BETTER CARE THROUGH AN INTEGRATED PREVENTIve cARE NETWORK

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Presentation transcript:

BETTER CARE THROUGH AN INTEGRATED PREVENTIve cARE NETWORK

At Solera, we are inspired by the hundreds of organizations that are fighting chronic disease every day. Our mission is to improve the health of our communities, and we do that by connecting payers, physicians and those at risk for diabetes with a diverse network of local and digital diabetes prevention program providers.

58% The DIABETES PREVENTION POGRAM’S effectiveness has been proven PLACEBO PLACEBO 58% RISK REDUCTION METFORMIN %CUMULATIVE INCIDENCE OF DIABETES YEARS N Engl J Med. 2002; 346: 393-403

dpp financial SAVINGS Have also been demonstrated Health plans save significantly when members avoid developing diabetes. Florida Blue PMPM for DPP Participants AVERAGE HEALTH PLAN COST Diabetic Member Non-Diabetic Member $11,700 $4,400 $671 $583 $505 Attended 1 class Partial Program Completed Program Completed The Center for Medicare and Medicaid Services (CMS) cited a savings of $2,650 per DPP participant who attended four sessions. Pre-diabetic members who completed the DPP with 5+% weight loss experienced a 20% decrease in PMPM Citations: http://www.changelabavsolutions.org/sites/default/files/LADPH-DPP%2OROI%2OFactsheet_FINAL_11_2015.pdf https://www.cms.gov/Research-statistics-Data-and-Systems/Research/ActuarialStudies/Downloads/Diabetes-Prevention-Certification-2016-03-14.pdf

DESPITE THE DPP’S PROVEN IMPACT AND OUTCOMES, NO SINGLE DPP PROVIDER HAS ACHIEVED SIGNIFICANT ENROLLMENT 8,780 0.1% of At Risk Have Attended at Least 4 Sessions Participants who have attended at least 4 sessions Individuals enrolled in a DPP 0.6% of At Risk Have Enrolled in DPP 55,586 Individuals at risk for diabetes 86 Million 86 Million at Risk Source: CDC DPRP Data–July 20, 2016

SINGLE PROVIDER SOLUTIONS CANNOT MATCH THE NEEDS OF A DIVERSE POPULATION U.S. POPULATION / GENDER DISTRIBUTION U.S. POPULATION / AGE DISTRIBUTION U.S. POPULATION / ETHNICITY DISTRIBUTION Source: The Henry J. Kaiser Family Foundation, State Health Facts, Timeline: 2015

At Solera, we recognize that our communities—and their needs—are diverse. We’ve built a network of DPP providers that offers members a range of choices. Members choose the program where they believe they’ll have the greatest success.

Health Plan / Employers accesses hundreds of DPPs SOLERA ENABLES HEALTH PLANS AND EMPLOYERS TO CONTRACT WITH ONE SOLUTION WHILE MEMBERS / EMPLOYEES CHOOSE FROM MANY WITH 1 CONTRACT Health Plan / Employers accesses hundreds of DPPs DPP DPP DPP DPP DPP DPP DPP DPP DPP DPP DPP DPP Tie integrator role back to supporting program scale. Solera has established an integrated national network of community organizations and digital DPP providers. All have full or pending recognition by the CDC, and we are continuing to build out the network, Community is critically important - 50% of participants across markets select an onsite option. One payment model for all DPP partners – let’s members select or find the “best fit” provider. Solera can offer a more narrow network based on documented outcomes for each provider. (Explain how we onboard and review efficacy). Ability to integrate with Humana programs. DPP DPP DPP DPP DPP WITH 1 DIGITAL TOOL Associates choose the DPP that best meets their needs

Provide engagement and outcomes reporting and dashboard reporting THE SOLERA SOLUTION ENROLLMENT REIMBURSEMENT REPORTING NETWORK Identify and refer employees to the best fit program based on needs and preferences. Securely submit milestone-based claims and manage payments to network partners. Provide engagement and outcomes reporting and dashboard reporting Build and maintain a national network of high-performing community and digital providers.

THE MANY FACES OF PREDIABETES Employer Benefit Physician Referral Consumer Advertising 57 years old, BMI of 38 38 years old, BMI of 28 26 years old, BMI of 30 NEEDS / PREFERENCES Spanish speaker Technology Group support NEEDS / PREFERENCES Community / Onsite Flexible schedule Group support NEEDS / PREFERENCES Individual support Flexible schedule Technology MATCH FOUND MATCH FOUND MATCH FOUND EXPECTED WEIGHT LOSS 6.13% EXPECTED WEIGHT LOSS 5.5% EXPECTED WEIGHT LOSS 5.7%

SOLERA MEETS THE NEEDS OF 100% OF THE TARGET POPULATION 40% COMMUNITY 20% 40% @WORK DIGITAL Solera Book of Business average weight loss at 6 months = 7.2%

SOLERA TECHNOLOGY: CENTRAL DATABASE FOR ALL DPP DATA Dashboard Reporting Supports KPIs across the Solera ecosystem DASHBOARD HOME