Who We Serve

Yes, there is one best solution. But it may be different for different clients. CastiaRx understands the nuances across healthcare payers and delivers solutions tailored to meet your needs.

Employers

We help you stay ahead of challenging industry trends.

You want employees who take care of their health. But rising specialty costs driven by costly, not necessarily novel new therapies, increasing rates of diabetes, opioid addiction and other health challenges don’t make it easy. At CastiaRx, we help you understand your current and future cost drivers and give you the programs, tools and guidance to stay ahead of these challenging industry trends.

With CastiaRx, you get a partner that anticipates market trends and develops innovative solutions. From clinical programs that educate members and help ensure they get the right drug at the best price, to innovative programs like our Specialty Additional Value program, to intuitive member tools, CastiaRx drives higher levels of member health and satisfaction.

Medicare Part D

We help you maneuver in this highly regulated environment.

Medicare Part D is a challenging landscape of regulatory requirements that demands specialized pharmacy expertise. Star ratings help beneficiaries compare service and quality across plans and create a heightened need for impactful clinical programs that result in higher ratings and higher levels of beneficiary health. CMS expects an ongoing focus on reducing cost and waste while consistently raising the bar for improved quality and coordination of care.

CastiaRx has provided delegated, actuarial assistance and contract services to Medicare Part D plan sponsors since 2006. Driven by an in-house clinical team and an agile claims system, we build custom solutions for clients. Our services include comprehensive support for audit protocols and we also support periodic risk assessment and mitigation processes. Our expertise spans Prescription Drug Plans (PDP), Medicare Advantage-Prescription Drug Plans (MA-PD), Employer Group Waiver Plans (EGWP) and Retiree Drug Subsidy (RDS). Our services include:

• Star Ratings support and maximization program
• Medication Therapy Management (MTM)
• 24/7/365 beneficiary support – owned and operated by CastiaRx
• Reporting and filing information to comply with CMS guidelines
• Custom formulary development and compliance assurance

Regional Health Plans

We get to know your situation, your membership and recommend ways to optimize your plan.

Health plans need to leverage the power of medication therapy to manage chronic disease and reduce total medical costs. You need a partner that can scale and adapt quickly as your needs change and the industry evolves. Regional plans have the opportunity to differentiate and grow their business by offering leading edge tools and technology to engage members in managing their health.

With the expertise CastiaRx brings from serving payers across private and public markets, health plans get the flexibility and support they need to adapt and succeed in today’s dynamic market. Our favorable discounts and impactful clinical programs help enable competitive premiums and new business wins. Member-friendly tools and services make it intuitive for members to make smart and informed decisions about medication therapy.

TPAs

We help you grow your business.

Wouldn’t it be great if you had a PBM partner that helped you grow your business? With CastiaRx you do. We make it easy to share pharmacy data to help you evaluate the cost drivers of your clients and find opportunities for case management intervention. We give you detailed analytics—through robust online tools, quarterly reports and annual strategy sessions—to evaluate client plan performance and help you develop new strategies for emerging trends. We’ll collaborate with you as we look to pilot new programs to increase savings and achieve better health outcomes.

With CastiaRx, you’ll get the account management, clinical and analytic support to take charge of pharmacy costs and differentiate the level of service you can offer your clients. And you’ll get innovative programs that help you stay steps ahead.

Unions

We understand the challenges you face.

You want to offer a comprehensive pharmacy benefit that helps your participants maintain and improve their health. At the same time, you want to make sure you are taking advantage of opportunities to save money on your pharmacy costs. And let’s not forget that you want your members to receive great service that makes it easy for them and takes special care to meet their needs.

With CastiaRx, these priorities are all within reach. We offer the flexibility with our formulary, our pharmacy network and our clinical programs, to ensure the pharmacy benefits you put in place work for you—and your participants. And we back it up with detailed analytics to show you exactly how you’re doing.

Workers' Compensation

We put injured workers on the fastest, most appropriate road to recovery.

You are looking for partners that understand the jurisdictional nuances and can help navigate state requirements and ensure compliance. Layer in the challenges of effective pain management amid the ongoing misuse, abuse and inappropriate prescribing of opioids and the workers’ compensation environment becomes even more complex.

CastiaRx starts with a specialized formulary for workers’ compensation providers, which can be tailored to address acute and chronic pain, or even specific injuries, while offering coverage only for medications commonly prescribed in occupational injury cases. At the point of injury, we can issue a card preloaded with cost controls. The CastiaRx clinician-managed programs promote appropriate drug utilization and help prevent fraud, waste, and abuse that may be associated with on-the-job injuries.

Brokers & Consultants

We help you solve your clients’ priorities.

Your clients count on you to guide them to high quality partners that bring the specialized expertise to deliver great value and service. And as pharmacy costs rise and consume a greater portion of the healthcare dollar, choosing the right PBM partner has never been more important. CastiaRx understands the critical role you play in health benefits and we align closely with you to offer the flexibility, financial results and exceptional service that you want your clients to receive.

The nuances of pharmacy benefits are complex. CastiaRx clinical pharmacists and analytic experts offer the insights and guidance to help you make the best recommendations for your clients. Working together, we can help your clients understand their pharmacy trends and deploy strategies to meet their cost management and employee wellness goals.

Interested in learning more?

We’re ready when you are! Give us a call and we’d be glad to schedule a time to discuss your needs and how we can help you achieve your goals. Or send an email to request the information you need.

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