Waltz Health enters Medicare Advantage space with SCAN collaboration
SCAN Health Plan is the first payer to offer a tailored version of Marketplace Search for its members specifically for a Medicare use case.
Photo: Marko Geber/Getty Images
Digital health company Waltz Health, which focuses on technology-enabled ways to price, distribute and prescribe medications, will be entering into the Medicare Advantage arena.
The company will offer health plans that support Medicare beneficiaries' customizable configurations of its proprietary Marketplace Search technology, which lowers prescription drug prices for members while also providing health plans with insight into adherence trends.
Marketplace Search is a white-labeled digital search engine that applies AI to a curated mix of discounted drug pricing sources to help healthcare organizations – including health plans, PBMs, pharmacies and self-insured employers – save their populations money when filling prescriptions.
For plans that support Medicare beneficiaries, the use cases for Marketplace Search can vary depending on their needs. According to Waltz, it gives health plans a tool to assist members in finding savings on covered medications during a coverage gap, finding lower-cost, cash-pay solutions for medication not covered by their plan, and finding patient-assistance programs available to the Medicare population.
WHAT'S THE IMPACT?
SCAN Health Plan, one of the nation's largest nonprofit Medicare Advantage health plans, is the first payer to offer a tailored version of Marketplace Search for its members specifically for a Medicare use case.
This is the second unique deployment for Waltz Health's technology since the company expanded to the payer, pharmacy benefit manager and self-insured employer markets last September. While Waltz Health's first deployment of its Marketplace Search for Health Plan tool is primarily catered towards the commercially insured population, the second deployment allows Waltz to extend its technology to address the needs of the Medicare population.
In addition to its recent deployments in the health plan segment, the company also has other unique versions of Marketplace Search deployed in four national pharmacy chains with thousands of locations, with the company saying the savings being generated compare favorably to other solutions.
Concurrently, the company is working on a specialty drug solution for health plans, which it said will provide more transparency, reduce medication costs, enhance member experience and improve health outcomes for complex specialty conditions.
THE LARGER TREND
Waltz Health launched in 2022 with $35.4 million in Series A funding. GV led its Series A round with participation from Define Ventures, Echo Health Ventures, Blue Venture Fund, Byers Capital, Twine Ventures and individual healthcare executive investors.
Other companies looking to lower prescription drug prices for consumers include Mark Cuban Cost Plus Drug Company, drug cost and telehealth company GoodRx, Amazon and Transcarent, a healthcare platform for self-insured employers.
ON THE RECORD
"Our tailored versions of Marketplace Search empower the members of Medicare Advantage plans with more choice and information when they're searching for better prices on their prescription drugs, delivering savings for them and helping the plan with member retention," said Waltz Health CEO and cofounder Mark Thierer. "We're honored to be working with such prestigious Medicare-focused health plan partners and look forward to helping them solve more unique use cases like coverage gaps."
Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.
