What You Should Know:
– 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: Revolutionizing Specialty Pharmacy with AI-Driven Transparency and Efficiency
Waltz Connect transforms specialty pharmacy management by offering payers unparalleled transparency, fostering competition among specialty pharmacies, and significantly reducing specialty drug costs. The platform enhances member experience and health outcomes through its adaptable design, allowing payers to implement it across their entire specialty-drug formulary, for specific drug classes, or even down to individual drugs. Built on Waltz Health’s AI-powered Intelligent Specialty Engine, Waltz Connect optimizes prescription routing to identify the most suitable specialty pharmacy based on criteria selected by each payer.
Key Highlights:
– Specialty Drug Costs and Challenges: Specialty drug costs have surged to over $300 billion annually, a 40% increase in recent years, now constituting over half of all U.S. drug spending. The traditional process of filling specialty medications is fraught with inefficiencies:
– Patients often endure weeks-long waits for medications.
– Pharmacies frequently receive prescriptions they cannot fulfill.
– Payers unnecessarily incur higher claims for identical drugs.
– Overall costs increase when lower-cost pharmacy options are overlooked.
– Efficient Prescription Routing: Waltz Connect reengineers the prescription process for greater efficiency and effectiveness. When a specialty prescription is submitted, regardless of the receiving pharmacy’s network status with the payer, the solution reroutes it to the optimal pharmacy based on:
– The member’s benefit design.
– A weighted list of attributes (e.g., price, turnaround time, fulfillment accuracy, member experience, adherence rates).
– Adjustable attributes by drug class or specific drugs, ensuring optimal pharmacy utilization with minimal friction.
– Comprehensive Data Capture: Waltz Connect captures essential information to ensure a consistent and seamless member experience, including:
– Member’s condition details.
– Prescription onboarding information.
– Contact details for the selected pharmacy.
– Expected fulfillment turnaround time and number of refills.
– Payers benefit from more predictable pricing, while members experience less friction in filling prescriptions.
Strategic Partnerships and Milestones:
– New Network Addition: Waltz Health announced that Reliance Rx has joined Waltz’s specialty network, offering payers a high-performance, cost-efficient fulfillment option for generic specialty medications.
– Expansion and Impact: Over the past year, Waltz Health has achieved significant milestones, including:
– Official entry into the payer, pharmacy benefit manager, and self-insured employer markets.
– Unique deployments of Marketplace Search technology with SCAN Health Plan and a national commercial health plan.
– Implementing Marketplace Search in four national pharmacy chains with thousands of locations, yielding an average savings of $5 to $10 per prescription over other drug-savings card solutions.
Waltz Connect represents a crucial step forward in the pursuit of streamlined, cost-effective, and patient-centric specialty pharmacy management.
“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.
