Alternative pharmacy benefit manager and administrator Capital Rx is acquiring Amino Health, a care navigation company.
The acquisition, the company said, will allow CapitalRx to offer a better member-facing experience to complement its unified claims platform on the back end.
Capital Rx serves 4 million members through its PBM business, which Capital Rx CEO AJ Loiacono says is more ethical than competitors because the company doesn’t make money from drug spend as an administrator.
The company has licensed its Judi (short for adjudication) business for the last three years to large health plans and third-party administrators to help with prescription claims processing—and now, with the Amino acquisition, care navigation. About 30 health plans use Judi technology, and Capital Rx contracts with an additional 19 Blue Cross plans.
“One of the things that we expanded into at the end of last year was medical claim processing, or just one system to process medical and pharmacy claims on the same platform,” said Loiacono in an interview with Fierce Healthcare. “But what we realized is we were lacking a front-end navigation.”
Amino Health CEO John Asalone positions the company as helping large, self-insured employers (often Fortune 100 companies) lower their costs through a sleek interface helping members search for top-rated providers, view integrated cost estimates, uncover prescription drug savings and book appointments easily. This allows members to not only search by medical provider or procedure but also search for drugs like GLP-1s.
Asalone felt Amino Health, a company that started as a consumer-focused business, was a perfect fit for both parties. He preferred Capital Rx’s model over other bids he received for the company. Financial terms of the acquisition were not disclosed.
“The biggest gaps we have are getting access to data, medical claims, pharmacy claims to more members,” he said. “The technology is infinitely scalable but those two blockers kept us from hitting our scale.
Now, members should be able to see all benefits and savings opportunities in one easy-to-use tool.
As part of the acquisition, Asalone will join Capital Rx as executive vice president of Judi Care, the care navigation division. He was previously at GoodRx as general manager and senior vice president of telehealth.
The two executives believe Capital Rx is better positioned to compete with Transcarent, a digital health company, and similar platforms. Transcarent recently absorbed health benefits platform Accolade in a $621 million deal.
“Because we control the administrative workflows, there’s no gap,” he explained. “There’s no waiting for data. You suddenly have a hyper-accurate platform; we call it a single source of truth because all of the workflows are operating on the same system.”
The company is looking to hire, pointing to hundreds of job openings across the Capital Rx division.
“The benefit platform wars have begun,” said Asalone. “We’ve seen consolidation happen in the industry. Employers and customers are telling us, ‘please give me a one-stop shop.'"