New technology-powered, end-to-end solution gives payers more flexibility and optimizes savings with a network of specialty pharmacies that compete on price and clinical outcomes.
Reliance Rx joins Waltz Health’s pharmacy network, bringing better prices on generic specialty medications.
Waltz Health, a digital health company developing smarter, technology-enabled ways to price, distribute and prescribe medications, today unveiled Waltz Connect, a new end-to-end solution that manages all aspects of a payer’s specialty medication coverage. It includes proprietary technology, patient engagement support, and a first-of-its-kind dynamic marketplace with a network of high-quality specialty pharmacies that compete on price, service levels, and clinical outcomes.
Waltz Connect empowers payers with unmatched transparency by unlocking competition among specialty pharmacies and is engineered to reduce specialty costs, improve member experience and deliver better member health outcomes. Its flexible design allows payers to deploy the solution across their entire specialty-drug formulary, on specific drug classes or even down to individual drugs. The solution is built on Waltz Health’s Intelligent Specialty Engine, which is an AI-enabled prescription routing software that intuitively finds the best and most-appropriate specialty pharmacy option based on specific criteria selected by each payer.
“Our novel approach layers on modern technology to bring transparency, efficiency and flexibility to specialty benefit management. For too long, the opaque and archaic structure of the traditional specialty drug supply chain has contributed to inefficiencies and misaligned incentives that have ballooned healthcare costs,” said Waltz Health Co-founder and CEO Mark Thierer. “When you bring marketplace principles to healthcare, you unlock competition on price and differentiation on experience. That’s no different in specialty drugs, which is why we’re offering a comprehensive solution that can be tailored to each payer’s unique needs and includes an entire network of specialty pharmacy partners committed to delivery savings and improved healthcare outcomes.”
The cost of specialty drugs has grown to more than $300 billion annually – up by more than 40% in just a few years – and now represents more than half of all spending on drugs in the U.S. Beyond just the high costs, the traditional process of filling specialty medications also has created frustrations for every stakeholder. Healthcare consumers often must wait weeks to get their medications; pharmacies receive prescriptions they are not able to fill; payers unnecessarily pay higher claims for the same drug; and everyone pays higher fees when another lower-cost pharmacy was an option.
Waltz Connect solves these issues by rewiring the process to make it more efficient and effective. When any specialty prescription for a member is submitted – regardless of the receiving pharmacy’s network status with the payer – the solution reroutes it to the best pharmacy option based on each member’s benefit design and a weighted list of attributes (price, turnaround time, fulfillment accuracy, members experience, adherence rates, and more). These attributes can be adjusted by drug class or specific drugs, ensuring members utilize the optimal fulfilling pharmacy with the least amount of friction.
Waltz Connect also captures all information payers need to ensure a consistent member experience including details on the member’s condition, prescription onboarding, contact details for the selected pharmacy, expected fulfillment turnaround time, number of refills and other important information. As a result, payers get more predictable pricing while their members experience less friction when filling their prescriptions.
In addition to launching Waltz Connect, Waltz Health also announced today that Reliance Rx has joined Waltz’s specialty network, providing payers with a high-performance, cost-efficient fulfillment option for generic specialty medications.
The launch of Waltz Connect marks another milestone for Waltz Health over the last year. Following its official entry into the payer, pharmacy benefit manager and self-insured employer markets, the company has launched unique deployments of its Marketplace Search technology with SCAN Health Plan and a national commercial health plan. The company also has unique versions of Marketplace Search in four national pharmacy chains with thousands of locations nationwide, generating savings on average of $5 to $10 more than other single-prescription drug-savings card solutions.
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