Inside AffirmedRx’s patient care advocacy model that turns pharmacy calls into empathy

By Greg Becker, CEO ConfirmedRxAdvocacy is a responsibility. The Patient Care Advocacy (PCA) model reflects this belief, offering a unique way of thinking about the benefits of pharmacy that emphasizes personal connection, proactive engagement, and meaningful support to members.

AffirmedRx is a public benefit corporation and pharmacy benefit manager (PBM) committed to transparency, fairness and improving the member experience. The company partners with employers and organizations to manage prescription drug benefits with an emphasis on clarity, access and accountability. “Our goal has always been to build trust in an area where members can often feel confused.” Baker says. “We’re here to simplify that experience and make sure everyone gets the care they need.”

At the heart of this approach lies the PCA model, a relationship-based framework where each advocate acts as a consistent point of contact for members. Whether coordinating prior authorizations, helping to identify cost-effective options, or detailing benefits, an advocate remains committed until the issue is fully resolved. “We don’t measure success by call length or volume.” Baker notes. “We measure that by decision and trust.”

Technology helps make this possible. The PCA platform integrates real-time claims visibility and data-driven alerts, allowing advocates to identify when a member may need help before they even reach out to them. “Technology provides insight.” Baker says, “But it is human connection that provides the solution.”

This connection often becomes life-changing. Earlier this year, during a conversation with a member, an AffirmedRx advocate discovered that a member’s heart failure medication was a financial drag. Realizing that the delay could impact the member’s health, she immediately began looking for alternative access options. I found a patient assistance program through the manufacturer that could provide the medication for free and coordinate the necessary paperwork with both the prescribing physician and the patient. To ensure continuity of care, she also arranged for the doctor to provide samples during the approval process. Within days, the member was enrolled in the program and received his medications for free until the end of the year.

“The member did not have to suffer the stress of waiting or worry about affordability.” says Megan Mullaney, Vice President of Client Management at AffirmedRx. “This is the effect of an advocate, someone working quietly in the background to make sure care continues uninterrupted.”

AffirmedRx’s approach is centered around consistency and compassion. Each advocate is trained as a community health worker, and equipped with clinical and interpersonal skills to support members in ways beyond pharmacy coordination. Advocates help members access assistance programs, locate community health resources, and even understand practical steps to maintain adherence. “The PCA’s role is part navigator, part listener, and part problem solver,” Baker says. “It’s about understanding the whole person, not just the prescription.”

The data confirms the value of this approach. According to Baker, AffirmedRx’s PCAs have completed more than 52,000 proactive outreach calls so far this year, reaching members before small obstacles turn into bigger challenges. Becker emphasizes that these interactions are deliberate efforts to anticipate needs, clarify options, and build trust. “It’s about being there before someone asks for help.” Baker says.

This attention can also benefit employers. By resolving pharmacy issues directly with members, PCAs help reduce the administrative burden often placed on HR or benefits teams. “When we take on the role of advocate, it means fewer interruptions for our customers and more confidence that their employees are supported.” Mulaney says. “It creates a sense of reassurance that the system is working as it should.”

The ripple effects extend to overall well-being and continuity of care. Studies have shown that when… Medication costs exceed $125A large percentage of patients choose not to fill their prescriptions. AffirmedRx’s PCA model addresses this gap by identifying cost barriers early and finding alternative pathways or resources to keep members on their treatment plans. “Commitment means removing obstacles that prevent people from getting the care they deserve.” Baker says.

As a public benefit corporation, AffirmedRx embeds purpose into every level of its operations. PCA is an expression of that mission, a blend of technology, empathy and accountability designed to serve individuals and organizations alike. “We believe that care should always start with listening.” Mulaney says. “When we listen, we learn. When we act on what we learn, we build a system that truly supports people.”

For Baker, this philosophy defines the future of pharmacy benefits management: one that moves forward through collaboration, transparency and empathy. “Every time an advocate helps someone get the medication they need, it’s a reminder of why we’re here.” Baker says. “It’s about care in the true sense of the word.”