CerpassRx
Transforming Prescription Cost Management

Self-funded health plans have long sought effective pharmacy benefit management (PBM) solutions to provide optimal options for employees. CerpassRx is leading the charge in personalization of prescription drugs with its member-centric PBM solution.

At CerpassRx, the needs of pharmacy benefits plan members are paramount, driving the company's business model and operations. Leveraging industry-leading pharmacy tools, technological expertise and clinical offerings, CerpassRx develops innovative solutions aimed at improving access and reducing prescription drug prices. This approach benefits all stakeholders battling against rising drug costs.

“We have specifically designed programs to help both members and plan sponsors save money on pharmaceuticals throughout their benefits journey,” says Greg Buscetto, CEO.

The Birth of a Boutique Pharmacy Management Partner

After working with industry giants for decades, Buscetto and his CerpassRx co-founder, Eric Yonkus, identified a gap in the market. They realized that smaller companies that self-fund their health benefits needed more personalized and flexible options, rather than a cookie-cutter approach.

Blending their expertise, Buscetto and Yonkus built CerpassRx from the ground up to address this gap. CerpassRx serves companies seeking to regain control over their pharmacy benefits. This includes selecting prescription drugs that provide good value for their employees, in turn, helping attract and retain talented staff.

Starting with just three employees and one client eight years ago, CerpassRx has grown significantly. The company now employs over 150 people and manages pharmacy benefits for about 500,000 individuals, maintaining nearly 100 percent client retention.

CerpassRx attributes much of its success to its exceptional service delivered through high-touch member experience. It maintains a commitment to not outsourcing core services. For those services that are outsourced, it ensures direct access into vendor systems through specifically designed application programming interfaces (API). This strategy benefits members through streamlined service delivery and responsive support.

A key component of its customer service is the call center, known for its high-resolution rate, rapid response times, and minimal to no hold times. Known for its compassionate and professional stance, the team handles each interaction with enthusiasm, always striving to do the right thing at the right time. Customers are treated like family, with their satisfaction a top priority.

Consistent premium service delivery is made possible by member service agents who excel within a unified cultural framework. Sharing and embodying a common organizational culture significantly enhances their capacity to provide high-quality service. Maintaining this level of high-touch customer experience requires operational efficiency. CerpassRx follows an extensive testing process for every new client before their services go live or when they request plan design changes. By rigorously testing each client's setup, potential disruptions are minimized, providing optimal access to medications.

Next Level Member-Oriented Initiatives

CerpassRx takes a unique approach to cost containment, focusing on innovative and creative solutions rather than compromising member experience or shifting costs onto members. One such initiative is Focus Prescription Benefits, a member concierge service designed for members who require high-cost drugs. CerpassRx proactively reaches out to these members, guiding them through upcoming changes in their benefits plan to help ensure seamless medication management. By preventing unnecessary auto-shipments and costly 90-day refills for high-value drugs, this service effectively controls expenses while maintaining superior member care.

This strategy has resulted in substantial cost savings. For instance, a large firm previously spending an average of $40 million annually on high-value drugs saw this expense decrease to approximately $22 million within the first six months of partnering with CerpassRx, without any change in the number of beneficiaries or prescribed drugs. Overall, clients managed under this program experienced a 4.7 percent negative drug trend from 2022 to 2023.

We have specifically designed programs to help both members and plan sponsors save money on pharmaceuticals throughout their benefits journey

CerpassRx's flexibility is key to this success. By not being tied to any specific pharmacy or dispensing method, it can create innovative solutions that best meet client needs. “The biggest reason for our company’s success over the last eight years is our ability to create innovative solutions that are agnostic to the distribution channel,” says Buscetto.

The recent acquisition by Nomi Health has further strengthened CerpassRx, positioning it within a broader ecosystem aimed at comprehensive healthcare management. Offering its grid PBM solution, CerpassRx complements Nomi's strengths in both pharmacy and medical plans. This alignment, already adopted in Michigan, Ohio, and Oklahoma, signals a promising trajectory for the company in integrated healthcare solutions.

Through a cohesive culture bolstered by advanced pharmacy tools and technology, CerpassRx empowers its members and plan sponsors to counter rising drug prices and improve medication access, solidifying its role as a trusted ally in the healthcare industry.