US-Based Waltz Health Partners with SCAN to Venture into Medicare Biz

The Marketplace Search tool, powered by AI, reduces drug expenses for Medicare Advantage members by offering curated prescription discounts.

US-based Waltz Health, a digital health company, has recently expanded its operations into the medicare market following its recent entry into the payer space. The company has partnered with SCAN Health Plan, a California-based medicare advantage insurer, to offer its marketplace search tool to medicare beneficiaries.

The marketplace search tool, which utilizes AI, aims to lower prescription drug costs for members of medicare advantage plans. It provides access to curated drug discounts, helping patients and healthcare organizations save on prescriptions. 

Sharing thoughts, Mark Thierer, CEO of Waltz Health, said, "We know that in Medicare Advantage, the biggest problem that they're dealing with, or one of the bigger problems, is that these seniors who cannot afford drugs are moving into a dangerous place.”  

He highlighted the importance of addressing the financial burden faced by seniors, particularly in navigating the "donut hole" where drug costs escalate significantly.

Partnership with SCAN Health Plan

Through the tailored version of the Marketplace Search tool for Medicare, beneficiaries enrolled with SCAN gain access to critical information on prescription discounts, especially pertinent when navigating the coverage gap, including the aforementioned "donut hole."

Additionally, Thierer noted that SCAN is using marketplace search to enhance its existing offerings, indicating SCAN's enthusiasm for the tool. He highlighted ongoing discussions with other payers about Waltz's technology, underscoring the growing interest in managing costs and enhancing patient experiences within the medicare space.

He said, "It's the fastest-growing part of the population related to health plan growth. By and large, most health plans are throwing a ton of weight and a ton of investment behind this space."

Expanding Horizons Beyond Medicare

In addition to its focus on Medicare, Waltz is developing a specialty drug platform to improve transparency and patient outcomes. Adding insights, Thierer revealed plans to expand into the specialty medications segment beyond medicare advantage, recognizing the increasing importance of these therapies in drug spending.

Indicating a strategic expansion beyond the current initiative, he said, "The very next place we go beyond Medicare Advantage and the donut hole is we go into specialty medications.”

Continued Innovation in the Payer Space

This move into medicare marks another milestone for Waltz Health, following its recent partnership with a prominent health plan, where it integrated its technology into the pharmacy benefit management (PBM) system. By leveraging its marketplace search tool, Waltz aims to revolutionize the pricing, distribution, and prescription of medications, offering members access to the lowest prices at the pharmacy counter, whether through benefits or discounted cash-pay options.

While the identity of the new health plan partner remains undisclosed, Waltz's integration of its technology into a PBM serving millions across the nation underscores the company's commitment to driving innovation and affordability in healthcare delivery.

Waltz Health entered the healthcare landscape in 2022 after securing a Series A funding round of $35.4 million. The funding was led by GV (formerly Google Ventures), including Define Ventures, Echo Health Ventures, and Blue Venture Fund participation.

Founded by Mark Thierer and his son Jonathon Thierer, Waltz Health aims to address the issue of rising prescription drug costs. Mark Thierer explained the company's strategy as focusing on "building free market machinery," combining industry knowledge with technological solutions.