Ten health systems invest in Capital Rx's backend claims processing platform
Cloud platform JUDI drives savings for plan sponsors by providing patients with the lowest available drug prices, company says.
Photo: Alexsandar Nakic/Getty Images
Ten health systems, including Banner Health, Memorial Herman and Ochsner Health, with digital health equity company Transformation Capital, have invested over $50 million in Capital Rx, a full-service pharmacy benefit manager and pharmacy benefit administrator.
The funds will support Capital Rx's cloud-native pharmacy benefits administrator and backend claims processing platform JUDI. The money will go towards R&D related to JUDI's modules and capabilities, the growth of member and client service teams, and hiring in other key areas of the company, Capital Rx said.
Health systems participating in the investment include Atlantic Health System, Banner Health, Hawai'i Pacific Health, Inova Health System, Lehigh Valley Health Network, Memorial Hermann Health System, Nebraska Medicine, Novant Health, Ochsner Health and WellSpan Health, among others.
WHY THIS MATTERS
Capital Rx is promoting the move as a collaboration among health systems to improve transparency and affordability in the pharmaceutical supply chain.
JUDI administers pharmacy benefit programs, offering clear pricing, operational efficiencies and control over pharmacy spend across commercial, Medicare and Medicaid plans, Capital Rx said. The combination of JUDI and a Single-Ledger Model drive savings for plan sponsors by providing patients with the most appropriate care at the lowest available price.
Price volatility has plagued the pharmaceutical supply chain and driven costs higher for plan sponsors and patients, Capital Rx said.
"Inova makes strategic investments in healthcare companies that have the potential to drive meaningful transformation," said Inova CFO Alice Pope. "Capital Rx's ability to leverage technology to bring clarity and consistency to drug prices for its clients and to broaden access to medication for members while providing exceptional service represents a paradigm shift in the PBM industry."
"Novant Health strategically partners with and invests in organizations that are transforming the healthcare industry," said Dean Swindle, executive vice president and president of Novant Health Enterprises. "In Capital Rx, we found a like-minded partner that is committed to the patient experience and purposeful innovation. Together, we are discovering ways to reduce pharmacy costs, improve operational efficiency, and make medication more accessible so patients can thrive."
THE LARGER TREND
Capital Rx and JUDI connect services for over 2.4 million members for Medicare, Medicaid and commercial plans.
The Health Management Academy, which connected the health systems, and its Strategic Partnership Alliance arm, along with member health systems, identified technology-stack JUDI as best-in-class.
Twitter: @SusanJMorse
Email the writer: SMorse@himss.org
