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As of 2023, PBMs managed pharmacy benefits for 275 million Americans and the three largest PBMs in the US, CVS Caremark, Cigna Express Scripts, and UnitedHealth Group’s Optum Rx, make up about 80% of the market share covering about 270 million people [4] [5] with a market of almost $600 billion in 2024. [6]
Optum was formed as a subsidiary of UnitedHealth Group in 2011 by merging UnitedHealth Group’s existing pharmacy and care delivery services into the single Optum brand, comprising three main businesses: OptumHealth, OptumInsight and OptumRx. [2] In 2017, Optum accounted for 44 percent of UnitedHealth Group's profits. [3]
Formed in 2011, Optum says that it provides "data and analytics, pharmacy care services, population health, healthcare delivery, and healthcare operations". [78] It is organized into three businesses: OptumHealth – provides primary and secondary care. [78] [79] OptumInsight – provides data analytics, technology, and operations services. [78]
Catamaran Corporation (formerly SXC Health Solutions) is the former name of a company that now operates within UnitedHealth Group's OptumRX division (since July 2015). It sells pharmacy benefit management and medical record keeping services to businesses in the United States [3] and to a broad client portfolio, including health plans and employers. [4]
North American Medical Management (NAMM) develops and manages provider networks, offering a full range of services to assist physicians and other providers in their managed care and business operations.
Logo. CalOptima is a publicly funded health insurance plan for low-income citizens for Orange County, CA.With an annual budget of US$4 billion serving 940,000 members as of July 2022, [1] it is also the single largest county organized health insurer in the state. [2]
SCAN Health Plan (SCAN) is a not-for-profit, Medicare Advantage based in Long Beach, California. Founded in 1977, SCAN provides healthcare coverage to Medicare beneficiaries in California, Arizona, Texas and Nevada, serving more than 285,000 members. It is one of the largest not-for-profit Medicare Advantage plans in the country. [2]
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