Solera Health, a chronic condition management platform for payers and employers, is expanding its platform to include virtual specialty care facilitated by several new clinical partners.
Solera’s HALO Platform is an omni-condition management tool that aims to address high-cost chronic conditions, mostly serving commercial populations. The latest expansion into virtual specialty care furthers the company’s value-based care mission by widening access to specialist docs in a low-cost setting, executives told Fierce Healthcare.
The new capabilities leverage partnerships with two new partners, 9am.health and Vori Health, as well as an existing partner, Oshi Health.
Each partner specializes in addressing high-cost conditions, from obesity and diabetes to musculoskeletal pain to GI conditions. They offer a health coach, nutritionist, peer support and other support services while also coordinating with a patient’s primary or in-person care doc.
Payers and employers are increasingly interested in solutions that support specialty care needs, executives told Fierce Healthcare. These partnerships help them offer access to care in lower-cost settings that can drive ROI and transform the risk population of their populations.
“Employers know that the traditional fee-for-service care model has not really contained costs and led to changing the cost curve in the way that folks had hoped for,” Ed Liebowitz, chief product officer at Solera, told Fierce Healthcare.
Solera’s platform aims to give patients more personalized care at as low a cost as possible. Its algorithm matches a person to the care they need based on their behavioral needs, clinical needs and learning styles. This, the company argues, helps patients rely less on the traditional fee-for-service, brick-and-mortar system.
“Just like not every doctor is perfect for every patient, every point solution is not perfect,” Liebowitz explained. “That way, you don’t have to pick a single winner.”
A high volume of issues can be resolved virtually, Liebowitz said, but in cases of emergency or higher acuity needs, there remains a need for in-person care as well. “These specialty conditions really do require that team sport approach and that is what is really allowing digital to move beyond the pale and treat people as people not just as patients,” he said.
According to Oshi, from 20% to 40% of its patients will require coordinated, in-person care, like a colonoscopy to screen for colon cancer, breath testing for bacterial infections or medication infusions. Meanwhile, 9am.health refers about 5% of patients to in-person care, particularly complex patients like those on dialysis, advanced liver disease or advanced heart failure.
Vori said that it refers only about 2.5% of its patients to a surgical partner. For those who don't have an urgent issue like a fracture or draining wound, less than 5% of patients would need in-person care.
Solera’s partnerships in the latest expansion are all based in value-based contracts. Aligning care delivery with a billing model that is value-based incentives holistic management of health in a way that fee-for-service doesn’t, Liebowitz said. The goal of the company’s clinical partnerships is to drive outcomes, not procedures: “It’s something that’s really important to us,” Liebowitz said.