Solera Health Introduces a New Delivery Model for Preventative Healthcare

Video: California patient demonstrates opportunity to reverse U.S. chronic illness trends

Chronic disease ranks as a top cause of death in the United States: 86 million Americans — nearly 1 in 3 individuals — are at risk of developing type 2 diabetes or another preventable, chronic disease. Groups throughout the healthcare system now recognize the importance of proactive action to deter the onset of chronic illness and thus reduce the number of diagnosed patients in the future. New models of care can help increase the accessibility and cost efficiency of prevention programs, making it possible for more people to access high-quality preventative health services.

The Challenge: Making Prevention Programs Affordable, Accessible, and Efficient

Like millions of Americans, poor nutrition and inactivity increased the likelihood that Chris Bourke, a 62-year-old teacher living in Soledad, California, would eventually develop diabetes. Mr. Bourke often found himself snacking in the front of the television rather than consciously setting aside time to be active.

For at-risk individuals, recognizing the need for a change is simply the first step. It can be time-consuming, costly, and difficult to choose among the thousands of programs, diets, and exercise plans circling the internet. People who are interested in prevention programs, as well as current patients managing chronic diseases, often need access to resources, support, and personalized care. It also helps to remove additional barriers, like financial cost, to high-quality, third-party programs.

The Opportunity: Connecting Patients to a Growing Network of Providers and Personalized Solutions

Founded in 2015, Solera is committed to improving the health of communities and changing lives by connecting people to meaningful lifestyle, prevention, and chronic disease management solutions. The company’s partners span the healthcare industry as Solera works with health plans, digital therapeutics, community-based organizations, employers, and patients. Solera’s extensive and continuously growing network of community-based and digital health solutions integrates evidence-based programs into one easily accessible and personalized benefits platform. Solera’s clients recognize the value of empowering their members with choice – with Solera helping members navigate where to start on their wellness journey or equipping the member’s care team to directly enroll members into programs. Members access Solera’s curated network of providers are matched with qualified community and digital health solutions based upon eligibility criteria, preferences, goals, and needs. Solera’s solution offerings include diabetes prevention and management, weight and obesity management, falls prevention, and social isolation and loneliness, with tobacco cessation on Solera’s 2020 product roadmap. The breadth and depth of solutions, combined with the choice of program modality, whether in-person, digital, or virtual, mean that members are sure to find a program that meets their needs.

Diabetes and Weight Management Programs

A 5% to 7% reduction in body weight has been shown across studies to reduce the onset of diabetes by 58%, and for those over 60 years old, by 71% as documented by the CDC. In line with this objective, in April 2018, the Centers for Medicare & Medicaid Services mandated that the approximately 22 million Medicare beneficiaries, a population at high risk of being diagnosed with type 2 diabetes, have fully-covered (free) access to diabetes prevention services. At the same time, Commercial and Medicaid health plans across the country are offering similar diabetes prevention programs. After proving its model with over 40 health plans covering 60 million lives, Solera launched its comprehensive weight and diabetes management program to offer intensive, lifestyle-based counseling programs to the spectrum of people who could benefit from losing weight – or approximately two thirds of the U.S. population. Solera’s platform assesses the risk of Commercial, Medicare, and Medicaid members and then, if program eligible, connects them to their best-fit offering.

Individual Case Study: 84 Pounds and Counting for Chris Bourke

Solera helped Chris Bourke regain control of his health by connecting him to a Diabetes Prevention Program (DPP) that met his needs and goals, and Mr. Bourke cut his weight from 305 to 221 pounds. In referencing his previous unhealthy behavior, Mr. Bourke noted that “it’s so easy to do bad.” But with the help of Solera and the DPP that he selected, Mr. Bourke achieved step-by-step, sustainable success. “That’s why this program makes a difference. It stopped me from doing the same things I’ve been doing over time,” he said.

After signing up via, Mr. Bourke found the best suited program for him. Combined online and in-person support meant that at any time, he said, “a real, live person was always available at the other end of the phone.” The program was completely free as it was a covered benefit offered through the district health insurance for school employees. He noted, “it didn’t cost me anything. I haven’t given anything except losing the weight.”

Mr. Bourke started exercising on a regular basis and can now jog 2.7 miles for the first time in 30 years. After learning more about his nutritional needs, he changed his diet and began eating more fruits and vegetables. Mr. Bourke cited that he has more energy, is more productive at work, sleeps sounder at night, and overall, feels better inside. His new goal is to push through the 26.2-mile finish line at the Big Sur International Marathon.

Mr. Bourke is only one of over 160,000 people who have benefited from Solera to date, with 38% of patients completing Diabetes Prevention Programs in Solera’s network losing 5% or greater of their weight.

Social Determinants of Health

In 2003, the WHO introduced the concept of social determinants of health, or the idea that the myriad of factors that make up the conditions in which a person lives can have a drastic effect on their health. In the United States, millions of Americans lack education about and easy access to nutritious food and quality recreation, increasing their risk of developing a chronic condition such as diabetes and worsening their expected health outcomes. In response, the U.S. created the Healthy People 2020 program with an objective of highlighting social determinants of health to promote good health for all. The program identified five key areas to target: Economic Stability, Education, Social and Community Context, Health and Health Care, and Neighborhood and Built Environment.

In line with SDOH targets, Solera’s personalized integrated benefits platform can connect members to effective programs to lower health risk factors – including access to health services, health literacy, healthy foods, and physical activity – furthering the goal of good health for all by addressing social needs at home and in communities. Its dynamic platform can serve as a hub for health plan care managers or other health plan partner organizations to connect members to a range of solutions addressing social needs. Through this expanded offering, health plans can measure health impact and cost savings through Solera’s network, demonstrating an immediate value-add to plans, while addressing SDOH for individuals in a meaningful way.