PHOENIX, Oct. 17, 2024  -- Solera Health, a unique technology platform for connecting people seamlessly and easily to digital health solutions that work, today announced the results of a first-of-its-kind study estimating the potential total cost of care savings achieved by supplementing traditional on-premise care with an on-benefit, multi-condition virtual healthcare network.

Conducted in conjunction with healthcare machine-learning company Health at Scale, the research demonstrated that strategically shifting site of care from in-person care to virtual creates a potential 2.3-3.1% reduction in total medical claims spend. Based on Centers for Medicare & Medicaid Services (CMS) estimates of private insurer expenditures in 2022, that could yield a U.S. cost savings of $37 billion to over $50 billion annually.

On-premise healthcare has several well documented challenges, including physician and staff shortages, gaps in primary care access, geographic and other access barriers, and, ultimately, rising healthcare costs. Infrequent in-person visits make it difficult for patients to meaningfully impact their health trajectory, and claims data indicates that in many cases this exacerbates a chronic condition until it becomes emergent - resulting in higher-cost interventions like urgent care or emergency visits. Enter virtual care - which provides patients with more consistent access to care, more frequent and lower-cost interventions, that lead to improved health outcomes.

“In this analysis, we sought to understand the true potential of meaningful expansion of virtual care delivery across a broad set of conditions and at greater scale within the population,” said Dr. Byron Crowe, chief medical officer at Solera. “Our findings clearly highlight that there is an enormous opportunity to improve outcomes and reduce costs by offering patients virtual care earlier and more often in the care journey.”

Methodology

This research was conducted using a data set that included longitudinal medical claims data of 50 million commercially insured U.S. adults. First, patients were identified as eligible for virtual care based on an index outpatient visit for a qualifying diagnosis during a six-month period. Next, the analysis looked at the previous 12 months of claims to determine whether a member’s condition was uncomplicated or complex, followed by a 12-month look forward to determining if their condition followed a controlled or uncontrolled trajectory after their index brick-and-mortar visit. The analysis then modeled the potential savings from substituting brick-and-mortar care with virtual care, as well as savings from getting more members into a controlled state with virtual options.

The analysis validates virtual health’s position within the healthcare ecosystem as a clinically and economically sound investment when implemented broadly across multiple conditions and specialties – providing an alternative when traditional care delivery has failed them, providing a whole new pathway to improve chronic health outcomes and to reduce the economic burden on payers and employers. Consistent, easily accessed virtual care can circumvent many access constraints (such as geography) faced by those attempting to receive traditional care, providing more efficacious, continuous, quality and timely care to those who need it most.

Solera will be discussing virtual health’s impact to total cost of care during HLTH next week in Las Vegas. Their full published white paper reviewing the findings will be available at soleranetwork.com in November.

About Solera Health
At Solera, we're redefining and streamlining digital healthcare delivery with a value-based, on-benefit solution that measurably drives down the total cost of care. Our HALO platform integrates seamlessly with payers’ brick-and-mortar operations, intelligently guiding participants to their best-fit solutions via a bespoke solution accommodating curated digital health solutions with your own preferred apps—all in a single digital space. Together, we can untangle healthcare's web of inefficiencies, siloed information, and outdated systems. It only takes one. It only takes Solera.

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Globe Newswire

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