Sempre Health Unveils New Adherence and Affordability Solutions for Medicare Populations

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Feb 16, 2024, 08:30 ET

Surpasses $20M in savings made possible by 18 payer & PBM partners

SAN FRANCISCO, Feb. 16, 2024 /PRNewswire/ -- Sempre Health, the leading solution for behavior-based healthcare pricing, today announced that it has surpassed $20 million in patient savings to date, made possible by a total of 18 payer and PBM partners on the platform including, Alluma, Blue Cross and Blue Shield of North Carolina, Blue Cross Blue Shield of Arizona, Blue Shield of California, Highmark, Maxor, Moda Health, Navitus Health Solutions, UPMC Health Plan, and other large health plans in Michigan, Massachusetts, Pennsylvania, New York, Tennessee, and nationally. The company is on track to deliver an additional $60 million in member savings by the end of 2024.

Growth of the platform has also driven the launch of Sempre's innovative adherence and affordability solutions tailored specifically for Medicare populations in the United States. This launch marks a significant step in enhancing healthcare outcomes and efficiency within the Medicare system.

The Medicare program currently serves over 60 million Americans, predominantly aged 65 and older, as well as younger individuals with certain disabilities. This population often faces unique health challenges, including chronic conditions requiring consistent medication adherence. Sempre's solutions are designed to address these challenges by improving access to essential medications and supporting adherence to prescribed treatments.

Sempre's new solutions focus on the critical aspects of medication adherence, a key factor in the Centers for Medicare & Medicaid Services (CMS) Star Ratings system. Star Ratings are a crucial component in Medicare, influencing both consumer choice and provider reimbursements. These ratings are particularly sensitive to adherence measures, with triple-weighted quality metrics playing a significant role.

Sempre's solutions focus on the:

2024 Sempre Medicare Advantage Reward and Incentive Program
- An innovative, SMS-based reward and incentive program for prescribed treatment regimens, which can support enrollment, medication adherence, health risk assessments, surveys, appointment and refill reminders, and additional Medicare Star Rating activities to improve member adherence and outcomes
2025 Sempre Medicare Part D 2025 Prescription Payment Plan
- A new, turnkey monthly payment program for out-of-pocket prescription drug costs (a Part D sponsor requirement under the Inflation Reduction Act (IRA)), which leverages Sempre's core capabilities for enrollment, claims adjudication and processing, copay calculations and discounts, data, and reporting to provide $0 copays and capped monthly payments for Part D participants
- Sempre submitted a CMS Comment Letter in response to this upcoming IRA requirement

By enhancing adherence, Sempre aims to positively impact these ratings, ultimately leading to better health outcomes.

"We are thrilled to introduce our new solutions to the Medicare market. Our focus on adherence and affordability has been our commitment since our founding, and now it drives an opportunity to improve the lives of Medicare beneficiaries across the country. By combining behavioral economics-based financial incentives with SMS engagement, we can make a substantial difference in the quality of healthcare in the US," said Anurati Mathur, CEO of Sempre Health.

"Sempre Health's innovative approach to addressing medication adherence aligns perfectly with the goals of Medicare's quality measures. By focusing on this critical aspect of patient care, Sempre is poised to make a significant impact on the health outcomes of Medicare beneficiaries," remarked Charlene Frizzera, former Acting Administrator of CMS.

About Sempre Health

Sempre Health works with leading health plans and pharmaceutical companies to reduce the cost of copayments for eligible patients who refill their prescriptions on time. Based on several internally and externally validated studies, Sempre Health boosts medication adherence by greater than 20% and drives a 95 Net Promoter Score across therapeutic classes and for enrolled patients in all 50 states.

For more information visit: www.semprehealth.com.

Contact: Michele Fox, michele@120over80mktg.com

SOURCE Sempre Health