Waltz Health, a digital search engine for prescription pricing and reimbursement, announced its move into the Medicare market.

The Chicago-based company will provide health plans supporting Medicare beneficiaries in accessing lower prescription drug prices via its Marketplace Search technology, an AI-enabled search engine that health organizations can give their consumers that utilizes data from different drug-discount programs to find lower-cost medications.

Waltz will also supply health plans with insight into medication adherence trends. 

The first payer to utilize Waltz's tailored version of its Medicare-focused Marketplace Search application will be SCAN Health Plan, a not-for-profit Medicare Advantage health plan supplier. 

"Medicare Advantage represents one of the fastest-growing market segments in all of healthcare, so expanding to support Medicare health plans that are looking to save members money on their drugs was a natural expansion for Waltz Health," Mark Thierer, CEO and cofounder of Waltz Health, told MobiHealthNews.

"These members often have very tight budgets and can't afford high-priced medications, which can be a huge issue when they enter coverage gaps like the 'donut hole.' If they reach their coverage limits and are forced to pay out of pocket for prescriptions – especially on name-brand drugs that can cost hundreds of dollars – it can force them to make hard decisions about whether to fill their prescriptions or not. Working with innovative health plans that are passionate about finding unique solutions, like our Marketplace Search application, and solving specific member pain points is a testament to the trust our team is building in the market."

Thierer served as CEO of pharmacy benefit manager OptumRx after UnitedHealth Group acquired fellow PBM Catamaran, where he was chairman and CEO. 

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.   

"Digital Twins in Healthcare: The Next Level in Medical Simulation" is scheduled for Tuesday, March 12, 4:15-5:15 p.m. ET, in W304A at HIMSS24 in Orlando. Learn more and register.