Sentara Health Plans

Bringing together the best of both of your great organizations, plus the national expertise we lend across the health services space, would be one powerful combination. We are a strategic pharmacy partner who will take your growth and retention goals as seriously as you do, and continually innovate to improve health and financial outcomes for your members and clients.
Optima-VA Premier

We're just getting started

We’ve thoroughly enjoyed the time spent getting to know your team and exploring how we can support your business. You need – and deserve – a strategic partner who is just as invested in the success and strategic growth of Sentara Health Plans as you are – not just a vendor who services your pharmacy claims. We look forward to digging in further with you, to take on your toughest health care challenges together.

Medicare key insights and findings

Sentara Medicare market analysis
Medicare market analysis
We operate on a belief that insights can lead to better action, and our Medicare strategists will equip you with market analyses for growth planning and insight-driven conversations focused on enrollment trends, Star Ratings trends, competitive market benefits and other aspects. These analyses can be done at the state level, service area level or county level to meet your needs. This market analysis is a baseline version. With more data and information about your plan, these become more detailed.
EGWP report
EGWP policy perspective
EGWPs offer tremendous value to retirees, employers, retirement systems and unions—as well as to Medicare—by improving access and affordability for patients at a low cost to the federal government. As policymakers focus on lowering drug prices and reforming the Part D
program, many of the reforms under consideration will have unintended consequences that both threaten EGWPs in Part D and create a windfall for drug manufacturers.
Powering your success
If you're like many teams we work with, your Sales team is well-versed in all things medical , but would benefit from education on pharmacy to fully leverage and convey the benefits you offer to your customers in the pharmacy space. Learn more about our strategic approach to helping you grow, retain and win.
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Powering your success

Building a winning go-to-market team

We support your value proposition that an integrated medical and pharmacy benefit substantially reduces total cost of care and improves member health when compared to carving out pharmacy benefits. How can you realize the full potential of this story to reach your plan's growth initiatives? It all comes down to effectively managing your sales, finance and cross-functional teams, and their understanding the importance of pharmacy is essential to fully conveying your unique value proposition.
60% 60%
of plans say they do not have the pharmacy resources or support personnel needed to meet their growth goals1
$30M $30M
revenue realized by a client after the first year of working with our market development team to optimize their pharmacy go-to-market team
15K 15K
lives carved-in for a client who secured their first pharmacy-only win after forming a pharmacy sales team including new sales, account management and broker relations

Market development opportunities and insights

Market Development Sentara
Market Development Offering
We understand the market challenges you face in the commercial space and are committed to helping you address them, overcome your competition and win. Review a summary of our Market Development offering.
public sector sentara
Understanding the public sector
Explore our recent thought leadership regarding understanding the buying and procurement habits of publicly-funded plans.
Rachel Reese
Rachel Reese
Vice President, Health Plan Sales
I am looking forward to getting to know your teams and digging in to find opportunities for us to grow together and work toward improved health care for all. With the recent formation of our health services portfolio, Evernorth, we are better positioned than ever to support you and your clients to create a better experience for your teams, members and providers.

Diversity, equity and inclusion

Our diversity, equity and inclusion (DEI) strategy fosters a culture of belonging and equity that advances our mission to positively impact the well-being of our people and the communities we serve.
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79% of employees agree that there is great DEI at our organization, outperforming other companies by more than 13%
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Committed to doubling diverse supplier spend to $1B by 2025
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Launched COVID-19 disparities project to slow the spread in three target markets with large Black and Hispanic populations
COVID-19 has challenged our health care system like no other. But we're always looking ahead, identifying ways to redefine what's possible. We polled consumers and plan sponsors across the U.S. to assess the state of health care in the years ahead.

Health Care in Focus
Glen Stettin
Glen Stettin, MD
Chief Innovation Officer, Evernorth
In the next decade, we are going to see health care change dramatically, and we believe technology will play an even greater role in a person's care than ever before.
Eva Borden
Eva Borden
Vice President, Behavioral Health, Evernorth
The impact of the pandemic on mental health will be long-lasting, and there is an urgent need to expand easy and timely access to care. Through Evernorth, we are delivering a more coordinated approach to health services that will make it easier for people to get the care they need, when they need it.

Exposing opportunities to better support hospital and health systems’ needs

Managing a hospital system as part of your plan, we understand the added degrees of difficulty you’re facing to meet your unique affordability, revenue and patient-centric goals. Driven by data insights and leveraging industry knowledge, our team is equipped to help align decision makers and influences to support your plan, your employees and the patients and communities you serve.
13% 13%
Health care costs are 13% higher for hospital workers and their dependents than they are for non-hospital workers2
8.6% 8.6%
Health risk for hospital workers and their dependents is 8.5% higher than for non-hospital workers2
67% 67%
or 2/3, of hospitals are part of a health system2

Flexible clinical solutions

In 2020, we saved clients $45 billion through our clinical solutions. Our programs are designed to bring plan sponsors the promise of simplicity, predictability and above all, affordability. See information below on several of the solutions that may be of interest for your plan.
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First outcomes-based care model in the industry
What financial and clinical outcomes are sacrificed without full integration and coordination? Explore the industry's only guaranteed clinical outcomes model.
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Value-based approach makes medicine work harder
See how our multi-program, value-based platform unlocks new financial value and better health outcomes.
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Protecting members and preventing abuse
Americans are now more likely to die of an accidental opioid overdose than in a motor vehicle crash. How can you make sure your members are protected?

Managing trend amid a global pandemic

In the face of the COVID-19 crisis, we worked together with clients to solve urgent and emerging needs with innovation, agility and focus while delivering results. See a snapshot of what we were able to help our clients achieve.
DTR 3
Held unit cost increases to 0.9%
For the fourth year in a row, we limited the increase in drug unit costs to under 1%, despite an average increase of 4.3% in list prices for brand drugs, by leveraging therapeutic mix and supply chain.
DTR 1
Delivered $45 million in savings
Leveraging innovative clinical programs and leveraging data to inform key decisions, we realized significant savings for our clients in 2020.
DTR 2
Getting ahead of the growth in specialty
For the first time, spending on specialty drugs accounted for more than half of total drug spend (51%). Our solutions and capabilities helped our clients stay ahead of this growth.
DTR 4
Negative trend for 1/3 of our commercial clients plans
Even in 2020, one trend held. For plans that took advantage of opportunities to help patients use the right drug – in the right amount and from the right pharmacy – the result was lower spending.
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If you have any questions or need further information, I'm here to help!
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