MARCH 2026 19TECH OUTLOOKand compliant coverage and prescription routing decisions. With embedded AI logic and automated decision support, it dynamically manages plan and program eligibility, routing and sequencing logic, incentive structures, penalties and limitations. Central to this approach is the use of real-time technology to ensure accuracy and transparency. The platform maintains a continuously updated data infrastructure that instantly delivers precise information to members about copays, eligibility and participation rules."Technology is just the starting point--true engagement comes from directly connecting with members, guiding them through the process, and supporting them every step of the way," says Gary Rice, COO. Through direct interaction with members, Exouza improves program participation, boosts retention and generates measurable clinical and financial gains. Whether guiding someone to the most cost-effective pharmacy or helping them understand the full scope of their benefits, every touchpoint is designed to add value.The combination of `high tech' with `high touch' in the integrated framework has produced industry-leading results. A recent impact analysis with a third-party administrator showed a 52 percent reduction in pharmacy spend. This was driven by six of Exouza's cost containment programs selected by the client: patient assistance, specialty drug clinical management, copay assistance, importation, clinical prior authorization, and site-of-care optimization for medical benefits. Enrollment across these programs exceeded 55 percent, significantly outperforming industry benchmarks, and member retention remained above 90 percent, month over month. Driving the Next Wave of PBM InnovationExouza remains committed to staying ahead of industry demands through its innovation roadmap. Among its upcoming features is a reverse auction capability that allows contracted pharmacies to bid in real time to fill prescriptions at the most competitive price. Fully automated through backend technology, the auction process is triggered as soon as a member leaves the physician's office. While members experience a seamless process of the complex infrastructure behind the scenes, they benefit from access to real-time, market-driven pricing.Exouza is also expanding the use of AI to enable real-time, rules-based routing of prescriptions to the lowest net cost by factoring in discounts, rebates and vendor contracts. These enhancements ensure each prescription is filled accurately and optimally, based on the full context of the benefit plan and market dynamics.Complementing these efforts is a bold reimagining of pharmacy payments. By tapping into the Federal Reserve's FedNow banking rails, Exouza facilitates real-time, merchant-to-merchant transactions that bypass the inefficiencies of traditional claims-based reimbursement. This innovation is a game-changer only available through OpenPBM.ai, empowering Exouza to transform payment models that expedite payments to pharmacies who participate in the reverse auction model.Exouza brings pharmacy benefits back in sync with patient care through intelligent infrastructure and hands-on service, delivering a seamless experience that scales with client needs - and is poised to adapt and innovate as the pharmacy landscape evolves. Nearly every other industry allows shopping for prices with fully transparency to buyers. Now for the first time, Exouza brings this experience to prescription drug pricing and management. We saw the growing gap and approached it with a blank canvas.
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