Solera Health and Blue Cross Blue Shield Institute are piloting a new program to address the social determinants of health (SDOH) and coordinate regional patient resources.
Solera—a benefits network that connects patients, payers and physicians with a curated network of programs—was founded by Brenda Schmidt with the goal of supporting network providers, while allowing health plans and community members to connect to high-value programs and services. Solera calls themselves the Match.com of healthcare, connecting patients to community providers and resources.
Solera teamed up with the BCBS Institute because of its wealth of health data on specific social health factors by zip code level. Using the technology, Solera is able to contract and pay local organizations through medical claims.
The new program has rolled out in three U.S. regions which include Chicago, Illinois; Dallas-Fort Worth, Texas; and Boise, Idaho, each with their own unique environmental and cultural influences and barriers to coordinate. The national launch of the program is expected in the second quarter of 2019.
“While the link between SDOH and healthcare costs has been widely recognized for years, the industry has grappled with how to address those factors in a sustainable, scalable way,” Schmidt told FierceHealthcare.
Providers and payers alike are putting more and more stock into addressing SDOH. A recent survey by Change Healthcare found that 80% of payers believe that addressing these factors will improve the health outcomes of their population.
And what's the key? Data is the crucial element in determining the best-fit program for each member, Schmidt said.
“There is no one-size-fits-all solution for healthcare or SDOH. Each individual has lifestyle/social needs that need to be met in a meaningful way, and member data allows Solera to match them to the right resource,” Schmidt said.
In addition, data is important in determining location and capacity needs at the community level, as well as documenting the performance of individual network providers against a standardized set of outcome metrics.
“This approach allows Solera to be fully transparent with health plans about the efficacy of each provider, as well as use this data to determine which providers are having the greatest health and cost impact for homogenous subsets of diverse populations,” she said.
Solera is one of many healthcare companies looking to foster hyperlocal community programs and services as a valuable addition to primary care.
For example, in 2018, Kaiser Permanente launched a $200 million initiative to improve access to affordable housing, and Geisinger Health launched “Fresh Food Farmacy” to address food insecurity for diabetics by improving access to healthier foods.
“The future of healthcare prevention moves away from the clinical setting into the community setting. This transition means that food, fitness and transportation will become an integral component of how we evaluate holistic approaches to the health and well-being of our population,” said Trent Haywood, M.D., J.D., president of the BCBS Institute, in a statement. “The collaboration with Solera will help us to better understand how we can address social determinants of health quicker and more effectively.”
Schmidt notes that the capabilities that Solera and BCBS Institute bring to the market are meant to be available through all health plans.
Looking toward the future, Schmidt wants people to view healthcare as something that happens not just in a clinical setting but also in the community and home. Solera would like to see healthcare dollars, which are currently spent on caring for the sick, reallocated toward social supports that help at-risk patients.
In other words, “Prevent chronic health conditions as opposed to focusing on high-cost complex patients in crisis,” Schmidt said.