BCBS Association Executive Joins Solera Health as VP of Emerging Care Models

August 7, 2018 / in Coverage / by admin

Teresa Clark will lead the integration of social determinants into emerging care models for Solera’s health plan clients

Phoenix, AZ – Aug. 7, 2018 – Solera Health, a leading integrated benefit network, today announced that Teresa Clark, MPH, MBA has joined the executive team as Vice President of Emerging Care Models. Clark is a leading executive with demonstrated expertise in platform technology, population health, and finance.

In her previous role as Vice President, Clinical Affairs, Blue Cross Blue Shield Association (BCBSA), Clark led the design and launch of the wholly owned subsidiary Blue Cross Blue Shield Institute, dedicated to creating a sustainable business model to address the social determinants of health in the private payer market. Clark led efforts for many of the Institute’s most recognizable products, including the development of its flagship geospatial platform technology, the Community Health Management Hub (CHM Hub®), which identifies the social, economic, and environmental barriers to health. Clark managed some of the BCBSA and the Institute’s often mentioned innovations, including the transportation services with Lyft that addressed the needs of BCBS members living in transportation and pharmacy deserts.

“Teresa’s wealth of health plan, innovation, business, and policy experience will be immensely valuable as we develop and scale new offerings that address social determinants of health,” said Brenda Schmidt, CEO at Solera Health. “Teresa’s track record of innovation and her experience addressing social determinants of health will be critical as we expand Solera’s curated network model, which has shown its effectiveness in helping scale the diabetes prevention program nationwide. Clark will be critical in supporting Solera’s strategic focus on innovation to address the highly fragmented community space.”

Clark studied computer science and neuroscience at the University of California, San Diego before moving on to study epidemiology at the Johns Hopkins University Bloomberg School of Public Health, and finance at the University of Pennsylvania Wharton School of Business.

“I am honored and delighted to join Solera, the nation’s premier platform for individuals to manage their health and wellbeing once they leave the doctor’s office,” said Clark. “I look forward to helping build innovative offerings and personalized experiences to patients, providers, and payers in every community Solera serves.”

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 or LinkedIn.

Solera Health Announces New Contract with ATRIO Health Plans

August 6, 2018 / in Coverage / by admin

Oregon-based health plan joins Solera’s national network to administer the Medicare Diabetes Prevention Program

Phoenix, AZ – Aug. 6, 2018 – Solera Health, a leading integrated benefit network, today announced a new contract with Oregon-based ATRIO Health Plans to administer the Medicare Diabetes Prevention Program (MDPP) for its Medicare Advantage book of business.

Through this new contract with Solera, ATRIO’s Medicare beneficiaries who are at risk of developing type 2 diabetes will be able to access the MDPP through one of the many Solera network suppliers within ATRIO’s service areas.

Solera Health connects payers, consumers, and providers with a diverse ecosystem of proven non-medical behavior change programs delivered by community partners and paid through medical claims. Solera’s integrated benefit network allows health plans to increase consumer access, choice and participation while lowering associated costs by matching eligible covered individuals with the MDPP supplier that best meets each members’ unique needs and preferences.

Effective as of April 1, the MDPP’s goal is to reduce the risk for type 2 diabetes through a series of group classes led by a trained lifestyle coach with a standardized curriculum. The two-year program aims to improve nutrition and increase physical activity with the goal of losing 5% body weight.

“We are looking forward to leveraging Solera’s diverse selection of MDPP suppliers and unique matching capabilities for our Medicare population,” said Matt Gougler, Chief Marketing Officer at ATRIO Health Plans. “We anticipate that this work will help us keep our Medicare population from potentially having to face the serious and costly health implications of a diabetes diagnosis.”

“The MDPP has been shown to reduce the risk for type 2 diabetes by up to 70% in older adults and provides a gross financial return of $2,650 within 5 quarters,” [1] said Brenda Schmidt, CEO of Solera Health. “We’re thrilled to be able to work with ATRIO Health Plans and provide such a robust program to their Medicare Advantage membership.”

About Solera Health

Solera Health is an integrated benefit network that connects consumers, payers, and providers with community organizations and digital therapeutics, 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 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 or LinkedIn.

About ATRIO Health Plans
ATRIO Health Plans is a Medicare Advantage (MA) plan that offers Preferred Provider Organization (PPO) options as well as a Health Maintenance Organization (HMO) Special Needs Plans for Dual Eligibles. The health plan is supported by the trusted physicians who care for individuals and families in the Oregon counties of Douglas, Jackson, Josephine, Klamath, Marion and Polk. For more information, visit http://www.atriohp.com.

[1] https://www.cms.gov/Research-Statistics-Data-and-Systems/Research/ActuarialStudies/Downloads/Diabetes-Prevention-Certification-2016-03-14.pdf

Healthcare Technology Innovator Accelerates Diabetes Prevention in the Cloud

July 27, 2018 / in Coverage / by admin

Microsoft Customer Stories

July 25, 2018

Solera Health is successfully fighting type 2 diabetes. Its secret? Using Microsoft Office 365 to give its distributed workforce the power to easily communicate and collaborate with health plans, diabetes prevention programs, and patients in a highly secure way. The company uses Microsoft Azure and Power BI to analyze member data, identify those at risk for type 2 diabetes, and connect them with best-fit diabetes prevention programs (DPP). Everyone wins, from patients enjoying healthier lives to health plans with lower costs.

The dedicated people at Solera Health believe that no one has to fall prey to chronic illnesses, and they’ve taken aim at type 2 diabetes. To help the US population embrace the healthy lifestyle choices that can help them avoid the disease, the Phoenix, Arizona–based integrated benefit network has created an innovative solution: a comprehensive network connecting health plans, healthcare providers, diabetes prevention programs (DPPs), and patients. The result? Happier, healthier individuals and communities all over the United States, lower reimbursement costs for insurers, and falling healthcare expenditures overall. Their catalyst for the innovative solution was Microsoft Office 365 and Microsoft Azure.

Forging a new path for preventative care

According to the American Diabetes Association, diabetes is the seventh-leading cause of death in the United States, costing the country $245 billion every year. Solera Health Chief Executive Officer Brenda Schmidt wanted to change those grim statistics. She saw a gap between the highly effective community prevention organizations that typically deliver low-cost, high-value outcomes and the insurers that aim to connect patients with best-fit prevention programs. Drawing on her deep background in healthcare IT, in 2015 she formed Solera Health, a service that connects insurers, patients, and community-based prevention programs. Now a company of more than 100 workers, Solera Health is disrupting healthcare in the best possible way, solving the need for aggregating and analyzing patient data and connecting patients to the most effective resources with its groundbreaking network platform.

Approximately 1,700 DPP organizations dot the US map, covering a patchwork of geographies and populations. Health plans recognize that prevention is key to better serving patients and lowering healthcare costs. But identifying patients at risk and connecting them with the DPP that meets each patient’s needs and preferences in their geographic area is complex and expensive. Community-based, nonclinical diabetes prevention programs frequently represent the most effective options for helping people make the changes they need to avoid chronic conditions like type 2 diabetes. However, these organizations are historically funded through grants and donations and are ill-equipped to meet the data security requirements necessary to obtain reimbursement from health plans. Enter Solera Health, with its safeguarded data aggregation platform and extensive DPP network—a new curated marketplace for diabetes prevention services.

Crafting a springboard for a modern workplace

For Solera Health Vice President of Technology Dan Hurley, creating a disruptive innovation begins with a leading-edge paradigm for the company’s workers. “We foster an agile, flexible culture,” he says. “At Solera, it doesn’t matter where we work. That’s the whole point of our Office 365 and Azure adoption.” This cloud-based environment involves such easy deployment and management that Hurley’s 35-person IT team has no trouble supporting nationally distributed employees. Everyone has a Microsoft Surface device and an Office 365 license. Hurley finds the flexibility of Microsoft licensing perfect for a rapidly growing startup. “We grew very fast,” he says. “The Microsoft pay-as-you-go approach is the best licensing model I have ever experienced in my 30-plus years in IT.”

Employees use Office 365 productivity tools like Word, Excel, and PowerPoint along with Skype for Business to work together online with colleagues all over the country. Hurley created a new approach for external collaboration with insurers and DPPs using the Phone System feature in Office 365 (Cloud PBX) and Skype for Business for private branch exchange (PBX) capabilities. Materials are easily shared visually in real time during Skype for Business calls, and customer contact data is contained within the Solera ecosystem. “We don’t use office phones anymore,” he says. “Instead, we assign everyone on the Solera team a Cloud PBX number anywhere in the country. If any customer-facing staff members leave Solera, we retain all their customer contact data.”

The company even designed the physical office space at its headquarters to promote collaboration. Rather than rows of cubicles and desks, clusters of tables form landing spaces for staff members who move fluidly among teams as their collaborative needs dictate. A network of remote marketing reps equipped with the same mobility-ready Surface devices are scattered across the United States. “Our modern physical and virtual workspaces support our ethos of cross-team collaboration,” says Hurley. “Finance people interface with our development team, our own marketing people, and our network partners. By using Office 365 cloud-based tools to work in a connected way, we’re constantly improving our product and processes.”

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Supporting the enterprise with highly secure cloud technology

Solera opted for a cloud-based infrastructure right from its beginning. Hurley sees a plethora of benefits from that approach: automated backups, redundancy, and high-availability network performance. Most important, in an industry where security is king, Solera has earned HITRUST certification, the highest security qualification possible for US healthcare organizations and the desired prescriptive framework for managing the security requirements of the Health Insurance Portability and Accountability Act (HIPAA). “If we’d been a traditional on-premises organization, it would have taken us almost an entire year to achieve HITRUST certification,” says Hurley. “And it would have meant extensive onsite inspections. But having our data in the Microsoft cloud gave us instant credibility—regulators know that our data is segregated from that of other companies and that it’s fully backed up and highly secured.”

Hurley’s team uses Microsoft Power BI as a multipurpose tool, collecting infrastructure reporting to monitor overall system health for proactive evaluation and action. The team drives critical goals by using data from insurers with ArcGIS Maps for Power BI to create compelling visualizations and sharpen the focus on locations with populations most vulnerable to diabetes. “We absolutely love the heat maps we get with ArcGIS Maps for Power BI. We can layer the prevention offerings from our network providers on top of these maps,” says Hurley. “After only two years, we’re seeing phenomenal success with all the high-risk populations, particularly the senior demographic, because our data and insights help connect those people with the diabetes care programs they need. Also, now that health plans use us to safeguard patient information, we can match more people with prevention programs. People tell us that they’re losing 15 to 20 pounds—in some cases, even more—keeping up with their grandchildren, and going places they never could before, because they’re fitter and healthier.”

Working toward a bright future

Solera plans to extend its diabetes prevention work. Core components of a healthy lifestyle—exercise, nutrition, sleep, and stress reduction—factor into prevention of other chronic conditions. Moreover, the diabetes prevention programs Solera amplifies can be also used to mitigate the progress of the disease in those who already have it. Solera’s cloud-based approach has won trust from the traditionally cautious healthcare insurance industry. “Every health plan we contract with performs a comprehensive risk assessment of Solera,” says Hurley. “The industry is still adjusting to our 100 percent cloud-based approach. It’s not what they’re used to, but they’re learning that with Office 365 and Azure, our data is safer than it would be if we used an on-premises datacenter.”

“We grew very fast. The Microsoft pay-as-you-go approach is the best licensing model I have ever experienced in my 30-plus years in IT.”

Dan Hurley: Vice President of Technology
Solera Health

Find out more about Solera Health on Twitter, Facebook, and LinkedIn.

Content from Blue Cross Blue Shield Association: Improving health through personal touch, technology

June 21, 2018 / in Coverage / by admin

President and CEO of Blue Cross Blue Shield Association Scott P. Serota moderates a conversation about how technology combined with a personal touch is uncovering community solutions and improving health for patients fighting chronic disease.
June 20, 2018 | 1:28 PM EDT

https://www.washingtonpost.com/video/postlive/wplive/content-from-blue-cross-blue-shield-association-improving-health-through-personal-touch-technology/2018/06/20/788646c2-74cb-11e8-bda1-18e53a448a14_video.html?utm_term=.2d8d9a46cc08

 

New Medicare Advantage rules hold big potential for pop health

June 14, 2018 / in News / by admin

HealthcareDIVE

The push toward valued-based care and population health management has raised visibility around nonmedical conditions that impact health outcomes.

Improving health outcomes using population health strategies could get a major boost with a new Medicare Advantage rule taking effect this week.

Payers will now be able to work with companies like Uber or Lyft to provide transportation, for example, as part of a more complete set of benefits for the quickly growing MA population.

CMS issued a final rule in May giving MA plans more flexibility in determining the types of supplemental benefits they can offer chronically ill enrollees, including nonmedical benefits. The new policy, part of a broad 2019 Medicare payment rule, means plans like UnitedHealthcare and Humana aren’t harnessed to a set palette of supplemental benefits for members with chronic conditions, but can tailor them to the specific needs of individuals.

The rule could see an array of new benefits aimed at improving health outcomes by addressing issues such as housing and food insecurity, transportation and social isolation. Potential benefits include ride-hailing services, home visits, nutritional support, air conditioners for people with asthma, home renovations like grab bars and other accommodations to prevent falls, and home health aides.

Providers have praised the expansion of benefits. “We now have a funding stream effectively within Medicare Advantage around social services,” Don Crane, president and CEO of America’s Physician Groups (APG), told Healthcare Dive in an interview. He called the change a “necessary and appropriate step” in managing chronic diseases.

The focus on social determinants of health and population health management is part of the broader shift to value-based care and reimbursement. Some providers, payers and employers already offer wellness and prevention programs or free rides to cut down on patient no-shows.

Whether the CMS rule leads to wider adoption of population health programs generally remains to be seen, but as a fast-growing segment of the Medicare market, insurers and providers are likely to be watching for any impact on access to care, outcomes and cost.

Currently, about 21 million Americans are enrolled in MA plans — or a little more than a third of Medicare beneficiaries. However, L.E.K Consulting predicts enrollment will jump to 38 million, or 50% of market penetration, by 2025.

‘Reasonable expectation of improving health’

Under the bipartisan budget deal signed by the president in February, Congress expanded supplemental benefits for the chronically ill to include ones that “have a reasonable expectation of improving or maintaining the health or overall function of the chronically ill enrollee and may not be limited to being primarily health related benefits.” The law also authorizes CMS to waive uniformity requirements, but only with respect to supplemental benefits for enrollees with chronic conditions.

Uber and Lyft, both with active partnerships in healthcare, say the new policy will help them expand their footprint.

“This guidance demonstrates how serious CMS is in giving health plans the tools they need to address the social determinants of health — of which transportation is foundational,” Lauren Belive, director of federal government relations at Lyft, told Healthcare Dive via email. “This new flexibility will allow us to partner even more dynamically with MA plans to not just help seniors suffering from chronic health conditions get to their health appointments, but to more broadly leverage our platform to remove transportation barriers and encourage healthy and active living.”

Katherine Hempstead, senior adviser to the EVP at the Robert Wood Johnson Foundation, agrees. “It fits into the overall trend toward paying for value and thinking about the broader array of things in our living conditions that affect our health,” she told Healthcare Dive. “There can definitely be sort of an ROI in covering some of these things.”

Tackling social determinants of health

Following CMS’ release of the rule, APG announced a partnership with the nonprofit Partners in Care Foundation to offer their patients new benefits enabled by the rule. With the new regulations, practices with MA members will likely want to avail themselves of the opportunity to expand benefits. The issue is whether to build the infrastructure for these services in-house or contract them out. “Our agreement with Partners in Care creates ready resources for members to use,” Crane said.

Integrated benefit network Solera Health also sees an opportunity in CMS’ expansion of benefits. “We think it’s extremely significant because it validates the realization that healthcare-related social determinants of health can have an impact on peoples’ ability to maintain and improve their health between doctor visits,” Brenda Schmidt, founder and CEO of the Phoenix-based company, told Healthcare Dive.

Solera, which is helping administer the Medicare Diabetes Prevention Program, recently announced a partnership with nonprofit Feeding America to address food insecurity. Among those who will benefit are Solera’s 37 MA plans, representing about 13 million covered lives. The company also serves about 6 million Medicaid beneficiaries and 40 million commercial lives.

Solera has a similar partnership with the Food as Medicine Coalition in California, which received a $64 million grant from MediCal to document the impact from providing medically tailored meals for 3,000 people in California.

Food and other social services for the needy and elderly have been around for a long time. Meals on Wheels, for example, brings healthy food to homes and addresses social isolation and inability to get around. What changed with the budget bill and the CHRONIC Care Act included in it is that industry now has the opportunity to operationalize and monetize these healthcare-related social supports so that there is a sustainable revenue model for organizations that typically have been philanthropically funded or grant-supported, Schmidt says.

At the same time, it increases visibility at the member level around who is receiving services so plans can document quality and cost.

This, in turn, provides a big opportunity for a new model in healthcare, Schmidt says. “These highly disparate, highly fragmented nonmedical social services really have never been integrated into healthcare and require a business model that’s going to help health plans feel comfortable with the quality and regulatory compliance of this class of providers,” she says.

Insurers that Healthcare Dive reached out to did not say whether or what new benefits they may offer next year. However, Sarah Bearce, spokeswoman for UnitedHealthcare, said via email that “Medicare benefits should not be one-size-fits-all, and continued rate stability and greater benefit design flexibility enable health plans to provide a more personalized healthcare experience for the millions of people who choose Medicare Advantage.”

While the new flexibility provides a lot of room for innovation, it could also be a slippery slope. “You have to think about what’s the limit to this,” Hempstead says. “On the one hand, you can reduce healthcare costs by making sure people have all these other things covered. On the other hand, you might think, wow, everything in the healthcare system is so expensive. To what extent do we want to bring all these things into the healthcare system?”

Plans need to carefully think about how they price these new benefits and how much the system is paying for them so patients get benefits without making everything cost more, she added. “I think there will be a lot to learn about what is a good investment and what is not.”

An unintended victim?

One potential victim of expanding MA benefits is the long-term care insurance market. The number of people purchasing LTC plans dropped nearly 14% from 2015 to 2016 — an eight-fold decline from the market’s peak in 2002. Earlier this year, a major carrier went belly up, forcing other carriers to pay into its guaranty fund. Carriers have complained that they are underpriced and that people are staying in policies longer than expected, with fewer lapses and higher claims than expected.

With an average annual premium of $3,490 for a 60-year-old couple, many seniors may choose to switch to MA plans now that they can provide some of the same benefits around daily living and home health aides.

“It will be interesting to see to what extent this partially solves the long-term care problem, because right now Medicare doesn’t cover that stuff, so people either buy long-term care insurance, they use their private savings or they end up kind of spending down and using Medicare,” Hempstead says.

June 6, 2018 / in News / by admin

Solera Health Founder and CEO Brenda Schmidt Named “Best MedTech CEO”
2018 MedTech Breakthrough Awards Program Recognizes Solera Leader for Innovation and Vision

Phoenix, AZ – June 6, 2018Solera Health, a leading integrated benefit network, today announced that Founder and CEO Brenda Schmidt has been recognized as the “Best MedTech CEO” by MedTech Breakthrough, an independent organization that recognizes the top companies, technologies, and products in the global health and medical technology market.

“It’s an honor to receive this award from MedTech Breakthrough,” said Schmidt. “When I founded Solera Health less than three years ago, I saw the need for a transformative network model to tackle chronic health issues at their roots by connecting patients, payers, and providers to proven non-medical health interventions – like medical nutrition therapy and diabetes prevention programs. We believe that getting these critical interventions paid through medical claims by payers like any other medical service is an important step in preventing and better managing chronic health conditions and lowering our national healthcare costs. This award is a validation of our work to-date, and I am excited about our plans for the future.”

The mission of the MedTech Breakthrough Awards is to honor excellence and recognize the innovation, hard work, and success across a range of health and medical technology categories. This year’s program attracted over 3,000 nominations from more than 12 different countries.

“We are thrilled to name Brenda Schmidt as our 2018 MedTech Breakthrough Award winner for “Best MedTech CEO” in recognition of her dedication to supporting and scaling evidence-based programs,” said James Johnson, managing director, MedTech Breakthrough. “It’s exciting to see the initiatives Solera Health is driving, from food insecurity to diabetes prevention. Brenda is not only a visionary healthcare entrepreneur and industry leader, she also contributes to several important organizations such as the Council for Diabetes Prevention and the Population Health Alliance. We congratulate Brenda and the Solera Health team on their successes and we look forward to seeing their future contributions to the health and medical technology field.”

Solera Health recently announced partnerships with Feeding America and the California Food is Medicine Coalition to address food insecurity, and on April 1 launched MedicareDPP.org, a national referral and selection website for the new Medicare Diabetes Prevention Program.

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 or LinkedIn.

About MedTech Breakthrough
The MedTech Breakthrough Awards program, part of the Tech Breakthrough Awards organization, is devoted to honoring excellence in medical and health related technology companies, products and people. The MedTech Breakthrough Awards provide a platform for public recognition around the achievements of breakthrough MedTech companies and products in categories including Patient Engagement, mHealth, Health & Fitness, Clinical Administration, Healthcare IoT, Genomics, Medical Data, Healthcare Cybersecurity and more. For more information visit www.MedTechBreakthrough.com.

 

 

Solera Health and EVA Health Announce Partnership

May 30, 2018 / in News / by admin

Phoenix, AZ – May 30, 2018 – Solera Health, a leading integrated benefit network, today announced that Covina, CA-based EVA Health has joined its national network of diabetes prevention program (DPP) providers.

EVA Health is a local pharmacy provider that is certified to hold classes for people at risk of developing diabetes who are registered for a DPP, like the Medicare Diabetes Prevention Program (MDPP), which was effective as of April 1 as a covered benefit for eligible Medicare beneficiaries.

The MDPP’s goal is to reduce the risk for type 2 diabetes through a year-long program. The small group classes will use a standardized curriculum and will be led by a trained lifestyle coach. The program aims to improve nutrition and increased physical activity with the goal of losing a minimum of 5% body weight; this has been correlated with a 70% reduction in the risk of type 2 diabetes for people over age 60.  Individuals who are successful in meeting the CDC-established weight loss and attendance goals in the first 12 months of the program can continue with ongoing maintenance in the MDPP for up to an additional year.

“We’re very excited to be part of the Solera network and have the expanded access to participants, and the administrative support, that comes with that,” said Chad Nour, CEO, EVA Health. “I’m hoping that our organization taking this step will be a catalyst for other independent pharmacies in the area to start offering the DPP as well. Pre-diabetes is a critical health inflection point. I’m passionate about helping ensure that people’s pre-diabetes doesn’t progress to a diabetes diagnosis.”

“Nearly all of Los Angeles county’s health plans now cover the diabetes prevention program – even more so when Medi-Cal adds DPP as covered service on January 1, 2019,” said Brenda Schmidt, CEO, Solera Health. “We’re thrilled that residents within San Gabriel Valley can now go to a trusted, local community site for their DPP classes.”

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 or LinkedIn.

California Food is Medicine Coalition Selects Solera Health to Help Drive a $6M Program for the Chronically Ill

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

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Solera Health Named one of Modern Healthcare’s Best Places to Work in Healthcare

May 17, 2018 / in News / by admin

Phoenix, AZ – May 18, 2018 – Solera Health, a leading integrated benefit network, has been selected by Modern Healthcare as one of the 2018 Best Places to Work in Healthcare. The complete list of this year’s winners, in alphabetical order, is available here. Modern Healthcare will publish a special supplement featuring ranked lists of all the winners along with the October 1 issue.

Modern Healthcare’s Best Places to Work in Healthcare award identifies and recognizes outstanding employers who foster positive work environments. The program uses employee surveys to gather feedback and evaluate organizations across a range of different areas, including culture, leadership, working environment, role satisfaction, pay and benefits, and overall satisfaction.

Now in its eleventh year, the Best Places to Work program recognizes 150 U.S. healthcare companies and organizations for their supportive, dynamic workplaces and for empowering their employees to provide patients and clients with outstanding care, products and services.

“We’re very honored to be named a Best Place to Work,” said Brenda Schmidt, CEO of Solera Health. “Winning this award is a validation that we’re not only working hard to serve our clients and partners, but that we’re also committed to creating a great corporate culture that supports and empowers our employees to achieve our mission of helping people maintain or improve their health.”

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 or LinkedIn.

 

 

Solera Health Introduces MedicareDPP.org to Match Medicare Beneficiaries with Diabetes Prevention Programs

April 2, 2018 / in News / by admin

The website offers millions of at-risk older adults a simple way to access the new Medicare Diabetes Prevention Program services

Phoenix, AZ – March 27, 2018 Solera Health, a leading integrated benefit network, today announced the launch of MedicareDPP.org, a national referral and selection website for the new Medicare Diabetes Prevention Program (MDPP). The site’s goal is to increase awareness of and participation in diabetes prevention programs by making it easy for Medicare beneficiaries to learn their risk for type 2 diabetes, and if eligible, find and participate in a local diabetes prevention program that fits their needs and preferences.

Effective as of April 1, the MDPP is a milestone in the history of Medicare. For the first time, an estimated 22 million Medicare beneficiaries at high risk of developing type 2 diabetes have access to evidence-based, diabetes prevention services at no cost. The MDPP, which aims to reduce the risk for type 2 diabetes through a two-year program, is the culmination of years of work across government agencies to scale the National Diabetes Prevention Program. This has included research from the National Institutes of Health, the translation of that research into community-based programming by the Centers for Disease Control and Prevention (CDC), the completion of the MDPP expanded model pilot and actuarial analysis by the Centers for Medicare and Medicaid Innovation (CMMI), and now the addition of MDPP as a covered preventive service by the Centers for Medicare & Medicaid Services (CMS).

MedicareDPP.org is a user-friendly portal that encourages individuals to learn more about the MDPP and verify that they meet the program qualification criteria. Once eligibility is verified, the site connects the beneficiary to Solera’s national network of non-medical, community-based MDPP suppliers that meet CDC and CMS requirements. Solera is contracted to administer the MDPP for more than 32 Medicare Advantage plans, however, the website is designed to verify eligibility and match all eligible Medicare beneficiaries with MDPP suppliers.

“The National Diabetes Prevention program can reduce the risk for type 2 diabetes and provide a positive financial return in 12 to 14 months,” said Brenda Schmidt, CEO of Solera Health. “Through MedicareDPP.org, we act like Match.com to find the best diabetes prevention program for Medicare members to help them live healthier lives. We are excited to work with our MDPP network partners to achieve this goal.”

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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 non-medical 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 or LinkedIn.

 

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