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Point32Health Selects OptumRx for PBM Services


Point32Health is the name of the not-for-profit health care organization formed by the merger of Harvard Pilgrim Health Care and Tufts Health Plan.

Point32Health, the not-for-profit health care parent company of Harvard Pilgrim Health Care and Tufts Health Plan, has entered into a new, multi-year agreement with OptumRx to provide integrated PBM solutions beginning January 1, 2023,

OptumRx officials said the new agreement is expected to generate aggregate pharmacy savings for commercial, direct and medicare customers of between 12% and 16% over the course of the three-year contract.

OptumRx has served Harvard Pilgrim members since January 1, 2020, and will work closely with Tufts Health Plan's current pharmacy benefit partner, CVS Caremark, to ensure a smooth transition.

Cain Hayes

Cain Hayes

“We look forward to collaborating with [OptumRx] to ensure our members have the most competitive prescription drug benefits program available and that our Tufts Health Plan members experience a smooth transition to OptumRx,” Cain Hayes, CEO of Point32Health, said in a statement.

Point32Health’s pharmacy services department will continue to manage its prescription drug program, including decisions about which drugs are included in its formularies and the specialty pharmacy program offering.

Point32Health provides health care to 2.3 million members across New England. Harvard Pilgrim Health Care and Tufts Health Plan combined their organizations January 1, 2021. At the time, company officials indicated they could save more than $100 million through administrative synergies, which they said would be used to mitigate premium increases and member out-of-pocket burden.

The Point32Health name is inspired by the 32 points on a compass

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