Capital Rx

🎙️ This week's #AstonishingHealthcare episode is an informative and fun discussion with one of our Senior Clinical Program Managers, Lauren Carroll. She returned to the studio to discuss #deprescribing and our #clinicalprogram Rx Retro! What is deprescribing, and how does it help #plansponsors, plan members, and health plans? How can modern technology, like Judi®, help patients avoid everything from risks associated with duplicative medications to overuse? 💊 With 1 in 5 Americans between the ages of 40 and 80 using at least five prescription drugs regularly, a program like Rx Retro is an extremely useful tool both to help enhance patient care and outcomes and also to reduce costs. 🎧 You're not going to want to miss this episode! Listen to it here: https://okt.to/1uwa7T

🤔 What does the future of healthcare administration look like? As our co-founder & CEO, A. J. Loiacono explains: ✅ A unified experience, with one platform - Judi Health™ - handling #pharmacy, #medical, #dental, and #vision claims workflows ✅ Innovative digital tools at #plansponsors' and members' fingertips, capable of enabling faster and better care delivery ✅ Costs and trends are clear and predictable - even when facing sudden industry shifts, like the emergence of #GLP1s ✅ Members are happy and enjoying their healthcare experience thanks to alignment and an intense focus on delivering exceptional customer care And that's just scratching the surface.

We wish it weren't true, but as we've mentioned on our podcast and in our other content, catastrophic claims have become more frequent and are larger than ever expected. So what do #plansponsors need to know to help manage and safeguard costs? 🤔 Sun Life's annual high-cost claim and injectable drug trends analysis is always an interesting read and highlights the relevant trends, including: 💰 Million-dollar+ claims are up 29% in the past year and 61% over the last four years 🔎 88% of employers saw at least one stop-loss claim from 2020-2023 🏥 Malignant Neoplasm remains #1 in spend as well as number of members with a claim, with reimbursements over $1.5 billion between 2021-2024 🦴 Orthopedics/Musculoskeletal has climbed to #3 for the first time, both in frequency and cost The bottom line? #StopLoss coverage has become even more essential to help #plansponsors manage catastrophic claims and maintain financial protection. 📰 Read the entire report here: https://okt.to/i3JBKd

One of the main points Jeffrey Hogan (President, Upside Health Advisors) stressed when he joined us in the #AstonishingHealthcare studio was how important it is for #plansponsors to do a deep dive into their contracts and find where their money is going. As he explained, this first step is incredibly important, and it's what's necessary to stop the cyclical "madness" that often comes with perpetuating the same issues across contracts and #RFPs. 🎧 Listen to the full episode here: https://okt.to/xKqVXU

Whenever Jeffrey Hogan (President, Upside Health Advisors) joins us in the #AstonishingHealthcare studio, we learn something new. 💡 Today was no different. In addition to breaking down recent legislative developments in Washington D.C., he explained why #employers should bring a similar mindset to the #medical side of the equation as they do to the #pharmacy side, starting with reviewing all of their existing contracts to identify areas of concern that need to be remedied. We'll definitely be using the "brave old world" phrase, too, Jeff. 😉 🎧 Listen to the full episode here: https://okt.to/QZsXzB

It's been a busy July! ☀️ We have a ton of news to share with you, including:   🤖 Deep insights into Judi Health™, #healthcare's first Unified Claims Processing™ platform (including early PEPM data that indicates both medical and holistic savings) 🎙️ Our latest podcast episodes, featuring Marsha Perry, SPHR,SHRM-SCP, Jackie Lolos, PharmD, Haleh Campbell, PharmD, Carrie Liken, Lindsey Butler, PharmD, CSP, and Chris England 📰 Our first edition of #HealthBenefits101, diving into the importance of a #transparent PBM model and how we're leading the pack 🔎 Brian TenEyck's insights on implementation season and the importance of finding and working with a trustworthy team Dive in below!

We all know #healthcare is broken, and it takes world-class talent to fix it. Our team is dedicated to developing the technology solutions and support services that our nation needs to deliver the level of care we all deserve. Whether you're looking for a career in #Tech, #Clinical, #Finance, #Legal, #AccountManagement, we would love to hear from you. Check out our current openings here: https://okt.to/2Y4eES

As #plansponsors face skyrocketing #pharmacybenefit costs, it's more vital than ever to partner with a #PBM that prioritizes member-centric care at a cost-effective, clear price. In our latest #HealthBenefits101 article, we broke down three major points: 😬 Why traditional PBM models are flawed, and how misaligned incentives, a lack of transparency, and unclear drug pricing have contributed to significant issues across the healthcare ecosystem 🤔 Why partnering with a transparent PBM is so important, and how you can find one that is dedicated to your plan's success 🤩 How Capital Rx and Judi Health™ are delivering complete #transparency through a combination of next-generation #healthtechnology and business model alignment, like fully passing through all manufacturer revenue and having a clear fee structure (i.e., not making money on drug spend) Read our full article here: https://okt.to/0fihAB

As Dr. Sunil Budhrani MD MPH MBA (Chief Innovation & Medical Officer) explained during our recent webinar, the #healthcare system is broken into silos for medical, pharmacy, vision, and dental care that all operate in isolation. This disjointed approach leads to duplicate work, delays in care, and higher costs, especially for critical conditions like cancer and heart disease. It's time to bridge the gaps with a unified system - #JudiHealth™ - that is both cost effective and patient-centric.

How much better would it be if patients were able to make sure their medications matched their genes, avoiding potential side effects and other medical concerns? Through #pharmacogenomics (PGx) and clinical programs like Rx Helix, this is possible! As Sara Izadi, PharmD put it in this article from Managed Healthcare Executive: "Pharmacogenomics is transforming healthcare - and its value is driving more precise, informed prescribing, particularly in complex areas like behavioral health and inflammatory diseases where traditional ‘trial-and-error’ approaches to therapy waste time and money, ultimately impacting patient well-being. That’s why we launched Rx Helix: to give plan sponsors a streamlined, cost-effective way to integrate PGx into their benefit programs." The result? Better outcomes, reduced costs, and a truly patient-centric #healthcare system. h/t to Denise Myshko for this well-written dive into PGx and inviting Sara to give her perspective on this important topic! Read the full article here: https://okt.to/j5SO6V