Patient Engagement, Health IT

Rewarding healthy behavior with lower medication costs, Sempre Health embarks on pilot with Pa insurer

Sempre Health Cofounder and CEO Anurati Mathur said the first pilot will focus on heart patients.

Studies have shown that using financial incentives to persuade people to follow their care plan sometimes but doesn’t always work.  Undaunted, Sempre Health sees a way to reduce the copay for prescription medication as a way to incentivize adherence when people pick up their drug prescriptions. The San Francisco startup has started a pilot with a large provider-led health plan in Pennsylvania to assess the effectiveness of its approach, but the company declined to name the payer.

The pilot will start with heart patients. Sempre Health Cofounder and CEO Anurati Mathur explained the company’s technology in response to emailed questions. 

“Depending on a patient’s adherence and default plan copay, patients can save up to $100 per fill. Patients will never pay more than their plan copay,” she said.

In an example of how its business works, a patient receives a text message along the lines of, “If you pick up your prescription by Sunday, you’ll pay just $20. Otherwise, you’ll pay $40.” Then, when or where the patient goes to fill, that’s the price they get.

Sempre Health gets real-time data from its pharmacy relationships. When patients get a prescription filled, it triggers updates for Sempre Health for the next price, the next expected refill date, and texts to patients, according to Mathur.

“We expose this data to our partners via a web dashboard which updates in near real-time as well. Additionally, we’ve built a sophisticated SMS management product, which can tag, parse and learn about how best to communicate with each patient, including best times to text, language to use, etc.”

Photo: Danil Melekhin, Getty Images