Solera Health provides access to digital preventive health solutions through referrals from healthcare providers and health plans. The company's SaaS platform connects patients, payers, and physicians with a new class of non-clinical healthcare providers. It also integrates a diverse ecosystem of community organizations and digital providers to manage patient identification and referrals, reimbursement and payment, while supporting increased consumer engagement. As such, Solera helps consolidate highly fragmented programs and services into one integrated network allowing health plans and medical providers to increase consumer participation while lowering associated costs. It proactively identifies the "best fit" chronic disease prevention program provider based on each individual's unique needs and preferences which has proven to have a significant impact on improved patient outcomes at a fraction of the cost of traditional medical care. How Solera works for health plans? Working with Solera, health plans and other payers securely and efficiently leverage a network of community-based and digital health solutions.
- First, Solera works with plans and physicians groups to identify members that are at highest risk for chronic disease using EMR and/or claims data; some members also self-refer using the online screener at Solera4Me.com.
- Then, patients are matched with the program provider where Solera believes they will have the greatest success. Patients who have a preference may select the program provider of their choice.
- Network partners use Solera technology to track patient activity and progress; when a patient achieves one of the four designated milestones, Solera submits a claim to the payer. Milestones are activity and outcomes-based.
- Based on the milestone achievement, the payer reimburses Solera, who then submits payment to the network partner.
- Along the way, Solera provides dashboards and regular reporting at the individual, group, physician practice and payer level. Network partners are also monitored closely to ensure they are meeting outcomes.
- First, Solera identifies high-risk employees — via biometric data or online screener — to assure the greatest return on investment.
- Employees are then matched with one of Solera's network partners, based on their needs and preferences. Alternatively, employees can select a provider they like the most.
- Employers are provided with seamless report detailing their employees engagement and outcomes.
- Solera is only paid if Solera can help employees achieve their outcomes. It will submit milestone-based claims for those employees who enroll and engage, so the cost is tracked and paid for as part of employer's medical spend.
- Solera identifies patients that are a good match for their partners' programs and enroll them on their behalf.
- Solera also handles regulatory requirements, to enable access to healthcare payers that might otherwise be out of reach.
- Solera submits claims on its partner's behalf as patient milestones are achieved.
- Solera doesn't get paid if their partners don't get paid.
Select investors BlueCross BlueShield Venture Partners, Sandbox Industries, Adams Street Partners, SJF Ventures
Last update: March 29, 2018
Disclaimer: We can not guarantee that the information on this page is 100% correct. more