Last month, SCAN Health Plan revealed that it would team up with Walmart to launch co-branded Medicare Advantage plans in two states.
Now, the partners are offering a deeper look at how those benefits have taken shape, and why they saw potential in coming together.
Beginning Jan. 1, SCAN will offer an HMO plan and a chronic special needs plan (C-SNP) that are co-branded with Walmart and lean on the retail giant's Everyday Health Signals capabilities. The plans will be made available in six Texas counties and three Arizona counties, reaching 2 million Medicare eligibles, SCAN said in an announcement.
Zack Myers, national general manager of SCAN Health Plan, told Fierce Healthcare that the partnership is built on a shared vision of making healthcare simpler for older adults.
"We see the opportunity to combine that deep Medicare experience that SCAN brings, and those capabilities that Walmart brings, to build a better Medicare Advantage experience built around the individual to help them navigate an increasingly fragmented healthcare system," Myers said.
Under the HMO plan, members will see $0 monthly premiums as well as $0 copayments for primary care visits as well as tier 1 and tier 2 prescription drugs. The plan also includes an over-the-counter benefit of up to $780 per year and access to low-cost medications through Walmart's preferred pharmacy.
The C-SNP, meanwhile, offers low monthly premiums and the same $0 copayment options, per the announcement. The annual over-the-counter benefit allotment is higher in this plan, at up to $2,400 per year. It also includes a $350 vision allowance and dental coverage at between $3,000 and $4,000.
Myers said that for the population with chronic needs, ancillary benefits like vision and dental end up being critical in their care, so a more generous offering there aligns with what would benefit C-SNP enrollees most.
Both plans lean on Walmart's Everyday Health Signals platform, which takes data on consumers' shopping behavior and uses it to build insights into their food habits, over-the-counter needs and lifestyle decisions. With that data, the plan can build personalized engagement and interventions to support their care management.
Consumers can choose whether or not to opt into the program, Walmart said.
Pravene Nath, M.D., group director for consumer health and data solutions at Walmart U.S., told Fierce Healthcare that the tool can help to recommend better food choices for a patient with particular nutritional needs, or identify any risks associated with over-the-counter products they may prefer.
That data can be surfaced to the member to help them make better choices in the moment, and can be deployed by the care team to identify risks upstream to prevent adverse effects in the future.
"We can effectively make those inferences about what those purchases are and how they impact health, and then think about moving upstream from the register to help people before they get to check out with what those choices are and making them goal aligned," Nath said.
The news about the Walmart partnership follows close on the heels of the official launch of co-branded plans with Costco, which lean on the bulk retailer's unique slate of services. At the time, SCAN CEO Sachin Jain said that the insurer was bucking a trend toward pulling back from these retail partnerships by rethinking how they define value generated by the plans.
Myers said that with Walmart, for example, the partners determined quickly that patients may get more mileage out of OTC benefits because of the retailer's pricing structure.
He added that both partners will continue to evaluate how effectively they're working together to generate improved outcomes.
"Ultimately, our growth isn't just about kind of adding new counties or putting more dots on a map," said Myers. "It's really about how do we improve the quality of lives of the members we're touching."