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CDPHP Selects Capital Rx as New Pharmacy Benefits Manager

June 24, 2022 by admin

Game-changing Rx decision will improve quality, cost, access and transparency for: CDPHP members, network providers and small and large businesses

ALBANY, NY – May 12, 2022 – CDPHP is pleased to announce that Capital Rx has been selected as the health plan’s new pharmacy benefit manager (PBM). This groundbreaking decision, effective January 1, 2023, will catapult CDPHP pharmacy strategy ahead of its competitors, ensuring quality, cost, access and transparency for patients, suppliers, and businesses of all sizes.

With more than 150 active clients spanning more than a million lives, Capital Rx is one of the fastest growing healthcare companies in America, providing breakthrough technology for both claims processing and benefit configuration.

“CDPHP has long been looking for a PPE partner that aligns with our mission, vision and values, and I am proud to say that we have found the perfect match with Capital Rx,” said CDPHP chief of pharmacy, Eileen Wood. “With Capital Rx, we have complete transparency in the pharmacy supply chain and are able to innovate in ways that provide affordability, efficiency and ease of use for all our members.”

By partnering with Capital Rx, CDPHP aims to turn the tide of rising drug prices through greater price transparency, as well as a new pricing model that determines the cost of drugs more accurately and fairly. Capital Rx sets its prices with complete transparency using actual drug costs per unit based on the National Average Drug Acquisition Cost (NADAC), which is tracked by CMS.

“Our partnership with Capital Rx deconstructs the traditional PPE model by deploying breakthrough technology that allows us to be more agile, giving us the ability to adapt formulas in days rather than weeks. With Capital Rx, as new, more affordable drugs enter the market, CDPHP will be able to offer these products more quickly to our members, suppliers, pharmacies, employers and government partners.” added wood.

CDPHP will leverage Capital Rx’s intuitive, cloud-native, enterprise pharmacy (EPP) platform (EPP) JUDI™ to increase efficiencies and achieve the highest standards of clinical care for its members. The platform enables real-time communication between doctors, pharmacies, patients and plans, facilitating faster and more efficient processing of prescriptions for members.

The health plan’s decision to move its PPE services to Capital Rx is yet another step in the process of creating an integrated delivery system in New York’s capital. CDPHP recently opened its doors to three retail pharmacies with the aim of providing its members and the community at large with a range of services to meet all of their healthcare needs.

“Our partnership with Capital Rx further reaffirms our mission to build an integrated delivery system where payers, healthcare providers and pharmacies are all aligned around delivering an enhanced quality and experience of care at the most affordable cost,” said CDPHP President and CEO, Dr. John Bennett. By partnering with Capital Rx, we look forward to improving efficiencies, eliminating waste and further enhancing our members’ experience with care.”

CDPHP believes there will be no disruption to care or coverage as a result of this change – including no changes to our formulary. In fact, they expect that their members and business partners will experience a better quality and experience of care as a result of this decision.

“CDPHP has always put patients first and is not afraid to challenge the status quo when it comes to providing great healthcare,” said Matt Gibbs, president of Capital Rx. “We are excited to partner with like-minded people who share our mission, vision and values ​​to provide the highest quality of care at the best prices for its members.”

Over the coming days, weeks and months, CDPHP will work in a strategic and coordinated manner to notify the appropriate parties, including members, brokers, employer groups, providers and other strategic partners, and will develop implementation working groups, timelines and action plans. .

About CDPHP®

Founded in 1984, CDPHP is a physician-founded, member-centered, community-based, not-for-profit health plan that provides high-quality affordable health insurance plans to members in 29 counties across New York. CDPHP is also on Facebook, TwitterLinkedIn and Instagram

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