Navitus Health Solutions and PerformRx are two of the Companies to Capitalize on Medicare and Medicaid Expansion, According to HealthLeaders-InterStudy
June 27, 2012—Nashville, Tenn. —
HealthLeaders-InterStudy, the leading provider of managed care market intelligence, finds that pharmacy benefit managers (PBMs) like PerformRx and Navitus Health Solutions have solid potential to grow their presence in government-sponsored programs because of their recent successes in the Medicaid sector.
PerformRx is owned by the AmeriHealth Mercy Family of Companies. Started in 1999, the Medicaid PBM has had years to figure out how to operate with the low budgets and high scrutiny of the heavily regulated government program. PerformRx has teamed up with a number of Blue Cross plans to get a foothold in the Medicaid market.
“The key to PerformRx’s success is not only the implementation of the expected Medicaid expansion but their ability to convince other Blue plans to partner with them and take advantage of their expertise to secure Medicaid contracts in new states,” said HealthLeaders-InterStudy Senior Market Analyst Chris Lewis.
Owned by Dean Health Plan, Navitus is a small PBM that has seen dramatic growth in 2012 with its pick-up of PBM services for 10 health plans serving the Texas Medicaid program. Its success in Texas sets the company up for attracting more Medicaid plans; taking advantage of a future growth source for PBMs. Navitus also has a track record with public-sector employers, such as the states of Wisconsin and Minnesota.
“Navitus distinguishes itself by charging fees for its service, rather than earning a profit by being a middle man between plan sponsors and drug suppliers,” said Ms. Lewis. “This pass-through business model and transparency in pricing positions Navitus to serve government entities and other public institutions that want more control over their drug spend.”
Complete PBM profiles of ten key market players are available from HealthLeaders-InterStudy as part of its Pharmacy Benefit Evaluator platform.
The PBM profiles will be updated throughout the year, capturing the latest developments among the profiled PBMs. In addition to key market events, the reports will also include competitive analysis, markets covered, and products and services offered by each company.
The Pharmacy Benefit Manager Profiles
include the following companies:
- Prime Therapeutics
- SXC Health Solutions/informedRx
- Catalyst Health Solutions
- CVS Caremark
- Navitus Health Solutions
- MedImpact HealthCare Systems
- Express Scripts