April 13, 2018 / in Blog Posts / by Neha Purohit
-by Brenda Schmidt, CEO, and Founder, Solera Health
How to address the epidemic of obesity remains a prominent challenge in healthcare today, even though it is preventable. The Centers for Disease Control and Prevention (CDC) has found that more than one-third (36.5%) of U.S. adults are obese and the associated medical costs for them are roughly $1,429 higher than for those who are at what is considered a healthy weight. While these millions of Americans struggle with weight issues, they are also at risk for — or are already suffering from — associated chronic diseases such as type 2 diabetes, heart disease, cancer or stroke.
Socioeconomic issues are tied to obesity. Studies have found that communities with the highest obesity rates are those that are socioeconomically disadvantaged, often lacking in basic resources such as access to healthy food, safe places to exercise, and the overall standard of care that they need to get healthy. Research has also proven that obesity and chronic disease is especially widespread among Americans with the low levels of education and those with the highest poverty rates. However, identifying this causal link is only the first step in working to solve the problem.
The National Diabetes Prevention Program (DPP), is an evidence-based, affordable, and high-quality lifestyle change program proven to reduce the risk of type 2 diabetes. The DPP is delivered by trained non-clinical lifestyle coaches using a standardized curriculum. With a wide range of program options delivered in the community, the DPP is well equipped to meet the needs and address the challenges of diverse populations — whether that be language barriers, need for cultural competency, and understanding of the opportunities and barriers in the community to make healthy lifestyle changes. Local programs are designed to be delivered in group settings where people live, work, play, and pray. These hyper-local community programs include culturally appropriate curricula, connection to resources for health foods, and an understanding of the built environment. However, while many of these DPPs are able to deliver the program that could benefit these underserved communities, they face other barriers to success, including a lack of staff and resources to drive and manage enrollment, and a shortage of back-office administration capabilities for billing and reimbursement.
At Solera Health, we have built a business model that supports community-clinical integration by offering a high-access, lower-cost network of non-clinical providers as an adjunct to primary care.
Solera connects a highly-fragmented grouping of community-based DPP providers by plugging them into an integrated national network as an adjunct to primary care, paid through medical claims. Solera’s integrator role is supported by our technology platform and back office compliance and program integrity oversight. This helps community providers plug into the existing healthcare system so they can concentrate on delivering programs that help their communities get healthy.
As a first step, Solera connects underserved populations with the “best fit” lifestyle-modification resources available in their areas. Meeting consumers where they are and empowering them with choice has proven to have a substantial impact on the ultimate success of the DPP. We leverage our proprietary analytics model to connect them to the DPP that best aligns with their cultural, economic, and personal needs and preferences.
Secondly, as the integrator and administrator with the operational expertise and technology, we work directly with DPPs to manage all of the back-office logistics such as compliance, program integrity, billing, reimbursement, reporting, etc. Thus, program providers are freed up to focus on their core competency — delivering their evidence-based, culturally-tailored lifestyle modification program to help underserved populations achieve health goals to keep chronic disease at bay.