Helping your plan achieve your goals

We work as an extension of your team, making your goals our own to solve problems for your clients in real time.

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Our business: never stop improving yours

We have the scale and capabilities to help you keep pace with a dynamic health care landscape and grow business in commercial and regulated markets.

Managing cost, quality and specialty pharmacy

We innovate to drive savings while delivering quality care to your members and helping plans prepare for the impact of specialty therapies.

Getting better, together

We work side by side with you to drive better health outcomes for your members and propel your plan forward.

Committed to your growth

Our dedicated growth teams and strategists prioritize innovation and personalized solutions to contribute to the goals of all your business lines.

True partnership built on trust and collaboration

Our flexible offerings and commitment to your growth help you achieve your goals on your terms, and we hold ourselves accountable to help make the best clinical and financial decisions with your business and members in mind.

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Delivering value for those you serve

Commercial

We analyze and uncover opportunities for growth. Our advanced expertise helps identify ways to enhance affordability, improve predictability of care and drive better health outcomes for your clients and members.

Health Insurance Exchanges

We provide the tools including formulary support, benefit compliance, regulatory support and market development strategies to achieve your marketplace objectives and help your members be active participants in managing their own health care. 

Medicaid

Our expertise in navigating the nuances of your market(s), member populations and regulatory challenges run deep.
 
With a flexible Medicaid service model, we help you remain compliant and improve your HEDIS quality measures and clinical outcomes for your plan(s) and members.

Medicare

Our dedicated team of Medicare market strategists provide you with actionable insights to improve Star ratings, achieve quality measures and drive greater affordability of care.
 
Overall—we’re equipped to help plans navigate the constant flux of changing regulatory and market dynamics.

Flexible, targeted solutions for your plan

Our innovative, industry-leading solutions help you reduce costs, increase quality and create health experiences that are truly equitable. We offer complete solutions with the flexibility to combine with your current offerings. Learn more about a few of our popular health plan solutions below:

Health Connect 360®

With unrivaled precision and analysis to make sure no patients fall through the cracks, Health Connect 360® provides a transformative solution by connecting the right people with real-time data to deliver guaranteed clinical outcomes and financial savings.

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Learn more how we can support your members.

Putting our clinical knowledge, capabilities and scale to work for you:

94%

of enrolled lives are in 4-5 star Medicare Part D (MAPD) plans1

$1.3B

in Quality Bonus Payments (QBP) earned by 4-5 star MAPD plans1

Unlock growth opportunities for your plan

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Enhancing health outcomes and savings through value-based solutions
April 15, 2024
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Keeping member health on track: A snapshot of the PBM’s clinical expertise
April 19, 2024

Sources

  1. Express Scripts Book of Business