Particle Health vs CoverMyMeds
Side-by-side comparison of AI visibility scores, market position, and capabilities
Particle Health provides a health data exchange API enabling healthcare apps to access longitudinal patient records from national networks with a single integration.
About
Particle Health is a health data exchange company founded in 2018 that provides developers and healthcare companies with a single API to access patient clinical records from national health information networks including CommonWell, Carequality, and others. The company abstracts the complexity of connecting to dozens of regional health information exchanges and national networks behind a simple developer-friendly API, enabling healthcare applications to retrieve longitudinal patient records including medical history, lab results, diagnoses, and medications from any participating provider. Particle raised $60M and serves digital health companies, telehealth platforms, health plans, and healthcare analytics firms that need access to real-world patient data to power clinical decision support, care management, and value-based care programs. The company provides HIPAA-compliant data access with identity verification and purpose-of-treatment validation to ensure appropriate use of patient records. Particle's API approach reduces the time and cost for healthcare companies to build clinical data infrastructure from months of complex integrations to days of API implementation.
Largest prior authorization network in the US connecting 75K+ pharmacies, 750K+ providers, and all payers. Columbus OH; acquired by McKesson; available free to providers and pharmacies; processes millions of PA requests annually for specialty and retail prescriptions at no provider cost.
About
CoverMyMeds is the largest prior authorization platform in the United States, operating a network that connects more than 750,000 providers, 75,000 pharmacies, and virtually all payers to streamline the authorization process for prescription medications. Founded in 2008 in Columbus, Ohio, and acquired by McKesson Corporation in 2017, CoverMyMeds processes millions of prior authorization requests annually and has become foundational infrastructure for the US pharmacy and specialty medication market. The platform is available at no cost to providers and pharmacies and is funded through health plan and PBM partnerships.\n\nCoverMyMeds' network effect is central to its value: because the platform is used by the vast majority of pharmacies and a very large share of prescribing providers, payers can reach their entire provider and pharmacy network through a single connection. The platform supports real-time benefit checks that show the formulary status and prior authorization requirements for a drug at the point of prescribing, enabling providers to make more informed prescribing decisions before a patient reaches the pharmacy counter. Automated electronic prior authorization (ePA) workflows reduce approval times from days to hours for eligible drug-payer combinations.\n\nAs part of McKesson, CoverMyMeds has expanded its capabilities to include specialty medication access solutions, patient assistance program enrollment, and medication adherence tools. The company's RxCrossroads subsidiary provides hub services for specialty pharmaceutical manufacturers, creating a comprehensive access ecosystem that spans from initial authorization through patient support and adherence management.
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