New PBM Platform, DomaniRx, Launched by SS&C, Anthem, and Humana

SS&C Technologies Holdings (SS&C), Anthem, and Humana recently entered into a joint venture, named DomaniRx, LLC, to develop a contemporary, cloud-native platform to support the operation of a full service pharmacy benefits manager. SS&C holds an 80.2% interest in the joint venture and Humana and Anthem each hold a minority interest. 

The companies have committed up to an aggregate of approximately $925,000,000 in the form of cash, property and/or services, to support the joint venture’s development project. This amount includes SS&C’s claims processing platform known as RxNova™ and an assignment to the joint venture of a services agreement SS&C has with Humana.

DomaniRx’s development work, in addition to the day-to-day management, the performance of the Humana services agreement and the provision of certain shared services, will be performed, initially, by the Company and its affiliates under subcontract with the joint venture in exchange for market-based fees. 

In addition, under the joint venture arrangements, SS&C is entitled, in exchange for the payment of market-based fees under certain circumstances, to a license back from the joint venture of any improvements made to the RxNova™ platform during the course of the development project, and each of Anthem and Humana have the right, under certain circumstances, including any failure to successfully implement the PBM Platform in accordance with an agreed timeline and certain other factors, to exit the joint venture and receive, in connection with any such exit, a license to the PBM Platform.

DomaniRx’s reimagined claims adjudication platform will leverage SS&C’s technology capabilities and reside on SS&C’s private cloud. The result will be a single cloud-native user experience with proven scalability, resiliency, and best-in-class transactional processing capabilities.

Through two business units, SS&C DST Health provides pharmacy, healthcare administration, and health outcomes optimization solutions to health plans in the commercial and government sectors, PBMs, integrated health systems, and providers. The company helps plans optimize clinical, operational and financial outcomes by integrating data, analytics, and insights with leading technology, business services and strategic advisory.

Takeaway: DomaniRx’s reimagined claims adjudication platform will leverage SS&C’s technology capabilities and reside on SS&C’s private cloud

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