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By Susheel Jain, CEO of Exouza 💡 The Easy Button Effect Health plan buyers are often encouraged to take the path of least resistance. When it comes to prescription coverage, that usually means accepting the built-in Pharmacy Benefit Manager (PBM) bundled with their medical plan. It feels like the easy choice, but is it the best one? 👩‍💼 The Buyer’s Dilemma An HR manager I spoke with recently manages prescription coverage for 2,000 employees in a rural town in the Southeast

Study documents PBM practices and impacts with comprehensive state-specific analysis, insights and recommendations. Exouza’s PBM report provides the most in depth analysis of PBM practices and impacts, leveraging industry viewpoints and the most comprehensive state-specific assessment of pharmacy and care deserts, drug reimbursement and impacts to pharmacies.   This report equips legislators with evidence-based insights, policy analysis, and key recommendations for a fair and

The smarter Pharmacy Benefit Management (PBM) platform that uses AI to save you money on prescriptions. Most health plans already have a pharmacy benefit manager in place. But as prescription costs rise and program complexity grows, many buyers are looking for more clarity and more control. We built OpenPBM.ai to support that shift. It’s a smarter, AI-powered PBM platform that helps brokers, TPAs, and plan sponsors reduce cost, minimize disruption, and better understand how

By Susheel Jain, CEO of Exouza In my last post, I talked about my incredible team of ex-pharmacists, technologists, and entrepreneurs who are united with me trying to improve the prescription drug insurance industry. We’re using AI to lower costs, improve access to critical drugs, and rewrite the patient experience for the better. Today, let’s focus on Exouza’s customers, the organizations that buy, sell, and administer health plans. These are benefits brokers, third-party ad

By Susheel Jain, CEO of Exouza “I’ll never forget patients in tears over $2,000 oncology co-pays, or being told their life-saving medication wasn’t ‘on formulary’. That disconnect between what a clinician prescribes and what a patient can actually receive, convinced me the system needed rebuilding.”  — Gary Rice, COO of Exouza To build a PBM that truly works for patients, I wanted a team who had firsthand experience inside our broken healthcare system. That’s why my Chief Ope

A New Era of Pharmacy Benefits Management Exouza offers OpenPBM.ai, a next-generation pharmacy management administrative platform that empowers employers to better manage rising costs and navigate the complexities of the healthcare ecosystem.

"Eligibility decisions that used to take hours now can be completed in minutes."