OptumRx to deliver lower cost, value added pharmacy services to members in Harvard Pilgrim’s and Tufts Health Plan’s service markets

(CANTON, Mass./EDEN PRAIRIE, Minn.) September 9, 2021 — Point32Health, the not-for-profit health care parent company of Harvard Pilgrim Health Care and Tufts Health Plan, today announced it has entered into a new, multi-year agreement with OptumRx to provide integrated Pharmacy Benefit Management (PBM) solutions that will enhance services and deliver improved pricing for Harvard Pilgrim and Tufts Health Plan members.

Effective January 1, 2023, OptumRx’s integrated health and wellness service model will provide pharmacy benefit offerings for Point32Health. OptumRx will support convenient and affordable access to prescription medications to Harvard Pilgrim and Tufts Health Plan members through a comprehensive retail, specialty and home delivery pharmacy network. The new agreement is expected to generate aggregate pharmacy savings for Commercial, Direct and Medicare customers of between 12%-16%* over the course of the three-year contract.

“Point32Health is committed to delivering on its promise of improving access to high-quality, affordable health care and investing in programs and services that guide our members to better health outcomes and wellness,” said Cain Hayes, CEO of Point32Health. “We are doing just that in working with OptumRx – an industry leader with an innovative focus on pharmacy care services and managing costs. We look forward to collaborating with them to ensure our members have the most competitive prescription drug benefits program available and that our Tufts Health Plan members experience a smooth transition to OptumRx.”

The new collaboration between Point32Health and OptumRx further broadens the long-term strategic relationships Harvard Pilgrim and Tufts Health Plan have had with Optum. OptumRx has been successfully serving Harvard Pilgrim members since January 1, 2020, and will work closely with Tufts Health Plan’s current pharmacy benefit partner, CVS Caremark, to ensure a smooth transition for January 1, 2023.

“We are honored to collaborate with Point32Health to provide enhanced pharmacy care services to Harvard Pilgrim and Tufts Health Plan members while reducing costs,” said Heather Cianfrocco, CEO of OptumRx. “OptumRx is committed to delivering exceptional pharmacy experiences to all members through our integrated services model. Our comprehensive retail, specialty and home delivery pharmacy network is designed to help improve access and outcomes, and lower prescription drug costs.”

Point32Health’s Pharmacy Services Department will continue to manage its prescription drug program, including decisions about which drugs are included in its formularies and the specialty pharmacy program offering.

* Actual savings will vary by account

About Point32Health

Point32Health is a leading health and wellbeing organization, delivering an ever-better health care experience to everyone in our communities. Building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

Our programs take a 360-degree view of health for our members—no matter their age, health, race, identity or income—and our Foundation and Institute work to improve population health. We use empathy to understand what’s important to those we serve, always making their priorities our own. And we work to guide and empower people by bringing together wide-ranging partners and perspectives to create new approaches that make a real difference for both our industry and our 2.3 million members across New England.

About OptumRx

OptumRx is a pharmacy care services company helping clients and more than 59 million people achieve better health outcomes and lower overall costs through innovative prescription drug benefit services, including network claims processing, clinical programs, formulary management, specialty pharmacy care and infusion services. Through expertise, flexible technology and a network of over 67,000 community pharmacies and state-of-the-art home delivery pharmacies, OptumRx is putting patients at the center of the pharmacy experience and making health care more connected and less fragmented — ensuring patients get the right medication at the right time at the best cost. OptumRx is part of Optum®, a leading information and technology-enabled health services business dedicated to making the health system work better for everyone. For more information, visit optum.com/optumrx or follow @OptumRx on Twitter.

Contact:
Phil Tracey
Philip_Tracey@harvardpilgrim.org