An Interview with VistaRx Leadership: Tripp Harper and Rob Thorn

In an industry defined by reactive processes and siloed systems, VistaRx is taking a fundamentally different approach to pharmacy spend management. We sat down with company President Tripp Harper and Chief Revenue Officer Rob Thorn to discuss how Vista is modernizing drug cost management in skilled nursing and long-term care for facilities and pharmacies through real-time data capture, automation, and integration that accommodates existing processes.

Purpose-Built for Skilled Nursing and Long-Term Care

Q: What inspired VistaRx’s formation, and what sets it apart in such a complex space?

Tripp Harper: Vista was built on the foundation of experience across multiple sectors, including healthcare, technology, and finance. We brought that perspective into post-acute care because we saw that no one had fully committed the time, resources, or customized technology needed to solve these complex problems at scale.

Rob Thorn: And skilled nursing and long-term care aren’t just complex, they’re underserved. Most of the solutions out there are adapted from other settings. They weren’t built for these types of care, and it shows. We’re not trying to shoehorn in systems from hospitals or retail pharmacies. Our solutions are purpose-built.

Tripp: You’ve also got silos everywhere—facilities, pharmacies, billing, and EHR systems that don’t talk to each other. We’re closing those gaps with real-time connectivity.

The End of the Rebates Era?

Q: What broader industry changes are shaping VistaRx’s work?

Tripp: For years, rebates were one of the main ways LTC facilities controlled pharmacy costs. But that strategy is running out of steam. Fewer drugs are offering rebates, and the rebate amounts are shrinking. So, operators have to find more sustainable, more proactive ways to control and reduce spend.

Rob: That’s exactly right. Managed care plans are becoming more prominent, and cost pressures are growing. The goal has to be stopping unnecessary spend before the medication is even dispensed. Not after the fact, when it’s too late to make a change.

Tripp: That’s where Vista comes in. If you can “accurize” the billing—tighten up the payer data, eliminate coverage gaps—you stop a lot of the leakage that’s been baked into the system. That’s core to what we have been bringing to market recently in the form of Clean Bill and Focus.

Clean Bill: Eliminating Errors Before They Happen

Q: How Did the Idea for Clean Bill Come About?

Rob: Clean Bill grew directly out of our philosophy of improving connectivity and communication. We wanted to connect the facility and the pharmacy in real time because they just weren’t speaking the same language. We started by building a commercial-grade adjudication platform that could enforce contract pricing, catch errors, and block invalid claims before they were billed. 

Tripp: When we originally approached PointClickCare with the concept of Clean Bill, it was mostly an integration that would handle census data corrections. As we built it out, we discovered a host of interrelated processes were triggered by a lack of census data integration, so Clean Bill grew to solve these issues as well. Our latest version integrates more data, automates more decisions, and eliminates human error. 

Rob: One of the biggest issues we solved with Clean Bill was the timing mismatch. Pharmacies aren’t notified in real-time when a patient changes census from Medicare Part A to a different payer, so they fill meds and bill incorrectly until that information is updated. Clean Bill prevents that by blocking the fill at the pharmacy’s point-of-sale system until the payer data is corrected.

Tripp: A unique aspect of Clean Bill is our exclusive API that enables us to connect with PointClickCare in real-time. This is the real magic of Clean Bill that works flawlessly. As the only pharmacy cost management solution on the PointClickCare marketplace, we’re also developing more ways for facilities and pharmacies to improve operations and streamline processes.

Real Results: ROI You Can See

Q: What kinds of savings are clients seeing from Clean Bill?

Tripp: A lot of facilities don’t even realize how big their billing issues are until we show them the numbers.

Rob: In terms of hard savings alone, we’ve identified upwards of $3500 per facility per month in billing discrepancies, namely contract price deviation and errors from coverage gaps. Once you factor in the soft savings Clean Bill provides by eliminating the need to spend time and money on audits and denials and improving processes, Clean Bill pays for itself multiple times over.

Real-Time Adjudication: The Backbone of Prevention

Q: What role does adjudication play in VistaRx and your services?

Rob: Our adjudication platform is a foundational component of our capabilities. It powers Clean Bill and Focus. With adjudication, we can do things like blocking high-cost medications, enforcing custom approval rules, and manage formularies in real time.

Tripp: It also means that we don’t just hand off reports with errors highlighted and say, “Good luck.” That’s the approach we’ve seen when vendors audit retroactively and then tell the facility to go fix it. But SNFs are overworked. They’re not pharmacy experts. They don’t have the time or training to chase down every correction, let alone improve practices that prevent these mistakes from happening.

Rob: And that’s the real value of our adjudication infrastructure. Our system prevents the issue before it ever hits the facility’s ledger. And if a pharmacy doesn’t allow third-party adjudication, we still audit faster than anyone else. We can turn audits around daily or weekly, so the window to reverse claims is still open. This is almost impossible to achieve on a 30-day recurring schedule.

Focus: Smarter Pharmacy Cost Management

Q: Explain how Focus works—it’s not a typical service or functionality that rebate aggregators have been offering in the space.

Rob: Firstly, most rebate aggregators use flat files. That means they take a pharmacy’s billing spreadsheet, highlight the basic drug data, and send it off. It’s minimal, and because of that, rebate claims often get denied or flagged in audits, there are duplicates submitted, invalid data, and so on. 

Tripp: Focus is different in many ways. We ingest any billing data and run it through our adjudication platform before submission. That means every claim is clean, complete, and audit-ready. It’s the kind of data quality that actually increases rebate amounts.

Rob: We’ve invested in a commercial-grade adjudication engine that meets NCPDP standards. That’s rare in this space because most vendors don’t want to spend against their rebate margin. Our model isn’t dependent on rebates, so we can afford to do it right.

Tripp: And since we’re creating infrastructure that proactively controls pharmacy spend, not just a rebate service, we can submit rebate data to a provider’s existing rebate partner if needed. It doesn’t matter who “owns” the pharmacy relationship, Focus provides drug cost management from day one—streamlining rebate workflows, formulary adherence, and contract pricing. 

Rob: It’s a winning piece of the puzzle that benefits SNFs by saving 8% or more on net costs and streamlines processes for pharmacies. There are a lot fewer calls or faxes required when Focus is supporting operations. 

Onboarding and What’s Next

Q: What’s the turnaround time for getting started with Vista’s solutions?

Rob: We’re live within a month in most cases. The biggest lift is setting up contract rules correctly in the system. Once that’s done, it runs smoothly. We’re collaborative, and we customize based on what the facility or pharmacy wants, whether it’s Clean Bill, Focus, adjudication, or any combination.

Tripp: The work is front-loaded on our end. But once it’s in place, it’s a huge operational win that pays off in dividends month after month.

Final Thoughts

Tripp: We’re not just another rebate manager. We’re a full spend control solution. Whether it’s census data, contract rules, or pharmacy workflows, we solve for all of it.

Rob: The end goal is simple: stop problems before they happen. And make it easy for SNFs and pharmacies to focus on care, not paperwork. We aim for everything we do to be low-intervention, or even zero intervention, so the SNFs and pharmacies can control costs and improve their operations without having more to monitor, more calls to make, more sheets to check.

Proactive Pharmacy Spend Management

VistaRx develops purpose-built pharmacy spend management solutions for skilled nursing facilities and long-term care pharmacies. Using commercial adjudication, PointClickCare integration, automation, and deep industry expertise, we help organizations lower the impact of drug costs, by eliminating billing errors, and streamlining operations. 

Our approach means a near-zero intervention infrastructure platform that works seamlessly to enforce contract pricing and correct payer billing. We also manage formularies with drug tier strategies that build more flexibility into operations to lower net costs.

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