Kroger Prescription Plans

What Kroger Prescription Plans does

Kroger Prescription Plans (KPP) is the pharmacy benefit management (PBM) division of Kroger Co. (NYSE: KR), operating within the broader Kroger Health ecosystem and headquartered at 1014 Vine Street, Cincinnati, Ohio. KPP provides pharmacy benefit administration to self-insured employers, health plans, and plan sponsors, structured around six core services: Network Management (dynamic drug utilization review across 65,000+ retail, specialty, and mail order pharmacies), Formulary Management (clinically appropriate drug utilization), Pharmacy Benefit Design (preferred pharmacy networks and tiered drug solutions encouraging generics), Specialty Care (24/7 complex medication support), Clinical Program Management (medication necessity and safety review), and Member Services. The company serves members via the KPP Member Portal (myrxinfo.com), the Kroger mobile app, telephone member services, and physical access through Kroger's 2,200+ retail pharmacy locations.

KPP's technical platform layers these PBM services with two proprietary consumer-facing modules: OptUP, a nutrition rating system developed by registered dietitians to help shoppers evaluate food products, and Telenutrition, a video-based counseling service with registered dietitians. The formulary architecture is segmented across seven tiered plans (Adhere 90, Preventive Drug List, Elite Impact Biosimilar, Elite Impact Standard, Impact Plus, Base Impact, and Value Managed) to address varying employer cost-containment requirements. Pricing appeals and Maximum Allowable Cost (MAC) disputes are processed through MedImpact as a third-party vendor, indicating an ecosystem approach where KPP concentrates on clinical and commercial functions while outsourcing dispute operations.

KPP operates as a wholly-owned business unit of Kroger Co., generating revenue through quote-based administrative fees, network contracting, and rebate arrangements under a subscription/recurring model. Distribution spans the Kroger Retail Pharmacy Network (2,200+ stores), the extended 65,000+ pharmacy network, Kroger Specialty Pharmacy, mail order via Postal Prescription Services (PPS), the KPP Member Portal, and The Little Clinic co-located retail clinics. Leadership is anchored by President Jim Kirby (PharmD, BCPS, FAPhA), with Kristen Proctor leading PBM Operations and Clinical Services, Sydnee Hewitt leading PBM Sales and Commercial Partnerships, and Jason Posey leading Client Services. The company does not disclose revenue separately and operates without independent external funding.

Name

Kroger Prescription Plans

Legal name

Kroger Prescription Plans

Website

https://kpp-rx.com

Company type

Private

Founded year

2018

Operating status

Operating

Headcount range

11–50 employees

Short description

Kroger Prescription Plans (KPP) is the pharmacy benefit management division of Kroger Co., providing network management, formulary management, specialty care, and clinical programs to self-insured employers, health plans, and plan sponsors across the United States.

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)

akta.pro primary industry

Formulary Management & Clinical Pharmacy Programs (HLAEAKAA)

akta.pro secondary industries

Prior Authorization, Utilization Management & Step Therapy (HLAEAKAG), Claims Processing, Adjudication & Payment Integrity (HLAEAKAC), Pharmacy Benefit Management (PBM) & Pharmacy Network Administration (HLAFALAI)

Keywords

• Pharmacy benefit management
• Formulary management
• Specialty pharmacy services
• Clinical program management
• Prescription drug coverage

Headquarters

HQ city

Cincinnati

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. Pharmacy Benefit Management Services: Provides comprehensive PBM services including network management, formulary management, clinical program management, and specialty care services to employers and health plans. Revenue is generated through administrative fees, pharmacy network contracting, and rebate arrangements.

Go-to-market motion1 record

Distribution channels6 records

Marketing channels5 records

Core offering

Kroger Prescription Plans is a pharmacy benefit management (PBM) division of The Kroger Co. that delivers network management, formulary management, pharmacy benefit design, specialty care, clinical program management, and member services to self-insured employers and health plans. It supplements these PBM services with the OptUP nutrition rating system and Telenutrition video counseling to integrate pharmacy, clinical, and nutritional care into a single employer-facing value proposition.

Product overview

Kroger Prescription Plans is a pharmacy benefit management (PBM) platform integrated within the Kroger Health Ecosystem. The platform offers a unified portfolio of six core services: Network Management, Formulary Management, Pharmacy Benefit Design, Specialty Care, Clinical Program Management, and Member Services. These core services are supplemented by add-on programs including OptUP (nutrition rating system) and Telenutrition Service (video-based nutrition counseling). The company provides multiple formulary tiers (Adhere 90 Drug List, Preventive Drug List, Elite Impact Biosimilar, Elite Impact Standard, Impact Plus, Base Impact, and Value Managed Formularies) through its KPP Member Portal. Kroger Prescription Plans connects 65,000+ pharmacies across 2,200+ retail locations with 8,000+ pharmacists and providers, delivering savings and health outcomes through an integrated, clinically-driven PBM model.

Differentiator

Problem solved

Functional benefit

Brands

• OptUP: A nutrition rating system designed to help customers make healthier food choices by providing nutrition ratings for products.
• Telenutrition Service

Products and services

• Network Management Pharmacy network management service that performs dynamic drug utilization review to build savings while providing access to nationwide retail, specialty, and mail-order pharmacy facilities for plan sponsors and members.
• Formulary Management Formulary management service that promotes the use of clinically appropriate drugs to provide effective and cost-efficient care through tiered drug lists and plan design. KPP publishes multiple formulary configurations including Adhere 90, Preventive, Elite Impact Biosimilar, Elite Impact Standard, Impact Plus, Base Impact, and Value Managed formularies.
• Pharmacy Benefit Design Pharmacy benefit design service that delivers financial reward to members through preferred pharmacy networks and tiered drug solutions that recommend cost-effective medications such as generics.
• Specialty Care Specialty pharmacy care service providing 24/7 access to specialty medication support, including patient education, adherence monitoring, financial assistance coordination, and social support for complex therapies.
• Clinical Program Management Clinical program management service that ensures prescribed medications are necessary, safe, and effective for members' conditions, delivering clinical value through utilization management, prior authorization, and adherence programs.
• Member Services Member services program that delivers a diverse range of services and tools designed to simplify healthcare and improve member health outcomes, including a phone-based member services line at 800.482.1285.
• OptUP OptUP is a Kroger-developed nutrition rating system that helps shoppers understand the nutritional value of food products, enabling healthier purchasing decisions and supporting Food as Medicine clinical goals.
• Telenutrition Service Telenutrition provides video-based nutrition counseling appointments with Kroger registered dietitians who help members achieve personal nutrition goals, including support for medical history, dietary restrictions, and chronic condition management (not available in New York and Alaska or where otherwise prohibited by law).
• KPP Member Portal Online self-service portal at myrxinfo.com that lets KPP members access real-time formulary information, benefit coverage details, the drug price check tool, and claim management resources.

Segments3 records

Ideal customer profiles1 record

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature7 records

Partnerships

Six partnerships are on record, tiered core and minor.

• Kroger Co.coreStrategic or Co-development PartnerKroger Prescription Plans is integrated with Kroger Co., the parent company. KPP serves as the pharmacy benefit management division of Kroger Health, leveraging the full suite of Kroger entities to optimize customer experience, improve health outcomes, and deliver savings. Kroger Co. is a major American retailer and the parent organization.
• Kroger Specialty PharmacycoreStrategic or Co-development PartnerKroger Specialty Pharmacy is part of the integrated Kroger Health ecosystem, providing specialty medication services including 24/7 access, education, adherence monitoring, financial assistance, and social support for complex conditions.
• The Little CliniccoreStrategic or Co-development PartnerThe Little Clinic operates retail health clinics within Kroger stores, providing co-located healthcare services alongside pharmacy operations. Located at 2620 Elm Hill Pike, Nashville, TN 37214.
• Postal Prescription Services (PPS)minorChannel Partner/ Reseller/ DistributorPPS (Postal Prescription Services) is listed as a partner entity under Kroger Prescription Plans, located at 3500 SE 26th Avenue, Portland, OR 97202. Provides mail order pharmacy services.
• MedImpactcoreTechnology or IntegrationMedImpact serves as the vendor for handling pharmacy pricing appeals requests for Kroger Prescription Plans. Appeals can be submitted through MedImpact's online portal, email ([email protected]), or phone (858.790.7165). Handles Maximum Allowable Cost (MAC) pricing dispute resolution.
• EverfiminorGTM or Marketing PartnerKroger is a partner supporting Everfi's mental wellness and prevention education programs for K-12 students. Kroger contributes to the Prescription Drug Safety course alongside HCA Healthcare, NFL Foundation, Major League Baseball, Elevance Health, Guardian, and Truth Initiative. Programs have reached nearly one million students during the 2025-26 school year.

Scale indicators3 records

Recent moves6 records

Expansion highlights5 records

Broad incumbents

• Express Scripts: Top-three U.S. PBM, owned by Cigna / Evernorth, serving employer, health plan, and government clients. Comparable to KPP across formulary management, specialty pharmacy, and mail order, with significantly greater scale.
• CVS Caremark: The largest U.S. PBM operated by CVS Health, vertically integrated with retail pharmacy (CVS), specialty pharmacy, and care services. Directly comparable to KPP as a PBM serving employer and health plan clients, but materially larger and broader in scope.
• OptumRx: PBM arm of UnitedHealth Group and one of the three dominant U.S. PBMs. Comparable PBM services including formulary, specialty, and mail order; benefits from integration with UnitedHealthcare's medical and analytics capabilities.

Emerging players

• SmithRx: Transparent, technology-driven PBM targeting self-insured employers with a modern technology stack. Comparable to KPP's employer focus and transparent pricing narrative, though without Kroger's retail pharmacy ecosystem.
• Elixir Rx Solutions: Independent PBM focused on transparent, pass-through pricing for employers, labor unions, and health plans. Comparable to KPP in the transparent-PBM segment and target customer base.
• Capital Rx: Technology-forward, transparent PBM operating on its own JUDI platform. Comparable to KPP in transparent positioning and employer/plan sponsor focus; differentiates on claims-processing technology rather than retail footprint.

Direct peers

• Navitus Health Solutions: Independent, transparent PBM owned by SSM Health and Costco. Comparable to KPP's transparent model and employer-focused value proposition; both compete in the pass-through / transparent PBM segment.
• MedImpact Healthcare Systems: Independent, pharmacist-founded PBM serving health plans, employers, and government programs. Directly comparable to KPP in transparent, client-aligned PBM positioning; KPP currently relies on MedImpact for pharmacy pricing appeals.
• Prime Therapeutics: Blue Cross Blue Shield-affiliated PBM serving health plan clients with formulary management, specialty pharmacy, and clinical programs. Comparable to KPP's plan-sponsor-focused PBM model.
• Humana Pharmacy Solutions: PBM division of Humana, providing pharmacy benefit management to employer, Medicare, and Medicaid clients. Directly comparable PBM services including formulary management, specialty pharmacy, and mail order.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights6 records

Customer concentration

Revenue estimate

Valuation estimate

Number of profiles

Profiles4 records

Funding overview

Funding rounds

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 Kroger Prescription Plans