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Medicaid insurer AmeriHealth Caritas is closing its PerformRx PBM at the end of this year

AmeriHealth Caritas, whose parent company also owns Independence Blue Cross, said it will hire UnitedHealth Group’s OptumRx for pharmacy benefit management services.

AmeriHealth Caritas, one of the nation’s largest Medicaid insurers, is closing its in-house pharmacy benefits manager, PerformRx, by the end of this year, the Newtown Square company said in an announcement to employees Wednesday.

Health insurers effectively subcontract with pharmacy benefit managers to oversee drug benefits. They have become increasingly powerful cogs in healthcare and face new restrictions under a law signed by President Donald Trump this month.

OptumRx, a unit of UnitedHealth Group Inc. and one of the three largest PBMs, is scheduled to take over for PerformRx on Jan. 1. OptumRx already provides PBM services to the majority owner of AmeriHealth Caritas, Independence Health Group. Independence is best known for its Independence Blue Cross business.

“This decision reflects evolving market and regulatory landscape, not the performance or dedication of our PerformRx leadership or associates,” the AmeriHealth Caritas announcement to staff said.

Caritas said in a statement to The Inquirer that it expected a “limited impact on jobs, with many functions remaining in-house to support the same high-quality experience for members and providers.”

The company did not elaborate on the market and regulatory changes that precipitated the decision to close PerformRx, which Caritas formed in 1999. PerformRx has contracts in 13 states, including Pennsylvania and Delaware, according to the Caritas website.

One of those states is California, where a new law took effect Jan. 1 that prohibits PBMs from charging health plans, including Medicaid plans, more than they pay the pharmacy for a drug. PBMs are still allowed to change a flat administrative fee in the state.

Independence owns 61.3% of AmeriHealth Caritas. Blue Cross Blue Shield of Michigan owns the rest. Caritas accounted for about three-quarters of Independence’s $32 billion in revenue in 2024. The former CEO of AmeriHealth Caritas, Kelly A. Munson, succeeded Gregory E. Deavens in the top job at Independence last year.