For Greg Baker, Chief Executive Officer of AffirmedRx, advocacy is a responsibility. Their Patient Care Advocate (PCA) model reflects that belief, offering a unique way to think about pharmacy benefits that centers on personal connection, proactive engagement, and meaningful support for members.

AffirmedRx is a Public Benefit Corporation and a Pharmacy Benefit Manager (PBM) committed to transparency, fairness, and improving the member experience. The company partners with employers and organizations to manage prescription drug benefits with a focus on clarity, access, and accountability. "Our purpose has always been to build trust in an area that can often feel confusing for members," Baker says. "We are here to simplify that experience and make sure every person gets the care they need."

At the heart of this approach lies the PCA model, a relationship-driven framework where each advocate serves as a consistent point of contact for members. Whether coordinating prior authorizations, helping locate cost-effective options, or clarifying benefit details, the advocate remains committed until the issue is fully resolved. "We don't measure success by call length or volume," Baker notes. "We measure it by resolution and trust."

Technology helps make that possible. The PCA platform integrates real-time claim visibility and data-driven alerts, allowing advocates to identify when a member may need help even before they reach out. "The technology provides insight," Baker says, "but it's the human connection that provides the solution."

That connection often becomes life-changing. Earlier this year, during a conversation with a member, an AffirmedRx advocate unearthed that a member's heart failure medication was a financial barrier. Recognizing that delays could affect the member's health, she immediately began researching alternative access options. She found a patient assistance program through the manufacturer that could supply the medication at no cost and coordinated the necessary paperwork with both the prescribing physician and the patient. To ensure continuity of care, she also arranged for the physician to provide samples during the approval process. Within days, the member was enrolled in the program and received their medication free of charge through the end of the year.

"The member didn't have to experience the stress of waiting or worrying about affordability," says Megan Mullaney, VP, Client Management of AffirmedRx. "That's the impact of an advocate, someone working quietly in the background to make sure care continues without disruption."

AffirmedRx's approach is structured around consistency and compassion. Each advocate is trained as a community health worker, equipped with both clinical and interpersonal skills to support members in ways that go beyond pharmacy coordination. Advocates help members access assistance programs, locate community health resources, and even understand the practical steps to maintain adherence. "A PCA's role is part navigator, part listener, part problem-solver," Baker says. "It's about understanding the whole person, not just the prescription."

The data underscores the value of that approach. According to Baker, AffirmedRx's PCAs have completed more than 52,000 proactive outreach calls so far this year, reaching members before small barriers turn into larger challenges. Baker emphasizes that these interactions are intentional efforts to anticipate needs, clarify options, and build trust. "It's about being present before someone asks for help," Baker says.

That attentiveness can also benefit employers. By resolving pharmacy concerns directly with members, PCAs help reduce the administrative load often placed on human resources or benefits teams. "When we take on the role of advocate, it means fewer interruptions for our clients and more confidence that their employees are being supported," Mullaney says. "It creates a sense of assurance that the system is working as it should."

The ripple effects extend to overall well-being and continuity of care. Studies have shown that when medication costs exceed $125, a significant percentage of patients choose not to fill their prescriptions. AffirmedRx's PCA model addresses this gap by identifying cost barriers early and finding alternative pathways or resources to keep members on their treatment plans. "Adherence is about removing the obstacles that keep people from getting the care they deserve," says Baker.

As a Public Benefit Corporation, AffirmedRx integrates purpose into every level of its operations. The PCA program is an expression of that mission, a blend of technology, empathy, and accountability designed to serve both individuals and organizations. "We believe that care should always start with listening," Mullaney says. "When we listen, we learn. And when we act on what we learn, we build a system that truly supports people."

For Baker, that philosophy defines the future of pharmacy benefit management: one that moves forward through collaboration, transparency, and compassion. "Every time an advocate helps someone access the medication they need, it's a reminder of why we are here," Baker says. "It's about care in the truest sense of the word."