23 Feb 2024

Waltz Health introduces Medicare market entry for prescription savings

Digital health company Waltz Health has entered the Medicare market with its customisable Marketplace Search technology. This AI-driven digital search engine aims to optimise prescription drug pricing for various healthcare organisations, including health plans, pharmacies, PBMs, and self-insured employers. For Medicare beneficiaries, Marketplace Search serves as a user-friendly tool to discover savings on covered medications during coverage gaps, identify cost-effective cash-pay alternatives for uncovered medications, and access patient-assistance programs tailored to the Medicare demographic. 


SCAN Health Plan, a nonprofit Medicare Advantage provider, is the first to adopt a customised version of Marketplace Search for Medicare use cases, providing a platform for eligible Medicare Part D members to explore reduced cash-pay rates and pharmacy-based patient assistance programs during coverage gaps. Waltz Health is extending its reach to address the needs of Medicare beneficiaries after initially targeting the commercially insured demographic with Marketplace Search.


The struggle with out-of-pocket drug expenses, particularly among underserved groups, is addressed by Marketplace Search, offering a valuable platform for health plan members to discover savings. Waltz Health's technology has already seen deployments in four national pharmacy chains, yielding average savings per prescription that surpass alternative single prescription drug savings card solutions. 


The company is also developing a specialty-drug solution for health plans to enhance transparency, reduce medication costs, improve member experience, and enhance health outcomes for complex specialty conditions, which represent the fastest-growing segment of prescription spending in healthcare. Waltz Health CEO Mark Thierer highlighted the company's commitment to empowering Medicare Advantage plan members with more choices and information, delivering savings and aiding in member retention.


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