Progressive Medical, Inc.

What Progressive Medical, Inc. does

Progressive Medical, Inc. (legal entity Progressive Medical, LLC) is a pharmacy benefit management and claims services provider operating as dba Optum Workers' Compensation Services of Ohio, a wholly-owned subsidiary of Optum, Inc. (itself part of UnitedHealth Group). The company delivers managed services to the workers' compensation and auto no-fault insurance verticals, including prescription management, pharmacy network access, clinical support, and claims workflow tooling for insurance carriers, claims professionals, healthcare providers, and injured workers. The business has 195 employees, is headquartered in Ohio, and reports serving 500,000+ injured persons with a 92% average client satisfaction rate and 15+ years of average industry experience across its team.

The company's product surface is organized around two core lines — Workers' Compensation Services and Auto No-Fault Services — and a set of modular digital and clinical add-ons: the Pharmacy Locator, Digital Pharmacy Card, Ask-a-Pharmacist consultation, Tmesys pharmacy network, Topicals Toolbox clinical resource, Home Delivery mail-order pharmacy, Clinical Connection insights platform, Policy Matters regulatory resource, and Continuing Education programs. Supporting assets include URAC Gold accreditation (certification ID WCP006610) for workers' compensation pharmacy benefit management, a content hub at workcompauto.optum.com, and a corporate LinkedIn presence. The entity is one of five affiliated legal entities (alongside PMSI in Florida, Cypress Care in Georgia, Healthcare Solutions in Georgia, and Procura Management) consolidated under the Optum Workers' Compensation and Auto No-Fault division.

Go-to-market is enterprise B2B field sales targeting insurance carriers and large self-insured employers under contract arrangements, with services distributed through direct enterprise relationships, secure web-based portals for claims professionals and providers, and the Tmesys pharmacy provider network. Pricing is not publicly disclosed. Revenue is recognized as managed services income and no specific financial figures are available in the input data. The company has no disclosed funding history, no M&A activity, no patents or trademarks, and no independent management team disclosures, consistent with its position as an operating subsidiary within a much larger parent organization.

Name

Progressive Medical, Inc.

Legal name

Progressive Medical, LLC

Website

https://progressive-medical.com

Company type

Private

Operating status

Operating

Headcount range

101–250 employees

Short description

Progressive Medical, Inc. provides pharmacy benefit management and claims services for the workers' compensation and auto no-fault insurance verticals, serving insurance carriers, claims professionals, healthcare providers, and injured workers through Optum's Workers' Compensation and Auto No-Fault division.

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), Ambulatory Health Care Services (621)

SIC

Services-Health Services (8000)

akta.pro primary industry

Mail-Order Pharmacy & Home Delivery (HLAEAKAF)

akta.pro secondary industries

Pharmacy/Medication Management & Virtual MTM (Payer-Sponsored) (HLALACAK), Medication Reconciliation & Transitions-of-Care Pharmacy Services (HLAFALAK)

Keywords

• Workers compensation pharmacy
• Pharmacy benefit management
• Auto no-fault services
• Pharmacy network services
• Claims care coordination

Headquarters

HQ city

Ohio

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

Revenue model

1. Workers' Compensation Pharmacy Services: Pharmacy benefit management and related services for workers' compensation claims, including prescription management, network access, and clinical support for injured workers

Go-to-market motion1 record

Distribution channels3 records

Marketing channels3 records

Core offering

Progressive Medical delivers pharmacy benefit management and integrated care coordination services for the workers' compensation and auto no-fault insurance verticals. Offerings include prescription management, pharmacy network access through the Tmesys network, clinical and policy insights, virtual pharmacy card access, mail-order home delivery, and customized care programs for injured workers and claimants under contract with insurance carriers and self-insured employers.

Product overview

Progressive Medical, LLC (dba Optum Workers' Compensation Services of Ohio) operates as part of the Optum Workers' Compensation and Auto No-Fault division, which also includes PMSI (Florida), Cypress Care (Georgia), Healthcare Solutions (Georgia), and Procura Management. The company offers a unified platform of workers' compensation and auto no-fault solutions comprising core pharmacy benefit management services, integrated care coordination, clinical insights (Clinical Connection), and policy guidance (Policy Matters). Supporting these core offerings are modular add-on services including a Pharmacy Locator, Digital Pharmacy Card, Ask-a-Pharmacist consultation, Tmesys Network management, Topicals Toolbox clinical resources, Home Delivery pharmacy, and Continuing Education programs. Together, these products serve injured workers, insurance carriers, claims professionals, and healthcare providers across workers' compensation and auto no-fault lines.

Differentiator

Problem solved

Functional benefit

Products and services

• Workers' Compensation Services Comprehensive workers' compensation solutions delivering outcomes for insurance carrier clients and injured workers, including pharmacy management, clinical connections, and integrated care coordination.
• Auto No-Fault Services Auto no-fault insurance solutions that extend benefits for policyholders and deliver improved experience for claims professionals through integrated pharmacy and care management.
• Pharmacy Locator Digital pharmacy finder tool enabling injured workers, claimants, and claims professionals to locate participating pharmacies within the Optum network.
• Digital Pharmacy Card Virtual pharmacy card solution allowing claimants electronic access to pharmacy benefits and claims information.
• Tmesys Network Pharmacy network management service coordinating pharmacy benefits across the workers' compensation and auto no-fault divisions.
• Home Delivery Pharmacy Mail-order pharmacy service enabling home delivery of medications for injured workers and claimants served via the [email protected] channel.
• Ask-a-Pharmacist Pharmacist consultation resource providing clinical guidance to injured workers and healthcare providers within the workers' compensation and auto no-fault service lines.

Quantifiable outcome

• 92% average satisfaction rate
• +1 more outcomes

Named customers2 records

Segments4 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature5 records

Scale indicators4 records

Recent moves5 records

Expansion highlights4 records

Broad incumbents

• Mitchell International (Genpact): Provider of workers' comp and auto claims management software, bill review, and pharmacy networks; comparable as a broader workers' comp services incumbent with overlapping PBM and network capabilities.
• Express Scripts (Evernorth/Cigna): One of the largest U.S. pharmacy benefit managers, serving commercial, Medicare, and specialty drug plans; comparable as a broad PBM incumbent whose infrastructure and scale compete with niche workers' comp PBMs.
• GENEX Services: Workers' compensation managed care services provider offering utilization review, case management, and pharmacy-related services to insurance carriers; comparable in serving the same workers' comp buyer base.
• CVS Caremark (CVS Health): Major diversified PBM integrated with CVS retail pharmacies and Aetna; comparable as a broad incumbent PBM that workers' comp and auto no-fault carriers may evaluate as alternatives for pharmacy benefit services.
• OptumRx: Optum's flagship PBM serving large commercial, Medicare, and employer clients; comparable as a broad PBM within the same parent organization that competes for similar pharmacy benefit administration workloads in adjacent lines.

Direct peers

• Healthcare Solutions, Inc. (dba Optum Healthcare Solutions of Georgia): Another sibling in the Optum Workers' Comp and Auto No-Fault division providing managed care services to workers' compensation and auto no-fault carriers, with overlapping PBM-adjacent capabilities.
• PMSI, LLC (dba Optum Workers' Compensation Services of Florida): Sister entity within Optum's Workers' Compensation and Auto No-Fault division offering the same workers' comp pharmacy benefit management, clinical, and digital services across different state jurisdictions; directly comparable in product, customer, and operating model.
• Helios (formerly HSM Solutions/Helios PBM): Workers' compensation-focused PBM and ancillary services provider serving insurance carriers and employers; directly competes with Progressive Medical in the workers' comp pharmacy benefit management niche.
• Procura Management, Inc. (dba Optum Managed Care Services): Optum Workers' Comp and Auto No-Fault sibling offering managed care services including utilization review and bill review; closely aligned with Progressive Medical in serving the same insurance carrier and claims professional buyer base.
• Cypress Care, Inc. (dba Optum Workers' Compensation Services of Georgia): Sister Optum entity delivering workers' comp and auto no-fault pharmacy and care management services in Georgia; mirrors Progressive Medical's offerings in a different state and is one of the most direct operational comparables.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks5 records

Key highlights6 records

Customer concentration

• LinkedInlinkedin.com/company/progressive-medical-inc.

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

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 Progressive Medical, Inc.