May 23, 2018 / in News / by admin
Partnership will enable medically-tailored meal interventions to be billed as health care benefits
PHOENIX, May 23, 2018 /PRNewswire/ — Solera Health, a leading integrated benefit network, today announced a partnership with the California Food is Medicine Coalition (CalFIMC). The news comes on the heels of Solera’s recently announced national partnership with Feeding America to address food insecurity. In this new partnership, Solera will work with CalFIMC to strengthen, accelerate, and scale their comprehensive medically-tailored meal and medical nutrition therapy interventions (CMTM) with the goal of improving outcomes for patients with complex chronic conditions.
CalFIMC is a coalition of nonprofit, medically-tailored food and nutrition services providers. Last year, the providers came together under a $6 million California pilot program to evaluate the delivery of CMTMs to eligible chronically ill Medi-Cal (California Medicaid) members. The pilot program is testing the impact of daily, nutritious medically tailored meals and medical nutrition therapy to 1,000 Medi-Cal members with congestive heart failure or type 2 diabetes. Researchers from the University of California San Francisco and Stanford will compare their results with 4,000 matched Medi-Cal beneficiaries who are not receiving the intervention.
“The pilot’s goal is to evaluate how a CMTM intervention impacts individual health outcomes and the cost of their care, by providing medical nutrition therapy combined with twelve weeks of meals tailored to the client’s chronic conditions after a hospital discharge,” said Mark Ryle, CEO of Project Open Hand in San Francisco, one of the California organizations that makes up the CalFIMC. “Preliminary studies indicate enormous potential to improve people’s health in the long-term and save money across the state.”
“We recognize that for CMTM to be a scalable solution for health insurers we need to ensure the highest standards of client privacy, data security, and auditable tracking of services and meal provision,” continued Ryle. “Our clients deserve an infrastructure and technology platform that allows for their CMTM services to be handled like any other health care service, billed as a covered benefit. Solera Health has demonstrated its ability to meet our needs for community-delivered, non-medical services through its experience scaling the National Diabetes Prevention Program.”
“There is now industry-wide recognition of the importance of social determinants of health, but it is a challenge to scale these interventions unless they can be integrated into the healthcare ecosystem like any other clinical service,” said Sandeep Wadhwa, MD, Chief Health Officer of Solera Health. “These new interventions must meet the rigorous program integrity, quality assurance and audit requirements for health plans to pay for healthcare-related social supports in the same way as other healthcare services.”
“On April 4, 2018 CMS finalized guidance allowing Medicare Advantage plans to expand supplemental benefits to include items and services that address social determinants of health,” continued Wadhwa. “We’re excited to work with CalFIMC to operationalize comprehensive medically-tailored meal interventions not only to prepare for eventual state-wide coverage by Medi-Cal, but to drive adoption by Medicare Advantage plans under this new CMS guidance. We believe commercial, marketplace and Medi-Cal managed care plans will now want to offer CMTMs, knowing they can ensure these items and services are flowing through as medical claims.”
The CalFIMC initiative is modeled off an earlier study conducted in Philadelphia by Metropolitan Area Neighborhood Nutrition Alliance. The organization retroactively looked at health insurance claims for 65 chronically ill Medicaid patients who received three medically-tailored meals each day for six months. Their medical claims were compared to a control group. The study showed that the health care costs for those 65 meal recipients were on average, $12,000 less than the control group.
About the California Food is Medicine Coalition
The California Food is Medicine Coalition (CalFIMC), the leading Nutrition Services providers in the state that serve thousands of clients annually with coverage across seven counties, offers a unique, cost-effective, high-quality managed-care solution for improving health outcomes for critically-ill clients. Members include Project Open Hand, Ceres Community Project, Project Angel Food, Mama’s Kitchen, Food For Thought and Health Trust represent a California contingency of the Food Is Medicine Coalition. For more information, visit www.calfimc.org or follow us on Twitter @CalFIMC.
About Solera Health
Solera Health is an integrated benefit network that connects patients, payers, and physicians with community organizations and digital therapeutics providers, simply and securely. Solera helps consolidate highly fragmented programs and services into one integrated network, allowing health plans and medical providers to increase consumer participation while lowering associated costs. Solera proactively identifies the “best fit” program provider based on each individual’s unique needs and preferences, which has proven to have a significant impact on improved patient outcomes at a fraction of the cost of traditional medical care. For more information, visit Solera Health at www.soleranetwork.com, call 800-858-1714 or follow us on Twitter @SoleraNetwork.
SOURCE Solera Health