UCare: Transparent Model Was ‘Table Stakes’ When Picking New PBM

In what is only the latest sign that PBM clients are growing increasingly disillusioned with the status quo, Minnesota-based insurer UCare recently chose Navitus Health Solutions, LLC as its new PBM partner — ending a relationship with The Cigna Group’s Express Scripts that had been in place since 2010.

“I think that there is a growing desire amongst employer groups and health plans to look at alternative options besides what we consider to be the big PBMs,” Patrick Mitsch, vice president of pharmacy at UCare, tells AIS Health, a division of MMIT. “There’s different value propositions that a PBM like Navitus can bring to the market that the Big Three just can’t,” he adds, referring to Express Scripts, CVS Health Group’s Caremark, and UnitedHealth Group’s Optum Rx, which control roughly 80% of the pharmacy benefits market.

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Leslie Small

Leslie Small

Leslie has been working in journalism since 2009 and reporting on the health care industry since 2014. She has covered the many ups and downs of the Affordable Care Act exchanges, the failed health insurer mega-mergers, and hundreds of other storylines spanning subjects such as Medicaid managed care, Medicare Advantage, employer-sponsored insurance, and prescription drug coverage. As the managing editor of Health Plan Weekly and Radar on Drug Benefits, she writes and edits for both publications while overseeing a small team of reporters who also focus on the managed care sector. Before joining AIS Health, she was a senior editor for the e-newsletter Fierce Health Payer, and she started her career as a copy editor at multiple local newspapers. She graduated with a dual degree in journalism and political science from Penn State University.

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