myMatrixx

What myMatrixx does

myMatrixx (legal entity Matrix Healthcare Services, Inc., d/b/a 'MyMatrixx by Evernorth') is a pharmacy benefit manager (PBM) that operates exclusively in U.S. workers' compensation. Founded in 2001 and headquartered in Tampa, Florida, with additional offices in St. Louis and Phoenix, the company serves enterprise payers of workers' comp pharmacy benefits — state funds, insurance carriers, self-insured employers, guarantee funds, and third-party administrators — managing medication utilization, prior authorization, opioid stewardship, and cost control for injured workers. It has been a wholly-owned subsidiary of Evernorth Health Services (Cigna's health services arm) since approximately 2020 and was rebranded under the Evernorth masthead in March 2024. The firm has been ranked the #1 workers' compensation PBM by CompPharma for six consecutive years (2019–2024), scoring 4.29/5 (21% above the segment average of 3.28) and 4.8/5 on customer service, and holds URAC PBM and AICPA/SOC accreditations.

The company's core product portfolio combines clinical programs (Alert, Review and Manage® for prospective alerts; One Drug Review for topicals; CASE Rx® for safety evaluation), technology modules (evidence-based prior authorization decision support, E-prescribing via Surescripts), the MyDataSense℠ analytics platform with its CARE module, and the MyPassport™ client portal built from direct client feedback. Its pharmacy network spans 65,000+ locations including every major U.S. chain (CVS, Walgreens, Walmart, Costco, etc.), augmented by Express Scripts home delivery and Accredo specialty pharmacy. The firm deploys non-generative AI for real-time medication decision support, formulary optimization, and fraud/waste/abuse detection, and operates with a 100% in-house 24/7/365 customer service team staffed by 30+ clinicians and long-tenured specialists.

Revenue is generated transactionally on pharmacy benefit management services for workers' compensation claims, billed under annual enterprise contracts with custom quote-based pricing — pricing is not publicly disclosed. Go-to-market is direct enterprise field sales augmented by presence at industry conferences (Workers' Compensation Institute, National Workers' Compensation and Disability Conference), a continuing-education webinar series (MyCE), white papers, the PharmaWatch newsletter, and an active social and content footprint. The firm's #1 customer ranking over six years and a 91.3% network penetration rate provide recurring enterprise stickiness; primary risk vectors are regulatory shifts at the state level (e.g., formulary mandates, PBM legislation) and concentration in a single vertical.

Name

myMatrixx

Legal name

Matrix Healthcare Services, Inc.

Website

https://mymatrixx.com

Company type

Private

Founded year

2001

Operating status

Operating

Headcount range

251–500 employees

Short description

myMatrixx by Evernorth is a U.S. pharmacy benefit manager exclusively serving workers' compensation payers — state funds, carriers, self-insured employers, guarantee funds, and TPAs — providing PBM services, clinical management, prior authorization, opioid stewardship, and analytics across a 65,000+ pharmacy network.

Ownership category

akta.pro rank

Product category

Workers' Compensation Pharmacy Benefit Management

NAICS

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

SIC

Accident & Health Insurance (6321)

akta.pro primary industry

Group Pharmacy Benefit (Rx) Coverage & PBM-Integrated Plans (FSAIAFAN)

Keywords

• Pharmacy benefit management
• Workers compensation pharmacy
• Clinical pharmacy services
• Prior authorization support
• Pharmacy claims management

Headquarters

HQ city

Tampa

HQ country

United States

HQ region

North America

Offices3 records

Markets served

GTM type

B2B

Offering type

Software

Cost components

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

Revenue model

1. PBM Services for Workers' Compensation: MyMatrixx provides pharmacy benefit management services specifically for workers' compensation cases, managing medication utilization, controlling costs, and ensuring patient safety for injured workers. Revenue is generated through management fees and transaction-based pricing with payers including state funds, carriers, self-insured employers, and TPAs.

Pricing tiers

Go-to-market motion1 record

Distribution channels5 records

Marketing channels6 records

Core offering

myMatrixx by Evernorth is a pharmacy benefit manager that delivers pharmacy benefits management, ancillary benefits management, and clinical management services exclusively for workers' compensation programs. It manages medication utilization, prior authorization, formulary compliance, and clinical safety for injured workers on behalf of state funds, insurance carriers, self-insured employers, guarantee funds, and third-party administrators (TPAs), supported by a 65,000+ pharmacy network and 24/7 in-house customer service.

Product overview

myMatrixx by Evernorth is a pharmacy benefit manager (PBM) with an exclusive focus on workers' compensation cases. The company offers a unified platform combining clinical expertise, customer service, and technology solutions. The core product portfolio includes clinical programs (ARM®, One Drug Review, CASE Rx®), technology solutions (Evidence-Based Prior Authorization Support, E-Prescribing), analytics platforms (MyDataSense℠ with CARE analytics), and the MyPassport™ client portal. All solutions are powered by advanced automation and AI capabilities for decision intelligence, fraud detection, and formulary optimization. The company provides 24/7 in-house customer service and maintains a network of 65,000+ pharmacies.

Differentiator

Problem solved

Functional benefit

Products and services

• Alert, Review and Manage (ARM)®

Quantifiable outcome

• Scored 4.29/5 (21% higher than average) in CompPharma 20th Annual Survey
• +4 more outcomes

Named customers5 records

Segments2 records

Ideal customer profiles1 record

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration4 records

AI capability6 records

Feature7 records

Partnerships

13 partnerships are on record, tiered core and minor.

• Kids' Chance of AmericacoreStrategic or Co-development PartnerNon-profit partnership supporting children of catastrophically injured workers through scholarships. MyMatrixx President Mike Cirillo serves as chair of the fundraising committee and member of advisory board. Company provides financial contributions, video sponsorship for national conferences, and actively promotes KCOA through employees and clients. Kids' Chance has awarded 8,000+ scholarships totaling $27 million across 48 states.
• Give Kids the WorldminorStrategic or Co-development PartnerCommunity partnership supporting the organization that provides free vacations for children with life-threatening illnesses and their families.
• National Multiple Sclerosis SocietyminorStrategic or Co-development PartnerCommunity partnership supporting MS research and patient support programs.
• The American Heart AssociationminorStrategic or Co-development PartnerCommunity partnership supporting heart disease research and education.
• Tampa Bay Boys & Girls ClubminorStrategic or Co-development PartnerCommunity partnership supporting youth development programs in the Tampa Bay area.
• Hillsborough Education FoundationminorStrategic or Co-development PartnerCommunity partnership supporting education initiatives in Hillsborough County.
• Feeding Tampa BayminorStrategic or Co-development PartnerCommunity partnership supporting food security programs in the Tampa Bay region.
• Make a Wish FoundationminorStrategic or Co-development PartnerCommunity partnership granting wishes to children with critical illnesses.
• Evernorth Health Services (Parent Company)coreOthersMyMatrixx is a subsidiary of Evernorth Health Services, which is part of Cigna. This relationship provides access to the largest retail pharmacy network, deep technology and security investment, and unmatched expertise in workers' compensation clinical pharmacy while maintaining personalized service.
• ODG by MCGcoreTechnology or IntegrationPartnership with ODG (Official Disability Guidelines) by MCG for evidence-based drug formulary management. ODG provides treatment guidelines and drug formularies that several states (Indiana, Montana, Texas) have adopted for workers' compensation systems. MyMatrixx maintains ODG-based formularies.
• Camelot Community CareminorStrategic or Co-development PartnerCommunity partnership supporting behavioral health and community services.
• Habitat for HumanityminorStrategic or Co-development PartnerCommunity partnership supporting affordable housing construction.
• SafePlaceminorStrategic or Co-development PartnerCommunity partnership supporting domestic violence awareness and services.

Scale indicators9 records

Recent moves7 records

Expansion highlights5 records

Broad incumbents

• CVS Caremark: The PBM arm of CVS Health and a top-three U.S. PBM, offering scale-based rebate negotiation, retail pharmacy integration, and specialty drug management that sets the competitive benchmark myMatrixx differentiates against.
• Prime Therapeutics: Blue Cross Blue Shield-aligned PBM serving health plan clients at national scale. Comparable to myMatrixx on clinical and formulary management, with a comparable payer-channel GTM but a much broader, non-WC book of business.
• Express Scripts: Largest U.S. PBM by script volume and a sibling to myMatrixx inside Evernorth/Cigna. Provides mail-order and specialty capabilities (home delivery, Accredo) that myMatrixx leverages but operates in far broader commercial, Medicare, and Medicaid markets.
• Magellan Rx Management: PBM and specialty drug management business (now part of Centene) that competes in government, commercial, and specialty pharmacy with formulary and clinical management capabilities analogous to myMatrixx's clinical suite.
• OptumRx: UnitedHealth Group's general-market PBM. Sister entity to Optum Workers' Comp and Auto No Fault and the broadest incumbent PBM against which myMatrixx competes for adjacent specialty and chronic-disease drug categories.

Emerging players

• MedImpact Healthcare Systems: Independent, client-owned PBM with a transparent-pass-through model. Though not WC-focused, its audit-friendly, lower-spread positioning attracts payer clients evaluating alternatives to traditional PBMs like myMatrixx.

Direct peers

• Mitchell International: Workers' compensation and auto casualty technology and services provider covering claims, pharmacy, and clinical management. Overlaps with myMatrixx on WC pharmacy and bill review with the same payer customer base.
• Helios (workers' compensation PBM): Workers' compensation-focused clinical management and pharmacy services provider. Competes with myMatrixx for the same state funds, carriers, and TPAs using injury-specific clinical programs and formulary controls.
• Optum Workers' Comp and Auto No Fault: The PBM and clinical services arm of UnitedHealth Group focused on workers' compensation and auto/PIP claims — the most directly comparable competitor to myMatrixx, with overlapping buyer set (carriers, employers, TPAs) and overlapping clinical/formulary playbook.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks5 records

Key highlights7 records

Customer concentration

• Xx.com/myMatrixx
• Facebookfacebook.com/mymatrixx
• LinkedInlinkedin.com/company/mymatrixx

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles11 records

Funding overview

Funding rounds1 record

Investors

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 myMatrixx