Humana/Anthem PBM Venture Could Attract More Blues Plans

Humana Inc. and Anthem, Inc. are teaming up with hedge fund administrator SS&C Technologies Holdings, Inc. to create DomaniRx, a new joint venture that aims to offer a “best-in-class” PBM cloud-based claims adjudication platform. Humana will be the first customer for DomaniRx, the companies say, and industry observers predict a potential market among Blues plans and Medicare Advantage plans.

The “second generation” claims adjudication platform will leverage SS&C’s technology capabilities and will reside on SS&C’s private cloud, according to the company.

SS&C already has a suite of pharmaceutical management services available, including formulary and rebate management, drug utilization management, specialty drug management, real-time benefit information at the point of care, and pharmacy network optimization.

Ashraf Shehata, national sector leader for health care and life sciences at KPMG, says the partnership between SS&C, Anthem and Humana is “a pretty bold move that I call ‘leading with tech,’” which he says ultimately could result in potent new patient-facing and pharmacy tools to manage drug benefits.

© 2022 MMIT
Freelance Reporter

Freelance Reporter Freelance Reporter

Related Posts

workers-prepping-infusion-drug
May 12

Major PBMs Look Ahead to 2023 for Biosimilars Boom

READ MORE
wall-street-sign
May 12

Centene Plans to Sell Magellan Rx, PANTHERx Rare for $2.8 Billion

READ MORE
pills-and-dollars
May 12

Study: With High Prices, Rebate Revenue Is Growing for PBMs

READ MORE

GAIN THERAPEUTIC AREA-SPECIFIC INTEL TO DRIVE ACCESS FOR YOUR BRAND

Sign up for publications to get unmatched business intelligence delivered to your inbox.

subscribe today