Company profile: Citizens Rx
1.1 - Company Overview
Company description
- Provider of pharmacy benefit management services to public and private companies and health plans in the United States, offering claims processing and real-time adjudication, formulary and Rx network management, clinical programs (MTM, disease and utilization management, prior authorization), rebate administration, and advanced analytics, predictive modeling, ad hoc reporting and decision support tools.
Products and services
- Claim Processing: Delivers real-time online claims adjudication with secure eligibility information uploads and multiple reporting capabilities, ensuring accurate benefit application and fast transaction resolution
- Clinical Services: Develops predictive-modeling-enabled programs including Medication Therapy Management, Disease Management, Prior Authorization, and Utilization Management to manage therapies, chronic conditions, prescription approvals, and appropriate drug use
- Formulary Management: Engineers tiered arrangements and generic substitution programs to ensure cost-effective drug therapy through structured benefit tiers and systematic generic replacement
Key contacts
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Financial details
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1.2 - Competitors and similar companies to Citizens Rx
Strenuus
HQ: United States
Website
- Description: Provider of healthcare provider network analysis and data management solutions, including the Network360 platform delivering actionable network intelligence services to payer clients nationwide with features for network analysis, reporting, and data validation, and TrueDisruption, an algorithm for matching healthcare providers with automated/manual matching, data validation, and comprehensive reporting.
- Rationale: This competitor operates in a highly similar market segment with overlapping features.
- Company type: Private company
- Employees: ●●●●●
- Total funding raised: $●●●m
- Backers: ●●●●●●●●●●
- Acquisitions: ●●
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Portico Systems
HQ: United States
Website
- Description: Provider of an end-to-end modular platform for healthcare organizations to design, build and service complex provider networks, enable value-based reimbursement, and align and automate network management activities including provider enrollment, credentialing, contracting and pricing, helping reduce administrative, medical and IT costs.
- Rationale: This competitor operates in a highly similar market segment with overlapping features.
- Company type: Private company
- Employees: ●●●●●
- Total funding raised: $●●●m
- Backers: ●●●●●●●●●●
- Acquisitions: ●●
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Change Healthcare
HQ: United States
Website
- Description: Provider of healthcare technology and data and analytics-driven solutions for the U.S. healthcare system, including revenue cycle management and payment accuracy, pharmacy and pharmacy benefit solutions, healthcare data and analytics, and clinical decision support, to improve clinical, financial, administrative, and patient engagement outcomes.
- Rationale: This competitor operates in a highly similar market segment with overlapping features.
- Company type: Private company
- Employees: ●●●●●
- Total funding raised: $●●●m
- Backers: ●●●●●●●●●●
- Acquisitions: ●●
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Health Solutions Plus
HQ: United States
Website
- Description: Provider of modern payer administration software for healthcare payers, offering comprehensive solutions with flexibility and automation to support medical, dental, vision, and specialty health benefits and claims administration, plus health plan administration to streamline operations, manage membership, and enhance agility for growth.
- Rationale: This competitor operates in a highly similar market segment with overlapping features.
- Company type: Private company
- Employees: ●●●●●
- Total funding raised: $●●●m
- Backers: ●●●●●●●●●●
- Acquisitions: ●●
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Elevance Health
HQ: United States
Website
- Description: Provider of integrated whole-health solutions and insurance, including commercial plans via employers or marketplaces, Medicaid, and Medicare (including Medicare Advantage). Focuses on healthcare spending and value, transforming care by integrating behavioral, social, and physical health with technology, and conducts health policy research through its Public Policy Institute.
- Rationale: This competitor operates in a highly similar market segment with overlapping features.
- Company type: Private company
- Employees: ●●●●●
- Total funding raised: $●●●m
- Backers: ●●●●●●●●●●
- Acquisitions: ●●
View full Elevance Health company profile →
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2.M&A buyers
2.1 Potential strategic acquirers in the sector
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2.2 - Strategic buyer groups for Citizens Rx
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Buyer group 2: ████████ ████████
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Buyer group 3: ████████ ████████
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3. Investors and private equity firms
3.1 - Buyout funds investing in similar companies to Citizens Rx
2.2 - Growth funds investing in similar companies to Citizens Rx
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4 - Top valuation comps for Citizens Rx
4.2 - Public trading comparable groups for Citizens Rx
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