Rightway

What Rightway does

Rightway is a New York-based, privately held healthcare technology company founded in 2016 by Jordan Feldman and Dr. Theodore Feldman that operates an integrated pharmacy benefit management (PBM) and clinical care navigation platform for self-insured employers and health systems. The company positions itself as the "industry's only neutral PBM" — it does not own supply chain assets, does not retain manufacturer rebates, and does not profit from spread pricing. Rightway earns revenue from a single transparent per-member-per-month (PMPM) administrative fee calculated against projected client savings, supplemented by the outcome-based SureSpend guarantee that caps total pharmacy spend and refunds 100% of overages. The company has raised approximately $239 million across multiple funding rounds from Khosla Ventures, Thrive Capital, and Tiger Global Management, with the most recent disclosed raise of $108.7 million in March 2024.

The company's core products are Rightway PBM and Rightway Care Navigation, sold together or independently. The PBM includes embedded pharmacist-led clinical support, formulary management, claims processing, mail-order access through Walgreens Mail Service and Cost Plus Drugs, and specialty pharmacy coordination. Care Navigation is a nurse-led service staffed by registered nurses, health guides, social workers, and billing specialists, using predictive analytics to identify at-risk members and close care gaps proactively. Members access services through a mobile and web application featuring digital ID cards, pharmacist chat, prescription cost comparison, in-network provider search, and bill resolution. Add-on modules include Care Complete Weight Management (a GLP-1 ROI optimization program launched April 2026) and RightwayHub, a partner integration platform connecting members to vetted third-party solutions (Virta, Vida Health, Curai Health, ClearCost Health). The provider-facing portal includes formulary search and prior authorization workflows via CoverMyMeds.

Rightway sells primarily through direct enterprise field sales targeting Fortune 1000 self-insured employers and a dedicated health systems vertical, supplemented by broker/consultant channels and a partnership channel anchored by ParetoHealth that extends care navigation to 4,000+ small and midsize employers covering approximately 1.3 million lives. Named customers include Tyson Foods, Instacart, Zoom, TikTok, Verisys, and Eli Lilly (which switched from CVS Health effective January 2026). The company reports 2 million PBM members, 150+ organizations served, 70 member NPS (8.5x industry average), 15% average client savings, 113% net revenue retention, and was ranked #42 on the 2025 Deloitte Technology Fast 500 with 2824% three-year revenue growth.

Name

Rightway

Legal name

Rightway Healthcare, Inc.

Website

https://rightwayhealthcare.com

Company type

Private

Founded year

2016

Operating status

Operating

Headcount range

501–1,000 employees

Short description

Rightway is a New York-based healthcare technology company offering an integrated transparent pharmacy benefit management and clinical care navigation platform to self-insured employers and health systems. It serves 2 million PBM members across 150+ organizations with pharmacist-led support, 100% rebate pass-through, and PMPM pricing.

Ownership category

akta.pro rank

Product category

Pharmacy Benefit Management

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)

SIC

Hospital & Medical Service Plans (6324)

akta.pro primary industry

Pharmacy Benefit Management (PBM) & Pharmacy Network Administration (HLAFALAI)

akta.pro secondary industries

PBM Technology Platforms (ePA/eRx/Real-Time Benefit Tools) (HLAEAKAL), Manufacturer Contracting, Rebates & Revenue Management (HLAEAKAD), Pharmacy Benefit Management (PBM) & Formulary Management IT (HLACAKAD), Pharmacy Network Contracting & Management (HLAEAKAB)

Keywords

• Pharmacy benefit management
• Care navigation
• Transparent PBM
• Healthcare benefits platform
• Prescription management

Headquarters

HQ city

New York

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B

Offering type

Software

Cost components

Personnel, Technology or R&D, Marketing or Sales, Operations, Others

Revenue model

1. PBM Administrative Fees (PMPM): Rightway charges a single, transparent per-member-per-month (PMPM) administrative fee based on projected savings. This is their primary revenue stream. The company does not profit from drug costs, rebates, or spread pricing.
2. 100% Rebate Pass-Through: Rightway passes through 100% of all rebates to employers and members. They do not retain any rebate revenue, which aligns their incentives with client savings rather than maximizing drug costs or rebate retention.

Pricing tiers

Go-to-market motion2 records

Distribution channels4 records

Marketing channels7 records

Core offering

Rightway provides pharmacy benefit management (PBM) and clinical care navigation services to self-insured employers and health systems. Its PBM operates on a 100% rebate pass-through model with a transparent per-member-per-month administrative fee, SureSpend cost ceiling guarantee, and licensed pharmacist-led member support. Its care navigation platform delivers high-touch, nurse-led clinical guidance, predictive risk identification, billing resolution, and care coordination via mobile and web applications.

Product overview

Rightway is a healthcare benefits platform combining two core integrated solutions: Rightway PBM (pharmacy benefit management) and Rightway Care Navigation, offered as a unified or standalone platform to employers and health systems. The PBM is built around a neutral, transparent model that passes through 100% of rebates to clients and uses licensed pharmacists at the center of every member interaction, differentiating from legacy PBMs through fiduciary alignment and no supply chain ownership. Care Navigation is nurse-led and uses predictive analytics to identify at-risk members, providing proactive outreach through registered nurses, health guides, social workers, and billing specialists. Additional modules include SureSpend (a spend ceiling guarantee), Care Complete Weight Management (GLP-1 ROI optimization), and the RightwayHub partner platform integrating third-party solutions (ClearCost Health, Curai Health, Virta, Vida Health). Members access all services via the Rightway App (mobile and web), while providers use a dedicated portal for formulary searches, prior authorizations, and clinical policies. Mail-order and specialty pharmacy services are delivered through partners (Walgreens Mail Service, Cost Plus Drugs). Telehealth services are available through a partnered Medical Group (RW Health FL, PC).

Differentiator

Problem solved

Functional benefit

Products and services

• Rightway PBM Rightway's pharmacy benefit management solution for self-insured employers and health systems. Provides 100% rebate pass-through, pharmacist-led member support, transparent per-member-per-month administrative fee, formulary management, claims processing, specialty drug management, and the SureSpend cost ceiling guarantee.
• Rightway Care Navigation High-touch, clinically-driven care navigation service for self-insured employers and health systems. Uses predictive analytics to identify at-risk members and delivers personalized support through registered nurses, health guides, social workers, and billing specialists to help members understand benefits, resolve billing issues, find providers, and make better healthcare decisions.
• Care Complete Weight Management Specialized GLP-1 weight management program that helps employers measure and improve outcomes from their GLP-1 (Wegovy, Zepbound, etc.) investments. Provides clinical team oversight, comprehensive reporting, therapy optimization, and ROI demonstration for GLP-1 programs, addressing high dropout rates and side effect management.
• SureSpend Financial guarantee program that caps total pharmacy spend (employer plus member costs) at a projected ceiling. If spend exceeds the ceiling, Rightway refunds 100% of overages with no cap; if spend comes in under budget, clients retain 100% of savings.
• Mail-Order Pharmacy Mail-order home delivery pharmacy service delivered through partners Walgreens Mail Service and Cost Plus Drugs, offering 90-day supplies of maintenance medications with automatic refills, cost comparison in the Rightway app, and prescription transfer coordination.
• Specialty Pharmacy Specialty medication management service delivered through trusted pharmacy partners, providing support for complex conditions requiring special handling, prior authorization coordination, copay assistance enrollment, and white-glove member support.
• Telehealth Services Telehealth consultation services provided through a partnered Medical Group (RW Health FL, PC), offering online medical consultations and secure messaging between patients and licensed healthcare professionals for Rightway members.

Quantifiable outcome

• 15% average pharmacy savings in year 1
• +10 more outcomes

Named customers8 records

Segments4 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration7 records

AI capability2 records

Feature6 records

Partnerships

Three partnerships are on record, tiered core.

• ParetoHealthcoreGTM or Marketing PartnerParetoHealth partnership makes Rightway's care navigation platform available to ParetoHealth's community of more than 4,000 small and midsize employers covering approximately 1.3 million people. This collaboration brings enterprise-level care navigation to smaller employers who historically struggled to implement effective self-funded healthcare plans.
• Walgreens Mail ServicecoreTechnology or IntegrationWalgreens Mail Service is Rightway's mail-order pharmacy partner offering convenient home delivery of medications. Members can compare costs between Walgreens Mail Service and Cost Plus Drugs in the Rightway app to choose the best option.
• Cost Plus Drugs (Mark Cuban's Company)coreTechnology or IntegrationCost Plus Drugs is offered as a mail-order pharmacy option within Rightway's platform. Mark Cuban's company offers transparent cost-plus pricing on generic drugs. Rightway helps members compare pricing between Cost Plus Drugs and Walgreens Mail Service.

Scale indicators14 records

Recent moves5 records

Expansion highlights8 records

Direct peers

• Included Health: Integrated virtual care and navigation platform combining clinical care, benefits navigation, and member advocacy for employers and health plans. Comparable to Rightway in the care navigation and benefits-experience category.
• SmithRx: Fast-growing transparent PBM focused on self-insured employers, offering pass-through pricing and modern technology. Closely comparable to Rightway on customer segment, transparent model, and growth-stage profile.
• HealthComp Holdings: Third-party administrator (TPA) and care navigation provider for self-funded employers. Comparable to Rightway on employer segment, self-insured plan administration, and integrated clinical/personal-support model.
• Capital Rx: Technology-led PBM operating a transparent, pass-through model with a clearinghouse-style claims platform (JUDI). Direct competitor to Rightway in the employer PBM market and similarly targets fiduciary, transparent economics versus legacy PBMs.
• Quantum Health: Independent healthcare navigation and care coordination company serving large self-insured employers. Directly comparable to Rightway's Care Navigation product and the most-cited benchmark in the navigation category.

Broad incumbents

• Express Scripts (Cigna / Evernorth): Second-largest U.S. PBM and part of Evernorth's health services portfolio. Competes head-to-head with Rightway for self-insured employer contracts and was the prior PBM for several of Rightway's marquee wins.
• CVS Caremark (CVS Health): Third member of the Big 3 PBMs and Rightway's most-named displaced incumbent (Tyson Foods and Eli Lilly both switched from CVS Caremark). Offers integrated PBM plus retail pharmacy and Aetna health plan distribution.
• Optum Rx (UnitedHealth Group): Largest U.S. PBM by prescription volume and the primary incumbent Rightway explicitly positions against. Operates the full PBM stack including owned retail, mail, and specialty pharmacy, with deeply embedded rebate economics that Rightway's neutral model is designed to disrupt.

Others

• Mark Cuban's Cost Plus Drugs: Transparent cost-plus pharmacy that Rightway integrates with as a mail-order partner. Not a direct competitor, but a key ecosystem participant reinforcing the broader transparent-pricing narrative against legacy PBM economics.

Emerging players

• EmpiRx Health: Smaller, clinically-focused PBM targeting mid-market self-insured employers with a transparent, pass-through model and pharmacist-led engagement. Comparable niche overlap with Rightway's transparent PBM positioning.

Market position

Strengths5 records

Weaknesses4 records

Competitive moat6 records

Key risks5 records

Customer concentration

• LinkedInlinkedin.com/company/rightway-healthcare
• Xx.com/rightwayhc

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles14 records

Funding overview

Funding rounds7 records

Investors6 records

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Rightway