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Forbes Healthcare Summit
2017-11-29 - 2017-11-30    
All Day
ForbesLive leverages unique access to the world’s most influential leaders, policy-makers, entrepreneurs, and artists—uniting these global forces to harness their collective knowledge, address today’s critical [...]
29th Annual National Forum on Quality Improvement in Health Care
2017-12-10 - 2017-12-13    
All Day
PROGRAM OVERVIEW The IHI National Forum on December 10–13​, 2017, will bring more than 5,000 brilliant minds in health care to Orla​​ndo, Florida, to find meaningful connections [...]
Dallas Health IT Summit
2017-12-14 - 2017-12-15    
All Day
About Health IT Summits U.S. healthcare is at an inflection point right now, as policy mandates and internal healthcare system reform begin to take hold, [...]
Events on 2017-11-29
Forbes Healthcare Summit
29 Nov 17
New York
Events on 2017-12-14
Dallas Health IT Summit
14 Dec 17
Dallas
Latest News

Startup Reaches \$3.25B Valuation with Drug Pricing Software

drug-pricing - EMR industry

Eight years after founding Capital Rx to expose hidden drug pricing fees, AJ Loiacono has rebranded the company as Judi Health, now backed by \$252 million to target wider healthcare costs.

AJ Loiacono proved the value of his medical benefits software by first testing it on his own company. The results were striking: annual cost savings of 11% for 1,800 members, claims processing reduced from over six months to just 18 days, and improved employee benefits—all while cutting hidden fees.

Building on this success, his company, originally launched as Capital Rx, has expanded beyond pharmacy benefits into medical claims administration. Now rebranded as Judi Health, the firm has secured \$252 million in equity funding led by Wellington Management and General Catalyst, pushing its valuation to \$3.25 billion—more than double its \$1.5 billion valuation in March 2024. With total funding now at \$607 million, investors including Goldman Sachs Asset Management and Generation Investment Management (chaired by Al Gore) joined the round, which was so oversubscribed that early backers sold over \$150 million in shares. Loiacono will present the new investment Wednesday at the New York Stock Exchange.

Medical and prescription benefits run on separate tracks, often leading to duplication, higher costs, and headaches for both doctors and patients. Drug pricing, in particular, is tangled with rebates, clawbacks, layered fees, and complex financial maneuvers. To fix this, AJ Loiacono founded Capital Rx and built Judi—modular, cloud-based software (short for “adjudicate”) designed to process claims more transparently and at lower cost.

As employers sought relief from rising drug expenses, the company grew into a major pharmacy benefit manager, with revenue projected to hit \$3.7 billion this year, up more than 75% from \$2.1 billion last year. Judi manages the administration of claims but doesn’t assume the financial risk of paying them—similar to how Fidelity oversees 401(k) recordkeeping.

“AJ has been working to solve this challenge for years,” said Jonah Surkes of Generation Investment Management. “In a highly complex industry filled with entrenched players protecting market power, he’s demonstrated remarkable persistence.”