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MedImpact

The PBM that puts clients and members first.

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Overview

MedImpact is a large, independent PBM that provides services to health plans, hospitals, and government entities. The company prides itself on a transparent, pass-through business model, which it claims better aligns its interests with those of its clients. They offer a full range of PBM services, including formulary management, clinical programs, and claims processing, without owning their own mail-order or specialty pharmacies.

✨ Key Features

  • Formulary Management
  • Transparent, Pass-Through Pricing Model
  • Clinical and Cost-Management Programs
  • Government Program Expertise (Medicaid, Medicare)
  • Claims Adjudication
  • Pharmacy Network Management

🎯 Key Differentiators

  • Independence from health plans and pharmacies, allowing for unbiased decision-making.
  • Focus on a pass-through pricing model and transparency.
  • Strong emphasis on clinical management to control drug trend.

Unique Value: Provides an independent and transparent PBM solution focused on clinical excellence and cost containment, free from the conflicts of interest associated with PBMs owned by insurers or pharmacies.

🎯 Use Cases (3)

Providing PBM services for self-funded employers, managed care organizations, and government health programs. Implementing formulary and utilization management strategies to control drug spend. Auditing and managing pharmacy network performance.

✅ Best For

  • Serving as the PBM for over 55 million members.

💡 Check With Vendor

Verify these considerations match your specific requirements:

  • Clients seeking a PBM that is vertically integrated with its own large-scale mail and specialty pharmacies.

🏆 Alternatives

CVS Caremark Express Scripts OptumRx Navitus Health Solutions

Offers greater transparency and a business model solely focused on the client's best interest, unlike vertically integrated competitors.

💻 Platforms

Web API

🔌 Integrations

Integrates with client health plan systems and pharmacy networks.

🛟 Support Options

  • ✓ Email Support
  • ✓ Phone Support
  • ✓ Dedicated Support (Client tier)

🔒 Compliance & Security

✓ SOC 2 ✓ HIPAA ✓ BAA Available ✓ SSO ✓ URAC ✓ NCQA

💰 Pricing

Contact for pricing

Free tier: NA

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