provided

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About Amazon One Medical

One Medical challenges the notion that delivering high-quality, accessible health care is unachievable and prohibitively expensive. In fact, we’re working to prove that just the opposite is possible — a system where quality care is affordable and available to everyone. To bring this vision to life, we rely on people-centered design, smart application of technology, and a team of talented primary care providers who have the time and tools to make the right decisions. The integration of these elements allows us to offer a seamless experience that not only saves our patients time and money but also leads to better... Show More
TrueScripts

TrueScripts

4.2 (1)
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Founded

2014

Employees

200

Funding Summary

None

Clients Your Size Clients Your Size

Clients size is Locked

About TrueScripts

TrueScripts is an independent, employee-owned pharmacy benefit manager (PBM) founded on a simple belief: prescription benefits should serve employers and members, not the PBM. Since 2014, we have built our organization around transparency, accountability, and delivering measurable value through a conflict-free business model that includes 100% pass-through rebates, open-book reporting, and no pharmacy ownership.

Today, TrueScripts serves more than 850 employer groups, plan sponsors, brokers, and TPAs nationwide, supporting over 450,000 members through innovative clinical programs, cost-containment strategies, and a service philosophy known as Amazing Care. Our proprietary Distinct Rx Advantage approach combines solutions such as specialty... Show More

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