How Acuity Matching Supports Value-Based Care

Digital health tools are paving the way toward cost-efficient chronic disease management and improved outcomes. Like their brick-and-mortar counterparts, the key to their success is an approach tailored to each patient’s medical needs and personal preferences. But with thousands of digital health solutions to choose from, this seems like an insurmountable task.

However, Solera’s acuity-based matching capabilities make light work of guiding patients to the appropriate set of services. A proprietary algorithm matches patients to best-fit virtual solutions covering a broad range of conditions and acuity levels (symptom severity). This personalization represents a giant leap forward in value based care for chronic disease.  

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Why One-Size-Fits-All Doesn’t Work

Acuity matching is a departure from the one-size-fits-all approach to digital health. Under a conventional model, patients have access to only a limited number of digital health solutions with little variability in service intensity. A person with mild symptoms receives the same level of care as someone whose symptoms are not controlled and is at high risk for complications.  

At the heart of the matter, not everyone with a chronic disease wants or needs expensive, high-touch solutions to get better. But without other options, everyone is on the same program, leading to inefficient resource allocation. And when patients aren’t matched to the right solutions, it results in lower engagement and sub-optimal outcomes.

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Precision Approach to Digital Health

Acuity-based matching is the antidote to the one-size-fits-all approach. The innovative HALO™ (Holistic Acuity and Leveling Optimization) platform at Solera serves as a gateway to a next-generation omni-condition ecosystem of digital health tools.  

True to its name, HALO captures a holistic patient assessment. It takes into account clinical indicators, such as test results and symptoms, as well as readiness for change and online communication preferences. These factors are critical for patient engagement and, ultimately, outcomes. So, why not match patients with digital health solutions that give them the best opportunity for success?  

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Acuity matching in action

Acuity-based matching from Solera goes beyond risk stratification, which merely segments patients into mild, moderate or severe disease. The HALO platform facilitates digital health experiences tailored to patients’ medical, social and practical needs.  

Here are a few examples of how it’s supporting value-based care for chronic disease:  

Digestive disorders

Patients who have Crohn’s disease with frequent symptom flare-ups benefit from a hybrid model that seamlessly blends virtual and in-person care. Patients with lower acuity may match with a less resource-intensive, fully virtual program. All patients receive services from a multidisciplinary team of a gastroenterologist, behavioral health provider, dietitian and care coordinator, all accessed via the HALO platform.

Diabetes

Patients who have poorly controlled diabetes with consistently high blood sugar levels are matched with a higher-acuity virtual program. They undergo frequent monitoring, meet with endocrinologists and receive support from health coaches for lifestyle changes. Patients with well-controlled symptoms participate in a less resource-intensive program featuring periodic monitoring and lifestyle support as needed.

Musculoskeletal conditions

Patients with chronic back and joint pain receive holistic, physician-led online services. Individuals with lower-acuity symptoms may benefit from virtual physical therapy and prescriptions for non-opioid pain relievers. Care for higher-acuity cases may blend virtual and in-person services. This model results in fewer high-cost interventions.

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Supporting Value-Based Care by Driving Outcomes, Not Procedures

The Solera HALO™ platform and acuity-based matching capabilities align with core principles of value-based care. This, in turn, helps payers and plan sponsors better manage their financial commitment to health benefits.

Here's how Solera’s solutions support value-based care:  

• Optimal resource allocation: Matching patients to the appropriate care intensity directs higher-cost resources to patients who truly need them. This approach reduces redundancies and unnecessary services that can stagnate a patient’s care journey.

• Increase in patient satisfaction: Patients who receive services reflecting their wants and needs are more likely to adhere to care plans. They feel heard and empowered, making it easier to stay on track with long-term therapies.

• Focus on prevention: Acuity matching connects patients with low- to moderate acuity to timely therapies and support. Using virtual care to intervene in earlier stages lowers the risk of exacerbations that may require costly interventions.

• Provider accountability: Solera providers are responsible for achieving quality metrics related to patient engagement, clinical improvements and cost savings. Doing so demonstrates their ability to provide cost-effective care tailored to patients’ needs.

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Contact Us

Solera Health simplifies digital health delivery with a streamlined ecosystem of best-in-class digital health solutions built for accountability, integration, flexibility and decision support. Payers and plan sponsors have one contract, one bill and one virtual front door.  

Get more information by emailing info@soleranetwork.com or schedule a consultation.  

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