Capital Rx Adds More than 80 New Partnerships in 2024 and Eyes Another Year of Record Growth in 2025
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New York, NY, Nov. 20, 2024 /PRNewswire/ - Capital Rx, the full-service pharmacy benefit manager (PBM) and pharmacy benefit administrator (PBA) advancing our nation’s electronic healthcare infrastructure, added more than 80 new partnerships (i.e., client relationships) in 2024, including iconic brands, innovative health systems, state municipalities and governments, and several of America’s larger employers. Demand is accelerating for the innovator’s tech-enabled, financially aligned PBM model and next-generation enterprise health platform, JUDI®, fueling exponential growth heading into 2025; Capital Rx is now servicing over three million PBM lives.
Employers expect healthcare costs to continue to rise by almost 8% next year, and they are “very concerned” about overall pharmacy costs1, prompting a reevaluation of their pharmacy benefit programs. After a record selling season in 2024, Capital Rx welcomes a new class of PBM clients, including seven Fortune 500 corporations, six municipalities, four universities, five leading health systems, a state employee plan, and fifty other plan sponsors.
“This year, we’ve seen an unprecedented number of forward-thinking plan sponsors recognize the need to move away from conflicted, legacy PBM vendors and select Capital Rx as their modern, aligned partner,” said co-founder and Chief Executive Officer A.J. Loiacono. “Capital Rx is a one-of-one organization that has the scale to service clients of every size, the expertise to handle government plans, the discipline to attain class-leading security certification, the thoughtfulness to lead the industry in patient satisfaction, the flexibility to integrate with any network or point solution, the resources to develop a next-generation claim administration platform, and the integrity to operate as a socially responsible B-Corporation™.”
In addition to the rapid expansion of its PBM services, Capital Rx set records for its expansion of PBA solutions in 2024. More than 30 unique health plans, including many administrated by Blues entities, representing scores of millions of lives, will run on the award-winning JUDI platform. Additionally, ten health plans will leverage Capital Rx’s new Medicare Prescription Payment Plan (M3P) solution, also powered by JUDI.
“Unlike the aging legacy systems that have dominated the market for years, JUDI is a true enterprise solution that provides both the scale and security required by large health plans,” said co-founder and Chief Technology Officer Ryan Kelly. “JUDI unifies all administrative workstreams into one platform, creating seamless management, allowing higher service levels, better clinical insights, and a single source of truth for AI and other applications.”
“A great fiduciary test for any plan sponsor is to see if its PBM can make money on an error, such as steering a patient to a specific pharmacy, making a clinical decision, classifying drug one way or another, or other formulary decisions,” Loiacono added. “Too often, the answer is yes, and that’s a serious concern of the payers we’re welcoming.”
The Need for Objective Pharmacy Benefit Administration Solutions
As a Certified B Corp™, Capital Rx maintains high accountability standards by not profiting from drug spend or directing members to specific pharmacies. By separating claim administration and member care from fulfillment/dispensing and other “commodity” components of pharmacy benefit management, plan fiduciaries can see their true costs and create a more sustainable model for the future.
“There are very real, tangible benefits of working with an objective, conflict-free, and financially aligned partner,” said Kristin Begley, PharmD, Capital Rx’s Chief Commercial Officer. “Organizations today need the right mix of modernized technology, unhindered access to data, and the ability to customize key components of their pharmacy program to unlock the greatest value from it.”
To support employers in transitioning to a better pharmacy benefits program, Capital Rx launched an unbundled offering, Never Move Again™, in August. Never Move Again™ brings unrivaled pharmacy program flexibility and control to larger employers by uncoupling administrative and fulfillment services and allowing price discovery and the agility to select services to best suit plan sponsors’ varying needs. “There’s no need for spread pricing, MAC lists, or other tactics that benefit the PBM at the expense of the plan and its members. Plan fiduciaries’ eyes are as wide open as ever to the issues with misaligned vendors,” Begley added.
Capital Rx maintains an exceptionally high level of customer and member satisfaction, managed through its domestic, 24/7/365 call center. Its unique service model yields a world-class-level client Net Promoter score of 90, compared to the industry average of 62; year-to-date member satisfaction of 99%, based on post-call, unadjusted ratings; and a first-call resolution rate of more than 96%.
To learn more about Capital Rx’s administrative solutions and JUDI, please visit http://www.capitalrx.com/.
About Capital Rx
Capital Rx is a full-service pharmacy benefit manager (PBM) and pharmacy benefit administrator (PBA), advancing our nation’s electronic healthcare infrastructure to improve drug price visibility and patient outcomes. As a Certified B Corp™, Capital Rx is executing its mission through the deployment of JUDI®, the company’s cloud-native enterprise health platform, and a Single-Ledger Model™, which increases visibility and reduces variability in drug prices. JUDI connects every aspect of the pharmacy ecosystem in one efficient, scalable platform, servicing millions of members for Medicare, Medicaid, and commercial plans. Together with its clients, Capital Rx is reimagining the administration of pharmacy benefits and rebuilding trust in healthcare. To learn more, visit www.capitalrx.com.
Media Contacts
Michael Passanante, SVP, Marketing & Communications
Justin Venneri, Director, Communications
References
1 Business Group on Health’s most recent Employer Health Care Strategy Survey.
2 Pharmaceutical Strategies Group’s 2024 Pharmacy Benefit Manager Customer Satisfaction Report.
