July 26, 2023
/PRNewswire/ — Sun Life U.S., the largest independent medical stop-loss provider in the country, has named OptiMed Health Partners as a preferred partner to further the company’s goal of improving healthcare access, while also managing rising healthcare costs. The new program through OptiMed will identify opportunities to administer specialty drugs to members who need them – in a convenient setting, such as the member’s home or an infusion center – working in concert with the member’s physician and care team. This type of highly coordinated and personalized delivery system reduces the risk of infections and complications for patients while decreasing the treatment costs for high-cost specialty drugs.
The new solution, Medical RX Management powered by OptiMed, is an extension of Sun Life’s Clinical 360 program, which combines innovative data analytics with superior clinical expertise to identify cost savings and ways to optimize patient care and outcomes. At no additional cost to the client, OptiMed’s vast experience in effectively managing specialty medication trends will help those who self-fund their health plans better manage their healthcare costs. According to KFF, an independent non-profit organization focused on national health issues, 65% of covered workers in the U.S. are in
a self-funded plan
, where employers pay their own medical claims.
“Expensive specialty drugs are major contributors to escalating healthcare costs which can significantly impact self-funded plans,” said
, president of Health and Risk Solutions, Sun Life U.S. “Through this collaboration with OptiMed, we will tackle two pressing issues in the healthcare ecosystem – access and cost. Medical Rx Management powered by OptiMed will provide more ways for members to receive vital healthcare while reducing unnecessary costs for our clients.”
“As therapeutic advancements continue, it is essential for plans to lean on industry experts and partnerships such as this, to promote sustainability and high levels of clinical support to members when they need it most” said
, Vice President, Business Development for OptiMed Health Partners. “Our passion to reimagine healthcare solutions that deliver unsurpassed value, leverages technology and concierge services; creating an exceptional patient experience and driving positive industry change.”
OptiMed provides specialty infusion medications and therapy management for many conditions including a large number of medications listed in
Sun Life’s annual High-cost claims and injectable drug trends analysis
of medical stop-loss claims.
OptiMed’s program has been reviewed and accredited by two nationally recognized accreditation bodies focused on patient care and safety.
Sun Life manages high-dollar medical claims for more than 2,800 self-funded employers covering more than 9 million people. Utilizing its extensive medical claims database, Sun Life provides expert insights each year on clinical conditions and medical trends that drive high-cost claims as well as how people utilize their healthcare. Sun Life is the largest independent stop-loss provider in the U.S. according to data from the National Association of Insurance Commissioners. An independent stop-loss provider does not sell medical claim administration services.
About Sun Life
Sun Life is a leading international financial services organization providing asset management, wealth, insurance and health solutions to individual and institutional Clients. Sun Life has operations in a number of markets worldwide, including
the United States
. As of
March 31, 2023
, Sun Life had total assets under management of
. For more information, please visit
Sun Life Financial Inc. trades on the Toronto (TSX), New York (NYSE) and Philippine (PSE) stock exchanges under the ticker symbol SLF.
Sun Life U.S. is one of the largest providers of employee and government benefits, helping more than 50 million Americans access the healthcare and coverage they need. Through employers, industry partners and government programs, Sun Life offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. Sun Life U.S. and affiliated companies in asset management employ approximately 8,000 people in the U.S. Group insurance policies are issued by Sun Life Assurance Company of Canada (
Wellesley Hills, Mass.
), except in New York, where policies are issued by Sun Life and Health Insurance Company (U.S.) (
). For more information visit our
OptiMed Health Partners, headquartered in
, is an independently owned and operated national healthcare organization, leading the charge in the infusion and specialty space. For more than 30 years, OptiMed has leveraged personalized attention to detail to deliver customized solutions that optimize patient outcomes while partnering with other healthcare organizations to usher in a new standard of excellence. To learn more about OptiMed’s innovative and personalized care, visit
Sun Life U.S.
OptiMed Health Partners
Connect with Sun Life U.S.
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SOURCE Sun Life U.S.