The Pulse | Issue 20

MedWatch The Pulse Issue No. 20

A Message from Sally‑Ann Polson, President & CEO

As part of MedWatch’s 2025 vision, we are continuously innovating to enhance the care and support we provide to plans and their members. In line with this commitment, we’re excited to introduce two transformative programs now fully integrated into our Case Management platform: Medzown’s Advanced Clinical Trial Access for cancer and complex diseases, and Quantify Specialty Care’s High‑Cost Drug & Infusion Services.

These programs go beyond being new offerings—they represent MedWatch’s commitment to the ongoing evolution of the comprehensive support already available through our Case Management. The integration is seamless, with minimal implementation requirements. By knowing how these new programs function, you can help guide your plans and plan members to take advantage of these services when they are contacted, thus enabling them to make confident and informed decisions about their care options. These decisions will positively impact both the clinical and financial outcomes for your plans and members!

Why These Programs Matter

  • Clinical Trial Access: Members with limited treatment options now have a lifeline. Through partnerships with cutting‑edge providers, we open up access to advanced therapies, eliminating concerns about placebo treatments and prioritizing personalized, results‑driven care.
  • High‑Cost Drug & Infusion Assistance: With nationwide home‑infusion services, dedicated care teams, and improved cost control, we make critical treatments more accessible, convenient, and cost‑effective.

Both programs are designed to provide hope, reduce stress, and deliver measurable cost savings. Your role in helping members understand and seize these life‑changing opportunities is crucial.

Sally‑Ann Polson

Sally‑Ann Polson

President
& CEO

In the Spotlight

When a young mother was diagnosed with an aggressive form of cancer while pregnant with twins, she faced a heartbreaking prognosis: just six months to live. With conventional treatments exhausted, her situation seemed hopeless. But instead of accepting the inevitable, she chose to fight.

Her story is a testament to the transformative power of clinical trials, where cutting-edge science meets the unyielding spirit of hope. This is more than medicine; it’s the promise of life, the gift of time, and the chance to leave a legacy of love.

This is the impact of innovation. This is the future of personalized care.

Medzown’s Personalized Support & Expanded Options for Patients

Navigating treatment options for cancer or rare diseases can be overwhelming, especially when standard of care is unavailable. Thousands of clinical trials exist, but finding the right one is often daunting, time-consuming, and costly.

That’s why MedWatch has partnered with Medzown. As part of our URAC-accredited Case Management program, MedWatch now has access to Medzown’s data scientists and clinicians who help identify and enroll patients in clinical trials tailored to their unique medical needs, providing hope and personalized care when it’s needed most. These trials ensure active, meaningful treatment without the use of placebos, offering a transformative approach to care.

Key Benefits for Patients

  • Guided Care: Patients receive clear direction and access to advanced treatments through Case Management.
  • Personalized Plans: Recommendations are tailored based on individual conditions, previous treatments, and preferences.
  • Cutting‑Edge Therapies: Options include immunotherapies, targeted therapies, and cell/gene therapies.
  • Dedicated Support: A team of experts provides hands-on assistance, reducing stress for patients and families.
  • Simplified Enrollment: Medzown streamlines the process, so patients can focus on their health.
  • Hope & Results: Innovative care pathways deliver improved outcomes and an enhanced quality of life.

Optimizing Plan Performance

For 2025, MedWatch’s enhanced Case Management program supports plans with significant cost savings and streamlined workflows while delivering high-quality care.

Key Benefits for Plans

  • Cost Reductions: Targets the top 6-10% of members responsible for 50% of high-cost claims, and over a third of all claims spend.
  • Clinical‑Trial Savings: Members in clinical trials generate an average savings per patient of 69% with some achieving up to 99%.
  • Improved Access: Addresses the gap in care for 70% of Americans included in a clinical trial.
  • Integrated Case Management: Operates seamlessly within the Case Management system, with billing tied to active cases only.
  • Streamlined Billing: Fees are consolidated into the monthly Case Management invoice for ease of administration.
  • Fiduciary Alignment: Focuses on evidence-based care and cost-effectiveness, supporting fiduciary responsibilities.

MedWatch’s partnership with Medzown redefines healthcare by combining compassionate support with innovative, cost-effective solutions. Integrated into our Case Management program, it ensures personalized care for patients and measurable savings for plans. Together, we are creating a brighter future for plan members and healthcare stakeholders alike.

For more information, please contact your MedWatch Client Success representative.


Health Focus

To address the financial and logistical challenges faced by patients with cancer or complex and rare diseases, MedWatch has partnered with Quantify to enhance its Case Management program. This collaboration identifies members who would benefit most from the program, ensuring those with the greatest need receive timely, personalized support. The initiative provides innovative solutions for patients while reducing costs for employers, reinforcing MedWatch’s dedication to delivering compassionate, efficient care.

Quantify Transforms Access to Care for Patients

Patients receive tailored support to simplify their healthcare journey and improve outcomes:

  • Nationwide Home Infusion Services: Infusions are available in all 50 states, delivered by over 680 specialized nurses who provide consistent, high-quality care—even traveling up to four hours to serve patients.
  • Specialty Clinics Across the U.S.: Unlike most drug care solutions, Quantify operates 65 clinics nationwide, offering an alternative for patients who prefer or require in-clinic infusions.
  • 24/7 Dedicated Care Teams: Around-the-clock support ensures continuity of care, remote monitoring, and personalized guidance to ease stress and confusion.
  • Streamlined Medication Access: Partnerships with top suppliers and three specialty pharmacies ensure fast, reliable delivery of critical medications.
  • Coordinated Care: The program acts as a bridge between primary care providers and specialists, ensuring alignment and clear communication for patients and their families.

Driving Savings for Plans

The program is designed to help employers manage healthcare expenses effectively while maintaining high-quality care:

  • Efficient Cost Management: Targets high-cost cases with innovative solutions, significantly reducing financial risk for employers.
  • Integrated Case Management: Seamlessly incorporates into existing workflows, eliminating administrative complexity while delivering results.

This partnership between MedWatch and Quantify combines compassionate care with cutting-edge, cost-effective solutions to address complex challenges faced by patients and health plans. By prioritizing personalized support, innovative treatment access, and streamlined management, MedWatch not only enhances patient outcomes but also delivers measurable value to plans through significant cost savings and operational efficiency to improve outcomes for patients and plans alike.

For more information about how this program can benefit your organization, contact your Client Success representative.