Walmart and Transcarent partner to lower costs in the self-insured market 

Transcarent, led by CEO Glen Tullman, has partnered with Walmart for prescription drug and other offerings for the self-insured market.

Photo courtesy of Transcarent

Walmart and Transcarent have announced a partnership to lower prescription drug and other prices for the self-insured market.  

The agreement allows Transcarent, which offers a digital platform "overlay" to existing plans for self-insured employers, to share Walmart prices on pharmaceuticals and other services with employees, the companies said.

Employers have no up-front or per-employee, per-month, fees, as Transcarent offers a fully at-risk model. Transcarent also pays health systems up-front for surgeries. 

WHY THIS MATTERS

The partnership is marketed as offering self-insured employers cost-effective health and wellness options.

"Together, Walmart and Transcarent have the scale and innovation required to transform the way health and care are delivered and paid for across the nation, regardless of a person's economic or geographic situation," said Glen Tullman, CEO of Transcarent. 

Walmart offerings include pharmacy, optical and telehealth services that include behavioral health. 

Transcarent will serve as the "on-ramp" for self-insured employers and their employees to round-the-clock personalized healthcare, the companies said.

Employees and their families will be able to engage Transcarent's Health Guides and extended clinical team for information and guidance to better understand care options and associated costs, and for access to virtual and in-person care through Transcarent's digital offerings, Transcarent's Centers of Excellence or Walmart's in-community clinics.

Transcarent navigates members to high-quality, low-cost care, even if that means flying them to the appropriate facility, Tullman said in a March interview with Healthcare Finance News.

THE LARGER TREND

The pairing is the latest in a trend towards cutting down on health insurance costs through digital innovation, a concept piloted, but never brought to scale, by the now defunct Haven, the company founded by Amazon, Berkshire-Hathaway and JPMorgan Chase. 

Another effort is that of using direct provider networks to bypass traditional insurance. 

Northwell Health announced last week that it had selected Northwell Direct to supply the provider network for the health system's 75,000 employees and dependents, eschewing the traditional approach of teaming with a private insurer.

Half of all Americans are covered by employer-sponsored health insurance, according to the Kaiser Family Foundation. In 2020, the average annual premiums for employer-sponsored health insurance were $7,470 for single coverage and $21,342 for family coverage.

The self-insured Walmart has 2.2 million employees worldwide.

ON THE RECORD

"We are committed to providing care to customers and the communities we serve through an integrated, omnichannel approach that improves engagement, health equity and outcomes," said Dr. Cheryl Pegus, executive vice president of Health & Wellness at Walmart.

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com