Our Solutions
ELMCRx has curated a comprehensive suite of PBM point solutions tailored to manage pharmacy costs, enhance the value of pharmacy benefits, and bring clarity to benefit contract performance.
PBM & Clinical Management Solutions
Delivers High Cost Rx Savings Across the Health Plan & Improves Rx Adherence
ELMCRx optimizes patient outcomes by managing high-cost medications through our specialty and non-specialty drug programs, with a strong focus on GLP-1 treatments for diabetes and obesity. Our programs adhere to prior authorization guidelines and incorporate biosimilars and therapeutic alternative strategies to control costs.
We Provide Real-Time Auditing and Full Management of High-Cost Medications
Specialty Drug Oversight
Protects health plans from high-cost claims with rigorous prior authorization and clinical oversight for specialty therapies.
Non-Specialty Cost Containment
Controls medication expenses by improving adherence, suggesting therapeutic alternatives, and reducing health expenditures.
GLP-1 and Weight Management Programs
Leverages step therapy, biannual medication reviews, and FDA guidelines to control costs tied to GLP-1 treatments while improving results.
Clinical Services
Our in-house clinical team evaluates the effectiveness of high-cost medications and infusion therapies and manages their use to enhance patient outcomes and deliver savings.
Forecast CGT risks before
they impact the plan.
Navigate pharmacy cost
and complexity with clarity
and confidence.
Access lower costs with a
fully transparent Rx marketplace.
PBA Design & Support
Seamlessly Design and Manage PBA Programs
Capital Rx’s JUDI® platform gives TPAs and Captives the tools to build successful programs for their clients by eliminating overly complex pricing, limited cost control options, and bringing transparency.
Capital Rx’s JUDI® Platform Integration
ELMCRx partners with Capital Rx to advance our pharmacy benefits management capabilities through the integration of JUDI®, delivering customizable and scalable solutions.
Modular Design
Supports diverse pricing structures and program customizations.
Real-Time Operations
Ensures efficient management with instant processing capabilities.
Data Analytics
Provides deep insights with comprehensive reporting tools.
API Connectivity
Offers seamless integration with existing systems for enhanced interoperability.
Payment Integrity & Claims Monitoring Solutions
Enhance Member Support
Our Payment Integrity solutions are built on years of auditing experience and advanced analytics. Our program scrutinizes claims in search of missed savings opportunities, helping plans meet their fiduciary obligations by identifying areas for improved performance and tracking how funds are spent.
Robust Auditing Processes and Analytics Support Continuous Performance Improvement and Drive Cost Containment
Rx Decision Support Services
We provide data-driven insights with real-time claims audits and continuous PBM monitoring, ensuring claims are thoroughly reviewed for accuracy and cost control to optimize plan performance and ensure cost containment.
How Can ELMCRx Help?
Connect with our team to explore how our comprehensive toolkit of PBM solutions can adapt to your evolving needs and deliver substantial pharmacy benefits value.