Cell and Gene Therapy Insurance
Creating Accessibility to Life Saving, Costly Therapies
Impossible. Incurable. Inaccessible.
Our cell and gene therapy insurance solutions provide cost-effective coverage, access to 100+ centers of excellence, and comprehensive patient support services to achieve optimal clinical and financial outcomes for members.
Who We Serve
Our comprehensive insurance solutions go beyond covering the cost of therapy. We uniquely include ancillary medical expenses and travel-related costs for both the patient and their family. Plans also gain access to value-added services such as dedicated patient care navigation and a national network of more than 100 Centers of Excellence.
As an independent, payor-agnostic partner, we integrate seamlessly with your existing ecosystem. Our stand-alone model allows us to collaborate without disrupting current vendor relationships.
Click below to learn how we can partner with you.
Deliver Financial Stability to Your Clients
We recognize the essential role the insurance brokerage community plays as trusted advisors, guiding clients through complex and emerging business risks.
That’s why OutcomeRx partners closely with brokers to educate employers on the rapidly evolving cell and gene therapy (CGT) landscape. Together, we deliver flexible, comprehensive cell and gene therapy insurance coverage solutions designed to address the financial exposure these therapies present — protecting both the organization and its employees.
We collaborate across the full brokerage spectrum, including wholesale specialty brokers, retail brokers and agents, employee benefit brokers and consultants, and reinsurance professionals.
Approved Cell and Gene Therapies Are Increasing.
So Should Your Coverage.
Cell and gene therapies (CGTs) are rapidly advancing through the FDA pipeline, increasing both opportunity and financial risk. Whether you’re a broker, TPA, carrier, captive, or MGU, now is the time to implement protective coverage and restore financial stability.
Amplify Your Cell and Gene Therapy Coverage Protection
These potentially life-saving therapies come with multi million dollar price tags attached, and the costs are going nowhere but up. It's time to fill the holes in your coverage.
Highly customizable coverage solution for CGTs backed by A rated carriers
Member access to over 100 Centers of Excellence
Data insights that capture essential quality measures
Financial predictability and laser protection
Implement at any time
Stay ahead of new risk exposure and access flexible coverage options.
Reducing Uncertainty with Cell and Gene Therapy Warranty
OutcomeRx's Cell & Gene Therapy (CGT) Warranties align healthcare stakeholders around patient access and durable clinical outcomes.
As more CGTs gain FDA approval, OutcomeRx can bridge the needs of plans and manufacturers by designing and administering therapy-specific warranties.
Features
A therapy-specific warranty structure that mitigates financial risk and uncertainty, and improves patient access to CGTs
Flexibility for a wide array of warranty coverage options that can benefit plans, providers, or patients
Fits within existing plan and provider claims management workflows to minimize administrative burdens.
Dedicated OutcomeRx team to design, develop and manage warranty programs, including claims management
Benefits
Easy to administer
Removes barriers to patient access
Differentiates your business without increasing risk
Complementary to OutcomeRx’s coverage for plans
The Challenge
Value-based agreements represent alternative options to address plan concerns about cell and gene-based therapy efficacy and durability. While these options can provide a measure of risk protection, they can also be limited in coverage scope, reimbursement terms, and administratively complex for plans and providers.
The Resolution
OutcomeRx’s Therapy Warranties can mitigate plan and manufacturer challenges and help improve provider and patient access to CGTs. OutcomeRx serves as an independent third party, providing the insurance infrastructure that bridges gaps between all key stakeholders.
CGT Conferences and Events
About Us
OutcomeRx is accelerating patient access to curative therapies. We strive to support our clients by delivering the industry's leading cell and gene therapy (CGT) insurance coverage solutions and patient support services through excellence by our underwriting, actuarial, claims management, clinical, and operations teams. Together, we ensure patients receive the greatest care and support possible.
Our Mission
Delivering affordable patient access to life-changing cell and gene therapies through innovative coverage solutions that stabilize risk, protect plan sponsors, and align clinical and financial outcomes.
Our Vision
We envision a world where every patient who needs a cell or gene therapy can access it without financial barriers, supported by expert care navigation and treated at leading Centers of Excellence to achieve the best possible outcomes.
Our Values
We believe in:
- Patient-Centric Care – Each decision we make is centered around improving patient outcomes and reducing their financial burden.
- Service Excellence – We provide premier service to our clients in everything we do to ensure their goals and expectations are fully met.
- Continual Innovation – Our dedication to maintaining thought leadership and anticipating market changes drives our ever-evolving solutions and delivery to clients.
- Trust – Our actions and decisions are motivated by building and nurturing trust in each relationship.
Our Team
Joe Morse
Chief Executive Officer
Joe serves as CEO of OutcomeRx. With 28 years in the healthcare industry, Joe has worked with every key stakeholder to align and deliver patient-centric solutions and services.
In 2006, he co-founded Therigy, LLC and served as President & CEO, overseeing its consulting and technology solutions for pharmacies, payors, and manufacturers. Prior to Therigy, he held the position of Vice President of Business & Corporate Development at the Aetna Specialty Pharmacy. Previously he served as Vice President of Business & Corporate Development with Priority Healthcare, where he applied his managed care expertise. Joe began his career at Accenture as a Manager in the Health Services Practice working with national and regional health plans on strategy, technology, and managed care initiatives.
Joe received a B.A. in Economics from the University of Florida. He has served and supported the Leukemia and Lymphoma Society for over 15 years. Joe collaborates with industry colleagues by serving on the Board of Directors for the National Association of Specialty Pharmacy as well as the Cell & Gene Task Force for the Self-Insurance Institute of America (SIIA).
Kirby Eng, R. Ph.
Chief Clinical Officer
Kirby has served in a wide array of senior and executive healthcare leadership positions within managed care, specialty pharmacy, healthcare consulting, healthcare technology, provider development, group purchasing, specialty distribution, and pharmaceutical manufacturers.
Before OutcomeRx, Kirby’s key roles and responsibilities included developing clinical oncology and specialty drug management solutions, business development, strategic planning, sales, and marketing representing organizations that included D2 Solutions, Onco360, CVS Health, CuraScript/ExpressScript, US Oncology, Oncology Therapeutics Network, Sicor, Fujisawa, and Eli Lilly & Company.
As Chief Clinical Officer for OutcomeRx, Kirby is responsible for creating and implementing practical cell and gene therapy clinical solutions that are patient-centered and align key stakeholders with costeffective options that complement OutcomeRx’s reinsurance and therapy warranty solutions.
Kirby is a licensed pharmacist with a B.S. in Pharmacy from the Arnold & Marie Schwartz College of Pharmacy and is an active member of the National Association of Specialty Pharmacy, the Academy of Managed Care Pharmacy, and the American Society of Gene & Cell Therapy.
Daryl Davis
Chief Financial Officer
Daryl Davis is Chief Financial Officer of OutcomeRx. Prior to joining OutcomeRx, Daryl held various CFO & Controller roles in the insurance, construction and software sectors. Daryl has spent most of his career in the insurance industry, from workers’ compensation, health and Medicare, including audits, NAIC Annual Statements, state assessments and income taxes. Daryl’s experience spans both public and privately owned companies and has also accumulated extensive work in mergers and acquisitions. Daryl previously spent several years in the public accounting field and is a CPA.
Larry Bailey
Vice President of Business Development
Larry has 25 years of experience in the Life & Health insurance industry, holding senior Financial, Product, and Underwriting roles with multinational insurers, working both domestically and overseas. His international roles were concentrated in Latin America and included Regional SVP of Finance, Mexico Chief Technical Officer, and Brazil Executive Director/Chief Actuary. His domestic roles included Head of Insurance Product and Operations and Chief Product and Underwriting Officer.
Recently he has concentrated on the InsurTech side, working with Fintech/Insurtech start-ups, as well as co-founding a digital Life and A&H broker.
Larry uses his broad experience and technical background to develop data-driven insights supporting sound business decisions. He has a BS in Management, an MS in Actuarial Science, and is conversational in Portuguese and Spanish.
Bill Megna
Insurance Regulatory Counsel
Mr. Megna has been in private practice for close to 4 decades. Prior to entering private practice, Mr. Megna held various in-house insurance positions including: Vice President and Counsel for Home Life Insurance, Associate Counsel and Florida Regional Council for USLIFE Corporation and Vice President and General Counsel for USLIFE Realty Corporation of Florida.
Mr. Megna has represented many clients in the formation and licensing of insurers and producers, in obtaining approval of rates and forms, as well as enforcement matters. Mr. Megna has served as counsel to the Washington, DC Life and Health Insurance Guaranty Association for over a decade. He is the co-director of the Genova Burns, LLC insurance practice group and frequently co-counsels for mutual clients with other insurance law firm regulator practice groups.
Regarded as an authority on insurance law, Mr. Megna frequently speaks on insurance matters before business and bar associations. Mr. Megna is the past Chairman of the New Jersey State Bar Association’s Insurance Section and a current trustee of the Captive Insurance Group of New Jersey. He has been listed in New Jersey Super Lawyers for insurance law and New York Area’s Best Lawyers for government relations law.