- The strategic investment round includes over 10 of the nation’s leading health systems and Transformation Capital
- The Health Management Academy’s Strategic Partnership Alliance and its member health systems identified Capital Rx’s mission-aligned PBM model and technology stack - JUDI® - as best-in-class
NEW YORK, October 11, 2023 /PRNewswire/ - Today, Capital Rx, the full-service pharmacy benefit manager (PBM) and pharmacy benefit administrator (PBA) advancing our nation’s healthcare infrastructure to improve drug price visibility and patient outcomes, is announcing the closing of a strategic investment round totaling over $50 million with participation from more than 10 of the leading health systems in the nation, including Atlantic Health System, Banner Health, Hawai’i Pacific Health, Inova Health System, Lehigh Valley Health Network, Memorial Hermann Health System, Nebraska Medicine, Novant Health, Ochsner Health, and WellSpan Health, among others, as well as Transformation Capital. Collectively, the health systems recognize the strategic importance of collaboration to accelerate the pace of innovation in the PBM industry, including the need to improve the affordability of drugs in the U.S. and bring transparency to drug costs.
“Capital Rx has made incredible progress with its JUDI® platform since we led the Series B funding round in late 2020,” said Jared Kesselheim, MD, Managing Partner at Transformation Capital. “They can now administer pharmacy benefit programs with unparalleled efficiency and customization across commercial, Medicare, and Medicaid plans, which makes Capital Rx an ideal strategic investment or partner for health systems who want us to serve their employees as well as the members of their provider-sponsored health plans. We are thrilled to invest further in Capital Rx alongside this luminary consortium of innovative health systems.”
“We are humbled and appreciative of the confidence our investors and partners have in our technology,” said Capital Rx Co-Founder and CEO AJ Loiacono. “Legacy infrastructure lacks operational efficiency to reduce costs or enable the delivery of a best-in-class experience for members. I’m thankful for the hundreds of colleagues who have contributed to JUDI and continue to develop new solutions to deliver superior savings and a better healthcare experience for plan sponsors, payors, and patients across the country. I’m also grateful to the team at the Health Management Academy for recognizing the opportunity to connect the leaders of so many health systems to ignite a collaboration that will continue to accelerate the pace of innovation to reduce pharmacy costs, improve patient access, and deliver better outcomes for millions of Americans.”
Health systems are coming together to improve transparency in the pharmaceutical supply chain.
The executives of the health systems involved in this funding round understand the power of knowledge exchange, collaboration, and co-investment among strong health systems. “They also recognize the need for change in the PBM industry, with a focus on aligning toward a more transparent, next-generation enterprise health platform like Capital Rx’s JUDI. The clear pricing, operational efficiencies, control over pharmacy spend, and ability to refocus resources on patient care to drive better outcomes are aligned with every health system’s core mandate,” said Health Management Academy SVP of Strategy Matt Gunther.
Capital Rx’s JUDI is the new standard for backend claims processing platforms in the PBM and PBA industry. The funds raised in this round will support R&D related to JUDI’s modules and capabilities, the growth of Capital Rx’s award-winning member and client service teams, as well as hiring in other key areas of the company.
“Inova makes strategic investments in healthcare companies that have the potential to drive meaningful transformation,” said Alice Pope, Chief Financial Officer at Inova. “Capital Rx’s ability to leverage technology to bring clarity and consistency to drug prices for its clients and to broaden access to medication for members while providing exceptional service represents a paradigm shift in the PBM industry.”
The combination of JUDI and a Single-Ledger Model™ allows Capital Rx to drive savings for plan sponsors while providing patients with the most appropriate care at the lowest available price. This offering represents a unique opportunity for the health systems, which are combining their resources and expertise to address the opacity and price volatility that has plagued the pharmaceutical supply chain – and driven costs higher for plan sponsors and patients – for over a decade.
“Novant Health strategically partners with and invests in organizations that are transforming the healthcare industry,” said Dean Swindle, Executive Vice President and President of Novant Health Enterprises. “In Capital Rx, we found a like-minded partner that is committed to the patient experience and purposeful innovation. Together, we are discovering ways to reduce pharmacy costs, improve operational efficiency, and make medication more accessible so patients can thrive.”
To learn more about Capital Rx’s pharmacy benefit administration capabilities and JUDI, please visit Capital Rx – JUDI®.
About Transformation Capital
Transformation Capital is a digital health growth equity firm dedicated to supporting commercial-stage companies focused on improving people’s health and the sustainability of the healthcare system. The firm was founded on the premise that investing in healthcare requires both a sophisticated understanding of the healthcare system, including the prevailing market forces and resulting opportunities, as well as deep connections with decision makers across key providers, payers, and digital health innovators. Transformation Capital has invested in digital health companies across the ecosystem, including Datavant, Apree Health, Capital Rx, Health Catalyst, Sword, Grow, Jeenie, and Groups.
We are Inova, Northern Virginia and the Washington, D.C. metropolitan area’s leading nonprofit healthcare provider. With expertise and compassion, we partner with our patients to help them stay healthy. We treat illness, heal injury and look at a patient’s whole health to help them flourish. Through our expansive network of hospitals, primary and specialty care practices, emergency and urgent care centers and outpatient services, Inova cares for more than one million patients annually, delivering the best clinical care and a seamless experience. Consistently ranked and recognized as a national healthcare leader in safety, quality and patient experience, Inova’s world-class care is made possible by the strength and breadth of our network, our 22,000 team members, our technology and our innovation. Inova is home to Northern Virginia’s only Level 1 Trauma Center and Level 4 Neonatal Intensive Care Unit and provides high-quality healthcare to every person in every community we are privileged to serve – regardless of ability to pay – every day of their life. More information about Inova can be found at www.inova.org.
About Novant Health
Novant Health is an integrated network of hospitals, physician clinics, and outpatient facilities that delivers a seamless and convenient healthcare experience to communities in North Carolina and South Carolina. The Novant Health network consists of more than 1,900 physicians and over 36,000 team members who provide care at more than 800 locations, including 16 hospitals and hundreds of outpatient facilities and physician clinics. In 2022, Novant Health provided more than $1.5 billion in community benefit, including financial assistance and services.
About The Health Management Academy
Since 1998, The Health Management Academy has cultivated the premier community of healthcare's most influential changemakers from the top U.S. health systems and innovative industry partners. We power more than 2,000 health system senior executives and 200 industry organizations through exceptional peer groups, original market insights, world-class leadership development programs, and novel member alliances. Our industry-leading programs and solutions enable members to facilitate meaningful relationships, navigate strategic transformation and address critical industry issues. To learn more, visit hmacademy.com and follow The Health Management Academy on LinkedIn.
About The Health Management Academy’s Strategic Partnership Alliance (SPA)
The Strategic Partnership Alliance, an arm of The Health Management Academy (THMA), explores new venture and partnership opportunities on behalf of a group of THMA member health systems.
About Capital Rx
Capital Rx is a healthcare technology company changing the way prescription drugs are priced and patients are cared for in America. As a Certified B Corp™, Capital Rx is executing its mission through an efficient Single-Ledger Model™ that increases visibility and reduces variability in drug prices. The company’s cloud-native enterprise health platform, JUDI®, connects every aspect of the pharmacy ecosystem, servicing over 2.4 million members for Medicare, Medicaid, and commercial plans. Together with its clients, Capital Rx is reimagining the administration of pharmacy benefits and rebuilding trust in healthcare. To learn more, visit capitalrx.com.
Michael Passanante, Senior Vice President, Marketing & Communications
Justin Venneri, Director, Communications