RxBenefits, a pharmacy benefits company, and Tria Health, a chronic condition and medication management company, have launched a new partnership to improve diabetes care and lower healthcare costs for the condition through a proactive approach. 

Through the partnership, the two companies have created the Optimize MyCare Diabetes Support Program, for which RxBenefits and Tria Health both review pharmacy claims to find members with diabetes, metabolic syndrome and comorbid conditions.

These members receive messages through mail, email and phone to schedule a phone appointment with a Tria Health pharmacist to discover why members aren’t not meeting care goals. Then, Tria, based in Overland Park, Kansas, works with members to create a customized care plan for their health, which is shared with members’ physicians. The program offers two incentive options to encourage participation: a $50 virtual Tria gift card shared online or a co-pay buy down. The co-pay buy down includes $0 generics and $25 off brand diabetes medications.

“Ultimately, with our shared values and commitment to helping clients better manage high-cost conditions that are driving up their plan costs, this partnership seeks to further increase member health literacy and accountability,” said Wendy Barnes, CEO of RxBenefits, which is based in Birmingham, Alabama. 

Barnes said most digital diabetes management programs are more meter-based and reactive, while this approach is proactive by reaching out to members directly and connecting them with licensed pharmacists.

“By focusing on medication management, health literacy, and lifestyle/behaviors that support good diabetes condition management, we’re going beyond what other diabetes programs in the market are currently able to do,” Barnes said.

Another digital diabetes program includes Omada Health. Its program reduced weight and hemoglobin A1c levels significantly, according to data shared in 2020.

But Tria Health CEO Jessica Lea said the partnership with RxBenefits will provide results unmatched by competitors.

“We are excited to partner with RxBenefits given the company’s focus on delivering results-oriented pharmacy solutions with a high-touch service model, which is consistent with Tria Health’s approach. This partnership will further expand our reach in the mid-market employer segment. We believe the product we have developed for RxBenefits will produce results that other diabetes management programs in the market will not be able to match,” Lea said in a news release. 

When asked how the two organizations will generate revenue through the partnership, Barnes declined to provide financial information.

Barnes was more forthcoming when it came to the partnership’s goals.

Barnes said the goal of the partnership is to improve medication adherence, health literacy and reduce the costs associated with poorly managed diabetes for self-funded employers. About one in three Americans develop diabetes in their lifetime, and 25% of U.S. healthcare expenditures — or $327 billion per year — are related to caring for diabetes, Barnes said.

If the partnership is successful, it could be one of the many efforts seeking to bend that cost curve. So far, it appears that Tria’s approach has benefits. In 2021, Tria Health’s customers saw a 1.3 average A1C reduction, 48% care gap closure for patients with diabetes and $2,255 average savings per engaged patient, according to the company’s website.

“Our mission at RxBenefits is to improve patient lives and bend the healthcare cost curve, which is why this partnership is so exciting for us,” Barnes said. “By working together, we’re better equipped to optimize member health and better manage the costs associated with poorly managed diabetes.”

Photo: AzmanJaka, Getty Images