Solera Health

- 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.
Funding 💰
Total $30.3M
Select investors BlueCross BlueShield Venture Partners, Sandbox Industries, Adams Street Partners, SJF Ventures
Last update: March 29, 2018
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