A partnership with Blue Cross Blue Shield Institute and Solera Health will help patients access community health resources that address the SDOH.
Blue Cross Blue Shield beneficiaries can now enjoy a digital platform that helps connect them to community health partners that provide services that address the social determinants of health, thanks to a partnership between Solera Health and Blue Cross Blue Shield Institute.
This partnership comes as a part of BCBSI’s emphasis on addressing the social determinants of health. Industry leaders are increasingly acknowledging that community-based health that integrates the social determinants of health will be essential on the path toward value-based care.
“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, MD, president of the Blue Cross Blue Shield Institute. “The collaboration with Solera will help us to better understand how we can address social determinants of health quicker and more effectively.”
The platform, created by the integrated benefits network Solera Health, lists the different community resources available to patients in a certain region. BCBS beneficiaries will be able to “match” with different community care providers that meet various patient social needs.
Solera reimburses its community partners through outcomes-based medical claims, the organization said. This emphasis on value-based and community-based care is a part of Solera Health’s philosophy that health starts outside of the doctor’s office, according to the company’s CEO Brenda Schmidt.
“The Blue Cross Blue Shield Institute and Solera Health strategic collaboration was conceived around our organizations’ mutual recognition that in order for healthcare to have the maximum impact on individuals, care must reach beyond the four walls of the doctor’s office and extend to the community,” Schmidt explained.
“To help improve overall health outcomes, Solera’s proven, curated network and payment innovation model is being applied to address social determinants of health, connecting BCBS plan members with a diverse array of local resources that best meet their unique needs and preferences. We look forward to seeing the full impact of the initiative as it scales nationally in the coming months.”
BCBS will use this system to match their patients with the resources they need to address the social determinants of health, or the social factors that influence a patient’s ability to be healthy.
Traditionally, health plans use complex data analytics programs to first identify patients with social needs and then to match those patients with programs that can help alleviate those issues. Targeting and segmenting high-risk populations is one of the fundamental challenges in addressing the social determinants of health, experts agree.
In partnering with Solera, BCBSI will overcome some of the challenges associated with connecting patients to community-based care and resources.
BCBSI is the organization’s newly-minted community health offshoot. The Institute is Blue Cross Blue Shield’s effort to create community- and business-based partnerships to address the social determinants of health.
“The time is more critical than ever for American business leaders to bring to bear the might and ingenuity of the world’s strongest economy to affect positive change in the health of all Americans,” Scott P. Serota, president and CEO of BCBSA and chairman of the board of the BCBS Institute, said in a statement. “Serving one in three Americans in nearly every geographic area in the country, Blue Cross and Blue Shield companies know all too well that what often dictates health isn’t genetic code, but ZIP code.”
Since its inception nearly one year ago, BCBSI has created relationships with different medical-based businesses that will help the Institute address the social determinants of health in each of its health plans cross the country.
In February 2018, BCBSI partnered with Lyft to help connect its Medicare Advantage members with medical transportation. Medical transportation is a key social determinant of health that dictates whether a patient can make it to primary care, preventive care, or chronic care management appointments.
Date: March 29, 2019