Escalating healthcare costs have created the need for quality improvement in healthcare. Value-based care has made it more important for healthcare organizations to focus on improving patient outcomes. Technology is an important tool that contributes to improving patient’s safety by reducing medication errors and increasing efficiency. EmsanaRx accomplishes this mission of improving healthcare outcomes by bringing total clarity to business practices, leading with clinical approaches, and utilizing state-of-the-art technology. Greg Baker, co-founder and CEO of EmsanaRx, was with the CEOViews team to share details about how they are bringing a needed change.

Inception and Mission

EmsanaRx was founded with the mission to improve healthcare outcomes by bringing clarity, integrity and trust to pharmacy benefit management. Tired of grappling with the rising costs and poor quality of health care, a group of pharmacy benefit experts decided to take things into their own hands and established a company that designs healthcare products to meet its members’ needs EmsanaRx, led by Greg Baker. ‘Emsana’ is a combination of the word ‘em’ for ‘employer/employee’ and the word ‘Sana,’ which means health in Sanskrit and simple/straightforward in Arabic.

The mission is to bring total clarity to business practices, leading with a clinical approach and utilizing flexible, state-of-the-art technology. EmsanaRx chose the public benefit corporation, or PBC, designation to align with their mission of generating social and the public good, along with operating in a responsible and sustainable manner.

The company is aligned with its clients and is deeply committed to delivering on its mission to operate in the best interest of its members/patients and clients.

PBM Solutions

EmsanaRx, PBC is a full-service PBM, providing exceptional pharmacy benefit solutions to self-funded employers. They offer clinical programs, in alignment with their Cleve- land Clinic partnership, and also provide the lowest cost generic medications from the Mark Cuban Cost Plus Drug Company through their EmsanaRx Plus product.

EmsanaRx is a fundamentally different PBM providing high-touch, white-glove service for each clients’ employee/member population, so they can focus on their own business and not have to spend time taking care of PBM problems.

Em|Rx Technology

Outdated, twentieth-century technology produces outdated, ineffective results. At EmsanaRx, the team knows they cannot design innovative, customizable, best-in-class pharmacy benefits using cost-prohibitive, antiquated technology. That is why they chose a technology solution that is hyper-flexible, customizable, and totally state-of-the-art. They meet twenty-first-century challenges with modern technology that is health outcome-focused.

Differentiating Factors

EmsanaRx is a PBC (Public Benefit Corporation) committed to a social mission and community considerations. It is created by employers, for employers and puts patients over profits. Health care is local and personal and EmsanaRx understands the complexities of the pharmaceutical industry. Members receive individual support for all their needs to mitigate script abandonment and decrease medical and emergency care costs due to non-compliance and adherence. EmsanaRx brings a personalized care and compassionate navigation model to the community and works from within that community.

‘Patients over Profits’ is the business motto for EmsanaRx. They deliver true cost control measures and reimbursement not predicated on shell games or bait and switch tactics no hidden charges or financial withholds. To reiterate, they do not retain rebates, or bill any extra fees. Care remains at the forefront of everything they do and in addition to translating to greater health and well-being, this approach mitigates medical costs resulting from denied medications in the traditional PBM model.

The company is aligned with its clients and is deeply committed to delivering on its mission to operate in the best interest of its members/patients and clients. Along with that, the intuitive, hyperflexible technology and intelligent care-driven platform make EmsanaRx uniquely different.

Client Testimonial

To further illustrate the efficiency of EmsanaRx’s PBM solution is an instance where one of their clients, a regional medical center, spent a significant amount of their funds on their pharmacy benefits budget and was facing bankruptcy. They sought assistance to drive better decision-making to escape their dire financial situation. EmsanaRx handled the case in a white-glove service approach and allocated Patient Care Advocates (PCAs) in the process to ensure analysis of each member’s situation individually. Following this, it replaced any high-cost drug with a similar low-cost variant while consulting with doctors and pharmacies in every decision to ascertain there was no member disruption. Over the course of 6 months, using state-of-the-art technologies and dedicated PCAs supervising every prescription request, EmsanaRx was able to significantly reduce the client’s pharmacy program costs – by 62.6 percent!

Workforce focused on positive change

Greg’s passion is focused on changing the PBM industry for the better. He has brought together a group of employees/staff and has led them, as a team, to develop substantial positive change. All new employees are partnered with a mentor outside of their department to build greater connections and knowledge within the company.

Greg has made it a strategic priority to host quarterly all-staff meetings in person. This allows each employee to feel engaged and share their passions with the organization. They can exhibit their leadership skills as they also have the opportunity to lead the team in the service project. Greg structures his time in a way that allows for mentoring programs not only within EmsanaRx, but also with Pharmacy college students. He has a people-focused approach in both his business relationships and internal philosophies regarding employees.

What’s Ahead

EmsanaRx has taken the industry by storm with innovative solutions. Speaking about their future vision Greg said, “Our vision is a clinically focused, patient-centric pharmacy benefit industry. As we disrupt the status quo in the traditional PBM industry, we look to nudge all PBM providers to change for the betterment of health care. We believe that the most important focus is on ethically providing pharmacy benefits to self-funded employers and their employee members. Americans deserve a better solution.”

EmsanaRx brings a personalized care and compassionate navigation model to the community and works from within that community.

The PBM market is projected to grow to $740.05 billion globally by 2029 as per a Fortune Business Insights report. All health insurers, employers, companies, and other payers will need PBMs to help in the cost management of pharmacy costs more than ever. EmsanaRx envisions reshaping the PBM industry with a clinically-led working model of total transparency, clarity, and ease. The company intends to continually build and improve PBM channels for their clients to provide better and more.