Centene Begins Leveraging RxAdvance’s More Transparent PBM in Mississippi

Centene Corporation is a diversified, multi-national healthcare enterprise that provides a portfolio of services to government sponsored and commercial healthcare programs, focusing on under-insured and uninsured individuals.

Centene also provides healthcare services to groups and individuals delivered through commercial health plans. Centene operates local health plans and offers a range of health insurance solutions. It also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health management, care management software, correctional healthcare services, dental benefits management, commercial programs, home-based primary care services, life and health management, vision benefits management, pharmacy benefits management, specialty pharmacy and telehealth services.

Centene’s membership at 2018 third quarter-end was 14.4 million recipients. This represents an increase of approximately 2.1 million beneficiaries over the third quarter of 2017. This growth is in part a result of the acquisition of Fidelis Care which closed effective July 1, 2018.

The Catholic Diocesan Bishops of New York State sold Fidelis Care to Centene for $3.75 billion. Centene will now have plans available in the four largest managed care states: New York, California, Florida, and Texas.

Centene recently announced that its Mississippi subsidiary, Magnolia Health, completed the implementation of a transformative pharmacy benefit management model using RxAdvance’s Collaborative PBM Cloud™ platform, covering 240,000 Mississippi Medicaid members.

As part of a successful reprocurement in October 2018, Centene entered into a new agreement to continue to provide services to Medicaid recipients in more than the Mississippi Medicaid program.

In March 2018, Centene announced a strategic partnership with RxAdvance to create its next generation pharmacy management solution. Magnolia Health is the first of Centene’s health plans to implement this new model.

Centene, since the acquisition, has provided the investment to RxAdvance to develop a more transparent version of the PBM model on a market-by-market basis through 2019. The model is built around transparency and cost sharing on total cost of care will be the focus so pharmacy cost will be integrated with the more comprehensive total medical cost.