Exemplar
Exemplar Healthcare Partnership Organization is a member-owned network connecting independent pharmacies, primary care physicians, and service providers across 48 states, offering sourcing, PBM, insurance, and management services plus its own CMS-approved Medicare PDP.
- Company typePrivate
- Founded2019
- HeadquartersHigh Point, United States
- Headcount101–250
- GTM typeB2B
- OfferingServices
What Exemplar does
Exemplar Healthcare Partnership Organization is a private, for-profit healthcare partnership network founded in 2019 and headquartered in High Point, North Carolina. The company builds and operates a member-owned network that aggregates independent pharmacies, independent primary care physicians, and healthcare service providers under a cooperative structure in which members hold equal voice and receive equal payment distribution. Its purpose is to enable independents to collectively compete with national pharmacy and primary care chains through preferred provider status, improved reimbursement rates, and access to a suite of managed services.
The company's core product is the Exemplar Healthcare Partnership Network, supported by a web-based platform that includes a Network Pharmacy Finder (ZIP-code-based search with configurable radius) and integrations with claims processing platforms for PBM services. Around this core, Exemplar bundles five service modules: Sourcing (access to VAWD-certified wholesale distributors across 48 states), Insurance Solutions (Medicare Advantage, individual/group health, life, P&C), Pharmacy Benefit Management (via partner Pro Rx Solutions), Pharmacy Management (KPI monitoring, inventory, operations), and Physicians Clinical Management Services (credentialing, contracting, billing optimization, accreditation). Additionally, Exemplar operates Exemplar Health, a CMS-approved Medicare Pharmacy Drug Plan serving beneficiaries in North Carolina and Texas, structured to eliminate DIR fee clawbacks.
Exemplar's business model combines zero-cost network membership with transaction-based revenue streams. The PBM is contractually required to distribute 50% of net profit to the network, creating a recurring revenue stream tied to prescription volume across member pharmacies. Additional revenue derives from insurance plan administration (PDP and commercial plans) and indirect monetization through preferred partner referral economics. Go-to-market combines direct field sales to independents, channel partnerships with service providers, and CMS-approved Medicare distribution. The company self-describes as the largest independent healthcare network in the nation, though most data points originate from 2019–2021 and the scale of more recent member growth is not independently confirmed.
Exemplar firmographics
Firmographics- Name
- Exemplar
- Legal name
- Exemplar Healthcare Partnership Organization
- Website
- https://exemplarhpo.com
- Company type
- Private
- Founded year
- 2019
- Operating status
- Operating
- Headcount range
- 101–250 employees
- Short description
- Exemplar Healthcare Partnership Organization is a member-owned network connecting independent pharmacies, primary care physicians, and service providers across 48 states, offering sourcing, PBM, insurance, and management services plus its own CMS-approved Medicare PDP.
- Ownership category
- akta.pro rank
Exemplar industry classification
Industry- Product category
- Healthcare Partnership Network & Pharmacy Benefit Management
- NAICS
- Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292), Direct Health and Medical Insurance Carriers (524114), Agencies, Brokerages, and Other Insurance Related Activities (5242), Offices of Physicians (62111), Pharmacies and Drug Retailers (456110)
- SIC
- Insurance Agents, Brokers & Service (6411), Retail-Drug Stores And Proprietary Stores (5912), Services-Offices & Clinics Of Doctors Of Medicine (8011), Services-Computer Integrated Systems Design (7373)
- akta.pro primary industry
- Group Pharmacy Benefit (Rx) Coverage & PBM-Integrated Plans (FSAIAFAN)
- akta.pro secondary industries
- Association & PEO Group Health Plans (AHP/PEO-Sponsored) (FSAIAFAH), Virtual Pharmacy & Medication Management Integration Platforms (HLALABAL)
Keywords
Where Exemplar is headquartered
LocationHeadquarters
- HQ city
- High Point
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
Exemplar business model
Business model- GTM type
- B2B
- Offering type
- Services
- Cost components
- Personnel, Operations, Marketing or Sales, Technology or R&D, Infrastructure
Revenue model
- PBM Revenue Share: The network generates revenue from the Pharmacy Benefit Management (PBM) operations. The PBM is required to pay 50% of Net Profit to the Network, creating a recurring revenue stream tied to prescription volume and pharmacy transactions within the network.
- Network Membership Value: The network grows and becomes stronger as more independent pharmacies and physicians join, enabling Exemplar to earn more revenue in unison with its members. No membership fee is charged to join the network.
- Insurance Plan Administration: Revenue generated from CMS-approved Exemplar Health PDP and commercial insurance plans, providing Medicare beneficiaries with coverage through independent pharmacies in North Carolina and Texas.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Other | Pay-as-you-go | Network Membership - No Fee |
Go-to-market motion3 records
Distribution channels4 records
Marketing channels7 records
Exemplar product offering
Product offeringCore offering
Exemplar operates a healthcare partnership network that unites independent pharmacies, primary care physicians, and service providers. The company delivers integrated service modules spanning VAWD-certified sourcing, insurance solutions, pharmacy benefit management, pharmacy management, and physicians clinical management, plus a CMS-approved Medicare Pharmacy Drug Plan (Exemplar Health PDP) serving North Carolina and Texas.
Product overview
Exemplar is a Healthcare Partnership Organization offering a unified platform of interconnected services for independent healthcare providers. The core product is the Exemplar Healthcare Partnership Network, which serves as the central hub connecting independent pharmacies and primary care physicians. Around this core, Exemplar provides five integrated service modules: Sourcing Services (VAWD-certified wholesale distribution), Insurance Solutions (Medicare Advantage, health, life, P&C), Pharmacy Benefit Management (claims, formulary, network), Pharmacy Management (operations, inventory, KPIs), and Physicians Clinical Management Services (credentialing, billing, accreditation). Additionally, Exemplar operates its own Medicare Pharmacy Drug Plan (Exemplar Health PDP). The network is powered by innovative software providing nationwide data access to independent healthcare providers.
Differentiator
Problem solved
Functional benefit
Products and services
- Exemplar Healthcare Partnership Network A collaborative healthcare network uniting independent pharmacies, primary care physicians, and service providers to compete with major healthcare organizations through shared tools, services, and expertise.
- Sourcing Services
Quantifiable outcome
- Nearly 250 network members within first six months
- +2 more outcomes
Companies that use Exemplar
Customer profileNamed customers3 records
Segments4 records
Ideal customer profiles5 records
Exemplar technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Feature3 records
Exemplar partnerships and signals
Strategic signalPartnerships
17 partnerships are on record, tiered preferred and core.
- NCPA (National Community Pharmacists Association)preferredExemplar is a corporate sponsor of NCPA, participating in industry conferences and events to connect with independent pharmacists.
- IPD (IPD Pharma)coreIPD Pharma serves as a sourcing partner, providing independent VAWD certified wholesale distributors nationwide. The partnership offers low-cost, high-quality pharmaceutical products from over 65 manufacturers.
- Pro Rx SolutionscorePro Rx Solutions is an independent Pharmacy Benefit Manager (PBM) that tailors solutions to unique needs, reduces costs, and ensures customers get medicines at affordable prices. They are fully integrated with mail, specialty, and compounding pharmacies.
- Exemplar Insurance AssociatescoreInsurance solutions partner providing marketing force for Exemplar Health and Exemplar Commercial Insurance. Offers Medicare Advantage, Medicare Support, and various individual and group insurance products.
- Exemplar HBA (Health Benefits Administrator)coreExemplar Health Benefits Administrator serves as the engine that drives Exemplar Health, handling insurance administration and plan management.
- Elite Benefits GrouppreferredInsurance solutions partner offering customized health insurance plans. Located in North Carolina, providing Individual Health, Group Health, Medicare Support, and other insurance products.
- Bukaty CompaniespreferredInsurance solutions partner providing comprehensive insurance offerings including Individual Health, Group Health, Medicare Advantage, Life Insurance, and Commercial P&C.
- Precision Senior MarketingpreferredInsurance partner focused on senior marketing and Medicare-related insurance products.
- Broker SourcepreferredInsurance broker partner providing access to various insurance products and carrier relationships.
- Allstate BenefitspreferredNational insurance provider partner offering employee benefits and individual insurance products.
- Pinnacle InsurancepreferredInsurance solutions partner providing commercial and personal insurance products.
- Pharmacy Management Company (pharman.co.uk)preferredPharmacy management services partner helping independent pharmacies implement cost-saving strategies and operational improvements.
- Pharmacy Management (pharmacymanagement.net)preferredManagement services partner providing pharmacy management expertise and operational support.
- The Pinnacle Financial GrouppreferredPharmacy management partner offering financial expertise and business optimization services for independent pharmacies.
- SRG (SpecRx Group)preferredPharmacy management services partner providing operational support and management solutions for independent pharmacies.
- Exemplar PAP (Physicians Administration Partner)preferredManagement services partner focused on supporting independent physician practices with administrative functions.
- CMS (Centers for Medicare & Medicaid Services)coreCMS approved Exemplar Health PDP (Pharmacy Drug Plan) contracting documents and post-application requirements for 2021, authorizing service to Medicare beneficiaries in North Carolina and Texas.
Scale indicators5 records
Recent moves7 records
Expansion highlights5 records
Exemplar competitors and assessment
Company assessmentDirect peers
- Pro Rx Solutions: Independent pharmacy benefit manager that is Exemplar's core PBM partner, providing claims processing, mail/specialty/compounding integration, and formulary management for the Exemplar network. Directly comparable in PBM service scope and independent-pharmacy focus.
- IPC (Independent Pharmacy Cooperative): Member-owned purchasing and service cooperative for independent pharmacies, providing sourcing, group purchasing, and operational support — a directly comparable independent-pharmacy alliance model to Exemplar's network.
- PBA Health: Independent pharmacy services organization offering group purchasing, PBM partnerships, insurance, and practice management to independent pharmacies. Highly comparable mission, customer base, and service portfolio to Exemplar.
- Apexus (340B Prime Vendor Program): PBM-like service provider focused on 340B drug pricing programs for safety-net providers, with contracting, distribution, and compliance infrastructure. Comparable as an alternative/non-traditional PBM serving specific provider segments.
Broad incumbents
- Cardinal Health (Cordavis / RxBenefits): Major pharmaceutical distributor and healthcare services company with significant exposure to independent pharmacy sourcing, distribution, and PBM-adjacent services. Comparable in distribution and back-office services for pharmacies but operates at vastly greater scale.
- Cencora (formerly AmerisourceBergen): Top-tier pharmaceutical distributor with independent pharmacy solutions, specialty distribution, and consulting services. Comparable in serving independent pharmacies with sourcing and operational services, though as a global incumbent.
- McKesson: One of the largest pharmaceutical distributors in the U.S. with retail, specialty, and independent pharmacy services including Health Mart, a franchise network for independents. Comparable in providing sourcing, technology, and clinical services to independents.
- CVS Health (Caremark / Aetna): Vertically integrated PBM (Caremark) and health insurer (Aetna) with the largest U.S. prescription volume share. The dominant incumbent competitor whose reimbursement policies and DIR fees Exemplar's PDP is explicitly designed to counter.
- Express Scripts (Cigna / Evernorth): One of the three largest U.S. PBMs, integrated with Cigna health insurance. A primary incumbent competitor shaping the reimbursement and DIR-fee economics that Exemplar's model is built to avoid.
- OptumRx (UnitedHealth Group): The third major vertically integrated PBM, part of UnitedHealth Group, and a key incumbent competitor whose scale and payer integration set the market standards for PBM pricing that Exemplar challenges.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat5 records
Key risks6 records
Key highlights6 records
Customer concentration
Exemplar social profiles
Digital presenceExemplar compliance and trust
Trust signalCompliance2 records
Exemplar financial estimates
Financial estimateRevenue estimate
Valuation estimate
Exemplar leadership team
Management profileNumber of profiles
Profiles3 records
Exemplar funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Exemplar M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Exemplar
What does Exemplar do?
Exemplar operates a healthcare partnership network that unites independent pharmacies, primary care physicians, and service providers. The company delivers integrated service modules spanning VAWD-certified sourcing, insurance solutions, pharmacy benefit management, pharmacy management, and physicians clinical management, plus a CMS-approved Medicare Pharmacy Drug Plan (Exemplar Health PDP) serving North Carolina and Texas.
Is Exemplar a public or private company?
Exemplar is a private company. It is classified as founder individual operated bootstrapped and is currently operating.
When was Exemplar founded?
Exemplar was founded in 2019. It employs 101 to 250 people.
Where is Exemplar based?
Exemplar is headquartered in High Point, United States, in the North America region.
How does Exemplar make money?
Three revenue lines are on record. PBM Revenue Share is the primary driver. The others are network Membership Value and insurance Plan Administration.
Who are Exemplar's main competitors?
Direct peers on record are Pro Rx Solutions, IPC (Independent Pharmacy Cooperative), PBA Health and Apexus (340B Prime Vendor Program). Broad incumbents are Cardinal Health (Cordavis / RxBenefits), Cencora (formerly AmerisourceBergen), McKesson, CVS Health (Caremark / Aetna), Express Scripts (Cigna / Evernorth) and OptumRx (UnitedHealth Group).
Does Exemplar have an API?
No public API is recorded for Exemplar.
What industry is Exemplar in?
Exemplar's product category is Healthcare Partnership Network & Pharmacy Benefit Management. Its primary akta.pro industry code is FSAIAFAN, Group Pharmacy Benefit (Rx) Coverage & PBM-Integrated Plans, with a secondary code of FSAIAFAH, Association & PEO Group Health Plans (AHP/PEO-Sponsored). Its NAICS code is 524292 and its SIC code is 6411.