Top 24 Massachusetts Pharmacy Benefit Management Companies
Top 24 Massachusetts Pharmacy Benefit Management Companies
Pharmacy Benefit Management (PBM) companies play a crucial role in the healthcare system, by managing prescription drug programs for health insurance companies and Medicare Part D plans. They serve as an intermediary between health plans, drug manufacturers, and pharmacies to negotiate drug prices, process claims and provide patient care services. As more and more emphasis is placed on personalized and efficient healthcare, the PBM industry in Massachusetts is growing at a steady pace. This article delves into Massachusetts' prominent PBMs, exploring their services, technologies, and their contributions to the healthcare landscape.
Top 24 pharmacy benefit management companies in Massachusetts
1. RxSense
- Website: rxsense.com
- Headquarters: Boston, Massachusetts, United States
- Founded: 2015
- Headcount: 201-500
- Latest funding type: Private Equity
RxSense is a pharmacy benefits management company that offers a cloud-based analytics platform for real-time claims adjudication. With a client-centered approach, they provide transparent intelligence and superior support. Their advanced technology platform ensures speed-to-market and flexible interoperability. RxSense empowers businesses to define their own pharmacy ecosystem, with cost-effective pre-contracted partners and vendors. They prioritize transparency, control, and flexibility in pharmacy benefits management.
2. RxAdvance
- Website: rxadvance.com
- Headquarters: Southborough, Massachusetts, United States
- Founded: 2013
- Headcount: 51-200
RxAdvance is a healthcare company offering innovative platforms and services to provide pharmacy benefit management and payer solutions. They aim to significantly reduce costs, improve member care, and empower consumers to manage their health in collaboration with care providers.
3. nirvanaHealth | RxAdvance
- Website: nirvanahealth.com
- Headquarters: Southborough, Massachusetts, United States
- Founded: 2013
- Headcount: 51-200
- Latest funding type: Series Unknown
Nirvana Health is a pioneering company in the healthcare industry, specializing in integrated Payer & PBM platform solutions. They automate core transactions, optimize financial outcomes, and provide actionable intelligence to all stakeholders. With their expertise in healthcare automation, robotic process automation (RPA), machine learning (ML), and artificial intelligence (AI), they deliver high-quality and cost-effective solutions.
4. Class Insurance Consulting
- Website: classins.com
- Headquarters: Boston, Massachusetts, United States
- Founded: 2009
- Headcount: 11-50
Classins is a benefit advisory firm that helps employers identify the best healthcare options for their employees, lowering costs and improving outcomes. They offer strategies to improve healthcare access and identify high quality providers and services. They also help carriers improve their products and services to remain competitive.
5. Cogito Corp
- Website: cogitocorp.com
- Headquarters: Boston, Massachusetts, United States
- Founded: 2007
- Headcount: 201-500
- Latest funding type: Debt Financing
Cogito Corp is a company that specializes in transforming the service experience with AI coaching. They provide retail contact center AI solutions and personalized guidance for customer service. They have expertise in industries such as pharmacy benefits managers, telecom and technology, insurance, and travel and hospitality.
6. Integrated Pharmacy Solutions Inc
- Website: integratedrx.net
- Headquarters: Melrose, Massachusetts, United States
- Founded: 1992
- Headcount: 11-50
Integrated Pharmacy Solutions is a pharmacy consulting group that offers pharmacy management services, auditing services, data management, legislative and regulatory affairs, and patient services. They provide comprehensive solutions to optimize pharmacy operations and data management.
7. Tufts Health Plan
- Website: tuftshealthplan.com
- Headquarters: Canton, Massachusetts, United States
- Founded: 1979
- Headcount: 1001-5000
Tufts Health Plan is a health insurance company that offers a variety of health insurance plans and benefits. They provide coverage for individuals, employers, and Medicaid recipients, with a focus on quality care and diversity and inclusion.
8. AllWays Health Partners
- Website: allwayshealthpartners.org
- Headquarters: Somerville, Massachusetts, United States
- Founded: 1986
- Headcount: 201-500
AllWays Health Partners is a healthcare company that offers health insurance plans and services. They provide benefits for pharmacy, mental health care, and care management. Their website offers resources for members and information on COVID-19. They also offer plans for businesses and Medicare Advantage plans.
9. Risk Strategies Company
- Website: risk-strategies.com
- Headquarters: Boston, Massachusetts, United States
- Founded: 1997
- Headcount: 1001-5000
- Latest funding type: Acquired
Risk Strategies is a company that specializes in providing risk management and insurance solutions to businesses in various industries. They offer expertise in areas such as commercial insurance, employee benefits, consulting services, and private client services.
10. Health Plans, Inc.
- Website: hpitpa.com
- Headquarters: Westborough, Massachusetts, United States
- Founded: 1981
- Headcount: 201-500
Health Plans, Inc. (HPI) is a Harvard Pilgrim company that specializes in providing health plan designs and benefit administration solutions. With over 40 years of experience, HPI offers innovative solutions tailored to the needs of employers and benefits brokers nationwide. They offer various health plan designs, including consumer-driven health plans (CDHP) and level-funded health plans, and provide services such as network relationships and population health management.
11. Injured Workers Pharmacy
- Website: iwpharmacy.com
- Headquarters: Andover, Massachusetts, United States
- Founded: 2001
- Headcount: 201-500
- Latest funding type: Acquired
Injured Workers Pharmacy (IWP) is a provider of workers’ compensation medications. They advocate for injured workers and deliver prescriptions conveniently to their homes. IWP streamlines the prescription process, offering next-day home delivery, no upfront costs, and a friendly, multilingual team.
12. NFP Health
- Website: nfphealth.com
- Headquarters: Braintree, Massachusetts, United States
- Founded: 1969
- Headcount: 51-200
nfphealth.com offers affordable health insurance plans for individuals, families, and small businesses. Customers can easily compare plans, enroll online, and get live support.
13. Baystate Benefit Services, Inc.
- Website: baystatebenefits.com
- Headquarters: Braintree, Massachusetts, United States
- Founded: 1990
- Headcount: 11-50
Baystate Benefit Services, Inc. is a company that specializes in reimagining employee benefits. They offer unparalleled service and support for all of their clients' benefit needs. With a proactive approach and innovative tools such as Benefit Communication, Employer Benefits Portal, and Employee Navigator, Baystate Benefit Services helps employers effectively manage their benefits.
14. Benemax, Inc.
- Website: benemax.com
- Headquarters: Medfield, Massachusetts, United States
- Founded: 1982
- Headcount: 11-50
Benemax is a company that offers comprehensive and tailored benefits solutions to businesses. They provide a range of services including employee benefits administration, wellness programs, and compliance support.
15. Commonwealth Payroll & HR
- Website: commpayhr.com
- Headquarters: Marblehead, Massachusetts, United States
- Founded: 2006
- Headcount: 11-50
Commonwealth Payroll & HR offers payroll processing services, employment tax management, and HR solutions to companies. Their Core service provides payroll processing and compliance tools. The Emerging with Time service combines HR, employee self-service, compliance, payroll, and time management. The HR & Benefits service includes HR functionality and tools for benefit management. The Premium service offers a full range of tools for the employee journey.
16. Teamsters Union Local 25 Health Services & Insurance Plan
- Website: teamsterscare.com
- Headquarters: Charlestown, Massachusetts, United States
- Headcount: 51-200
TeamstersCare is a health services and insurance plan that offers a range of benefits to Teamsters Union members and their families, including prescription drug coverage, clinical services, dental and vision programs, and wellness programs.
17. Captivated Health
- Website: captivatedhealth.com
- Headquarters: Methuen, Massachusetts, United States
- Founded: 2014
- Headcount: 51-200
Captivated Health is a company that provides employers with captive health plans, which are controlled and owned by multiple employers. Their primary purpose is to insure the risks of multiple employers who benefit from being able to own and control their plan, gain access to all their plan data to help make intelligent and meaningful plan design changes, and come together to share best practices, govern their plans and mutually decide on the future direction of their plans.
18. CIP Group
- Website: askcip.com
- Headquarters: Cambridge, Massachusetts, United States
- Founded: 1988
- Headcount: 11-50
- Latest funding type: Undisclosed
The CIP Group is an employee benefits broker that provides personalized service and helps companies navigate the complexities of benefits administration. They offer HR services, build and optimize benefits plans, and ensure plan compliance. Their team works closely with clients to minimize stressors and find cost-effective solutions. They also provide managed payroll solutions and background checks.
19. Genesis HR Solutions, Inc.
- Website: genesishrsolutions.com
- Headquarters: Burlington, Massachusetts, United States
- Founded: 1991
- Headcount: 11-50
GenesisHR Solutions is a professional HR consulting firm that offers comprehensive HR, benefits, payroll, and compliance services to businesses of all sizes. With over 30 years of experience, they provide strategic guidance and support to help companies navigate complex HR challenges and ensure compliance with ever-changing laws and regulations.
20. UltraBenefits, Inc.
- Website: ultrabenefits.com
- Headquarters: Worcester, Massachusetts, United States
- Founded: 2000
- Headcount: 11-50
UltraBenefits is an Employee Benefits Administration company focused on delivering cost-effective employee benefit solutions. Our purpose is to provide employers with innovative solutions in managing their employee benefit plan costs and exceed their expectations for customer service.
21. Neuro-psychology Associates of Western Massachusetts
- Website: cns-neuro.com
- Headquarters: Springfield, Massachusetts, United States
- Headcount: 11-50
CNS-Neuro provides innovative solutions for healthcare organizations to improve patient outcomes and quality of life. They specialize in benefits management, adapting quickly to cost containment initiatives from primary payors, and offering pharmaceuticals for efficient and cost-effective care.
22. AdaptiveHR
- Website: adaptivehr.net
- Headquarters: Boston, Massachusetts, United States
- Headcount: 11-50
AdaptiveHR offers comprehensive human resources and employee benefits solutions for cannabis companies, utilizing robust technology and industry expertise to minimize risks and ensure compliance with state and federal regulations.
23. Labor Cost Control
- Website: laborcostcontrol.net
- Headquarters: Worcester, Massachusetts, United States
- Headcount: 11-50
Labor Cost Control is a company that specializes in providing solutions to reduce labor costs for businesses.
24. Bickling Financial Services
- Website: bickling.com
- Headquarters: Lexington, Massachusetts, United States
- Founded: 1984
- Headcount: 11-50
- Latest funding type: Corporate Round
Bickling Financial Services is a financial advisory firm providing personalized financial planning services and investment advice to businesses and individuals.
Want to find more pharmacy benefit management companies?
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