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 RX

Archimedes RX

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Founded

2016

Employees

Funding Summary

Not Provided

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About Archimedes RX

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

VIVIO

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Founded

2016

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About VIVIO

We use data to understand what specialty drugs do at the individual, not population level. Our carveout product, VIVIO Precision Care™ fixes big unsolved healthcare problems: expensive drug therapies that don’t work; lack of real-world effectiveness; doctors not knowing what they think they know; the arbitrary line between pharmacy drug and medical benefit; and, egregious supply chain waste. We replace the current pharma-centric therapeutic model with our data-centric one and drive better patient outcomes without overpaying. Employees and physicians have access to the right drugs based on individual data rather than self-serving policies. Typically, we save large and mid-sized self-insured... Show More
ShaRX

ShaRX

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Founded

2017

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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

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Founded

2013

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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
Paydhealth

Paydhealth

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Founded

2021

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Not Provided

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About Paydhealth

Paying for specialty healthcare the old way no longer works for all of us.  Savings generated through network contracting and rebate pricing are not trickling down to group health plans, their participants nor their beneficiaries. Paydhealth is changing the funding of specialty healthcare to re-imagine the possibilities of bringing real savings to the purchaser of healthcare -- you.
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BeneCard PBF

BeneCard PBF

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Founded

1989

Employees

525

Funding Summary

Not Provided

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About BeneCard PBF

BeneCard PBF provides self-funded prescription benefit program administration with a personalized approach through focused, clinical expertise. Our transparent business model operates on a customized claim processing system offering unlimited capability and flexibility to respond to client needs in an evolving marketplace.

Advanced clinical programs and advanced technology provide the framework to maximize the use of all data elements available. This allows BeneCard PBF to filter the information, focus on clinical opportunities and facilitate interaction between the physician, the pharmacist and the patient to effectively promote complete health care.

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PharmPix Corp

PharmPix Corp

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Founded

2009

Employees

140

Funding Summary

Not Provided

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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

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Founded

1966

Employees

350

Funding Summary

Not Provided

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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
MedImpact Healthcare Systems, Inc.

MedImpact Healthcare Systems, Inc.

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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
Payer Matrix

Payer Matrix

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Founded

2016

Employees

203

Funding Summary

Not Provided

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About Payer Matrix

Payer Matrix was founded in 2016 as we saw a critical need for a solution to address the rising specialty drug costs and their impact on plan budgets. We focus on patient advocacy, with the goal of providing a substantial cost saving to our clients and members who may not otherwise have this type of discounted access to the affordable drugs they need.

Our founder and the senior management team have considerable experience in the healthcare industry, focused on specialty pharmacy, home infusion, and employee benefits. Our experience gives us the unique ability to provide specialized patient... Show More
Kroger Prescription Plans

Kroger Prescription Plans

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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
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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

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Founded

2021

Employees

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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MedOne Pharmacy Benefit Solutions

MedOne Pharmacy Benefit Solutions

Reviews pending
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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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Integrated Prescription Management

Integrated Prescription Management

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Founded

2009

Employees

Funding Summary

Not Provided

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About Integrated Prescription Management

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
Vivid Clear Rx

Vivid Clear Rx

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Founded

2020

Employees

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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Transcarent

Transcarent

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Product Info

Min. Group Size

2,000 eligible

Lives Serviced

4,200,000

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
✓

Pass-Through, Admin Fee Only Contracts

 ✓

Rebate Administration
Show All Features

Not Provided.

Product Description

Our specialty pharmacy contracts deliver 100% passthrough, fully auditable pricing for our clients. All specialty pharmacy providers are invited to join our pharmacy network based on the quality of their clinical and Member... Show More
Company Overview
PharmPix Corp

PharmPix Corp

Reviews pending
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Product Info
Company Overview

Founded

2009

Employees

140

Funding Summary

Not Provided

Clients Your Size Clients Your Size

Clients size is Locked

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
Alluma

Alluma

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Founded

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None

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About Alluma

Alluma is shifting the focus back to patient care by creating a new entity that is uniquely aligned to the needs of its clients and their members. With a Pharmacy Benefits Illuminator, we negotiate on the same side of the table as our clients, helping them uncover opportunities that optimize their benefits programs while supporting better health outcomes.

We are a provider-led, provider-focused alternative developed in partnership between Vizient and Mayo Clinic. As the nation’s only member-owned, member-driven performance improvement company, Vizient is uniquely positioned to approach the PBM market with a provider lens. Mayo Clinic is... Show More
AcariaHealth

AcariaHealth

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Founded

2003

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Funding Summary

Not Provided

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About AcariaHealth

AcariaHealth, an Envolve Pharmacy Solution, is a national specialty pharmacy focused on improving care and outcomes for patients living with complex and chronic conditions. Our specialized care management services put patients first, bringing a personal touch to specialty drug management.

Our clinical and operational expertise allow us to deliver innovative solutions, but it’s our passion for what we do that sets us apart. Show More
Advanced Medical Pricing Solutions (AMPS)

Advanced Medical Pricing Solutions (AMPS)

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Founded

2005

Employees

88

Funding Summary

Not Provided

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About Advanced Medical Pricing Solutions (AMPS)

Turn to Advanced Medical Pricing Solutions (AMPS) for your healthcare cost management services and we will help you achieve meaningful and visible savings for your clients. Here at AMPS we utilize physicians to perform line-by-line audits on all claims we review. This will not only demonstrate an added level of commitment to your clients, it will add a new line of revenue to YOUR company at ZERO expense to you.
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