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Solera Health
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Transforming the delivery of healthcare through community clinical integration; for patients, providers, community partners, and health plans including diabetes prevention programs (DPP).
Transforming the delivery of healthcare through community clinical integration; for patients, providers, community partners, and health plans including diabetes prevention programs (DPP).

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Making the Case for Scaling the National Diabetes Prevention Program as a Preventive Benefit: Solera Health Heads To Capitol Hill

Last week, Solera Health was honored to host a congressional briefing in Washington, DC that addressed the recently proposed Medicare Diabetes Prevention Program (MDPP) benefit, the role of Diabetes Prevention Program (DPP) providers/ integrators in delivering the program to at-risk patients, and how this newly reimbursable preventative offering can be scalable on a national level. The session, which was entitled “Diabetes Prevention Program: Scaling a New Preventive Benefit Across America” was introduced by Co-Chair of the Congressional Diabetes Caucus, Representative Tom Reed (R-NY) and brought together a diverse blend of individuals including a DPP participant as well as both hyper local and digital DPP providers, who each spoke to the significance of the program.

In my role as briefing moderator, I was encouraged to see what a profound impact the DPP has already had on so many lives. During the session Helen White, a DPP participant, spoke about her experience and success with the program. Prior to her enrollment, she lacked healthy eating habits, but would feed her family health food. When it came to her own meals, she wanted to stick with “comfort foods” that lacked nutrition. Helen admits at first that she was ignorant about her pre-diabetic condition but eventually the DPP curriculum saved her life by teaching her healthy eating habits and how to exercise. The DPP proved to be a strong starting point for her to make substantial and necessary lifestyle modifications, and, as a result, she is on a road to health that she never even imagined possible.

Next was Jerry Wayne, executive director, Valley Jewish Community Center who spoke on the organizations’ positive experience delivering the DPP as a community provider. During his presentation, he touched on both the opportunities and challenges the provider faced as a local program in terms of commitment and engagement and the critical role lifestyle coaches play in making their curriculum successful. Finally, we heard from Jared Saul MD, chief technology officer, HealthSlate who was on hand to share his perspectives on the specific value a digital DPP offering brings to qualified patients including allowing one to participate on their own time and making the program more accessible to individuals facing travel and/or transport limitations.

Following the briefing comments, one thing was abundantly clear, the DPP is having a profound impact on patients participating in the program either online or at the hyper-local level. As evidenced by the success stories above, the need to scale the initiative at a national level and as a new preventative benefit is more important than ever.

Click for the full blog: http://soleranetwork.com/making-case-scaling-national-diabetes-prevention-program-preventive-benefit-solera-health-heads-capitol-hill/
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ICER Report Affirms Value of DPP Integrator

This week, the Institute for Clinical and Economic Review (ICER) released its Diabetes Prevention Programs: Comparative Clinical Effectiveness and Value report, which reviews the comparative clinical effectiveness and value of CDC-recognized diabetes prevention programs (DPPs) and puts forth a number of key policy recommendations, including:

• Encouraging payers to cover CDC-recognized DPPs in a variety of formats across all plans with no copay. Payers should establish pay-for-performance contracts with DPP providers based on patient participation, retention, and weight loss.
• Directing clinicians to screen eligible patients for prediabetes using established clinical measures and, when prediabetes is identified, to immediately refer patients to a local or digital DPP.
• Noting that DPP providers should apply for CDC recognition for their programs, and should tailor their programs to include culturally appropriate curricula for diverse populations, as well as collaborate with payers in developing pay-for-performance reimbursement strategies.

We are pleased to see that the report affirms the value of Solera’s network integrator model in addressing some of the key requirements for DPP success, including scalability, sustainability, choice, and culturally appropriate curricula. In fact, the ICER report specifically refers to Solera in its section on DPP sustainability:

"While many DPPs have relied on grant funding and/or one-on-one contracting relationships with payers, there is at least one company (Solera) that acts as an intermediary by connecting patients, payers, and clinicians with DPPs. Potential benefits of such an intermediary include: health plans can offer both in-person and digital DPPs through one vendor, eligible patients can be matched to a DPP with the format that best suits them, more enrollees can be directed to DPPs leading to a steadier revenue stream, providers can easily refer patients to a DPP, and payments can be tied to key milestones (e.g., enrollment, engagement at 4 weeks and 9 weeks, ≥ 5% weight loss)."

Click here for the entire blog entry: http://soleranetwork.com/?p=1632
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Solera Health Prepared to Support DPPs In New Era of CMS Backed Diabetes Prevention Initiatives

Last evening the Centers for Medicare and Medicaid (CMS) took the first step toward a new era in prevention for America, starting with our nation's seniors with prediabetes. According to proposed regulation now available for public review and comment, that new era will start on January 1, 2018.

For years, the questions facing the Diabetes Prevention Program (DPP) - an intervention based in National Institutes of Health (NIH) research, authorized by Congress, and propelled forward a public-private partnership of the Centers for Disease Control and Prevention (CDC), community-based non-profits, and the private sector -- focused on whether it really prevented or delayed the onset of expensive, full-blown diabetes in people at risk- and if it would really save money. With ample evidence, and a CMS actuary certification, the answer is unquestionably that it works. Now the question facing policymakers and all of us who want the DPP to succeed is: how do we make sure that all Americans, starting with our seniors, have access to the program?

To improve the maximum number of lives and save the maximum amount of precious healthcare dollars, we need to work together to scale this program across every inch of our country by leveraging community organizations and digital DPP providers recognized by the CDC. These providers represent a new resource to battle diabetes – non-clinical providers in local communities who can provide culturally competent care and who recognize the barriers and opportunities for lifestyle change in their local communities. But while these new offerings bring additional opportunities they also present fresh challenges – as the coaches are typically non-clinical providers who have not previously integrated with the healthcare system.


Click here for the full story: http://soleranetwork.com/?p=1597
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Kudos to the AMA for Supporting DPP Coverage!

This week, the American Medical Association (AMA) formally announced a new policy encouraging private and public health plans to include the Centers for Disease Control and Prevention’s (CDC) evidence-based National Diabetes Prevention Program (DPP) as a covered benefit for their beneficiaries. This is an important and welcome development in the nation’s fight against this disease.

The AMA’s new policy encourages hospitals to offer the program to their patients and supports allocating community benefit dollars to cover the cost of enrolling patients in an in-person or digital DPP. The AMA will reach out to organizations such as the American Hospital Association and others to develop and disseminate guidance for covering the costs of DPP using community benefit dollars.

As a preventive health network on the front line of the effort to prevent diabetes and other chronic diseases, Solera applauds the AMA’s new initiative. We recognize the critical role health plans play in expanding the reach of CDC’s DPP, which is why we have built our network to make it easier for payers to manage members’ engagement and referrals, outreach and enrollment, reporting and reimbursement management. By consolidating DPP programs and services into one integrated network, we are helping health plans to increase consumer participation while lowering associated costs. Equally important, we are matching consumers to the “best fit” chronic disease prevention program provider based on their unique needs and preferences, which is improving patient outcomes — at a fraction of the cost of traditional medical care.

AMA has demonstrated it commitment to preventing diabetes through the its Prevent Diabetes Stat program and we are thrilled that the organization has strengthened their endorsement for DPP through this week’s policy statement.
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The Employer as a Lifestyle Modification Advocate

It is a truism that the most effective healthcare initiatives are the ones that actually decrease the need for healthcare in the first place. Employers recognize this, and are taking an active part in helping their employees adopt healthy lifestyles now, which will mean a more vibrant employee population – and a stronger bottom line – in the future.

With these end goals in mind, employers continue to explore and implement initiatives to help their employees improve their health and well being, from subsidizing gym memberships and healthy food options to establishing walking clubs, as well as an increased focus on stress management and the positive impact of mindfulness, among many others. Today, most companies that offer health benefits to employees have also implemented a wellness or wellbeing program in an effort to promote employee health and productivity and reduce health-related costs.

The need for these kinds of workplace initiatives has never been more acute, given the alarming rate of lifestyle-related chronic diseases in the U.S. On average, one in three U.S. adults have prediabetes, which, if left untreated, can progress to type 2 diabetes – one of the top medical expenditures of employers and insurers. Today, 29.1 million Americans are diabetic, incurring a total of $245 billion in healthcare costs – $176 billion in medical expenses and doctor visits, and $69 billion in reduced productivity, according to the American Diabetes Association (ADA). The ADA has also found that diabetes is the culprit for an estimated 25 million missed workdays and 113 million less-productive workdays.

For the entire story, please click here: http://soleranetwork.com/?p=1438
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Why American Diabetes Association Alert Day Matters

Earlier this month, a study from the University of Florida found that less than one-quarter of patients who met the criteria for prediabetes received drug therapy or lifestyle-modification treatment from their primary care physicians, indicating that healthcare providers are missing opportunities for diabetes prevention. The researchers studied visits to general, family or internal medicine providers by patients age 45 years and older who had physician-ordered blood tests done within the past 90 days. About 34 percent of the patients had a blood glucose level between 5.7 and 6.4 percent, which the American Diabetes Association considers prediabetic. Of those patients, very few were told they had prediabetes, and only 23 percent received treatment for the condition.

It is clear from this study that individuals need access to simple tools and resources for easy self-detection of health risks, as well as to treatment options.  The first step towards chronic disease prevention is detection, which is why initiatives such as the American Diabetes Association Alert Day are important.  The public health campaign is intended to be a 'wake-up call' for Americans to take the Diabetes Risk Test to find out if they are at risk for prediabetes and type 2 diabetes, and to take action to prevent the disease. 

Prediabetes is unique in that it is one of the few chronic diseases that can be initially identified and often treated outside the walls of a doctor’s office. This is why the second step in treatment is often focused on making critical lifestyle modifications to head off the development of full blown type 2 diabetes.  In fact, according to the Center for Disease Control and Prevention (CDC) losing a moderate amount of weight and increasing physical activity can prevent or delay new cases of type 2 diabetes by 58 percent overall, and by as much as 71 percent in adults over the age of 60. 

At Solera Health, we are helping overcome the problem of lagging physician referrals by  empowering at-risk patients  to combat chronic diseases on their own by giving them access to the tools they need to identify health issues such as prediabetes and directing them to the most appropriate and effective resources to treat them.  

Get the full story here: http://soleranetwork.com/?p=1131
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Our Nation’s Critical Need to Arm Socially Disadvantaged Populations with Tools to Achieve Health and Wellness

It’s no secret that there is a direct correlation between nutrition and people’s health and lifespan. The Dietary Guidelines Advisory Committee recently reported that American’s poor dietary habits are having devastating effects on our nation’s health: about two-thirds of American adults are overweight or obese and about half of American adults - approximately 117 million people - have preventable chronic diseases related to diet and physical inactivity. To help drive awareness around this growing health epidemic, the Academy of Nutrition and Dietetics has named March National Nutrition Month, in an effort to focus attention on the importance of making informed food choices and developing sound eating and physical activity habits. 

While these efforts are worthwhile, it’s hard to ignore the fact that many Americans don’t have access to healthy food resources, or convenient options for regular physical activity. And the long-term effects of poor diets and limited exercise can have dire health implications, particularly for lower income and minority populations. The U.S. Department of Agriculture Economic Research Service has determined that there is a direct link between obesity and poverty, and has found that in poverty-dense regions, people are unable to access affordable healthy food. And lacking nutritious food, those living in low-income communities experience higher rates of prediabetes and type 2 diabetes. 

Lower-income families have limited food budgets and choices, and must often stretch supplies toward the end of the month, before another check or allocation of government assistance arrives. This leads to unhealthy behaviors. Coupled with the fact that in many neighborhoods, safe and convenient options for regular physical activity are also limited, and the odds for developing a chronic disease such as type 2 diabetes are unfortunately in their favor. 

Solera supports interventions targeted toward socially disadvantaged populations to help them reduce their risk of diabetes and fully believes that the Center for Disease Control and Prevention’s (CDC) Diabetes Prevention Program (DPP) is an important first step. Currently the CDC has recognized more than 750 digital, national or community-based DPP delivery organizations that have been proven to help individuals make the necessary lifestyle modifications to reduce their risk for developing chronic health conditions driven by excess weight, such as diabetes and cardiovascular disease. These programs, which range from online food and nutrition curricula to on-site classes and even to faith-based walking groups, are teaching and supporting at-risk patients to reverse the onset of type 2 diabetes through weight loss, exercise and wellness habits. 

Find the full story here: http://soleranetwork.com/?p=1126 
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February is American Heart Month

The Centers for Disease Control and Prevention (CDC) notes that heart disease is the leading cause of death for men and women in America, and February has been named American Heart Month to create awareness around this chronic condition. Here at Solera Health, we are proud to support American Heart Month as we strive to work with community organizations and digital solutions to arm Americans with the lifestyle-modification programs they need to ward off chronic diseases such as cardiovascular disease and diabetes. 

Many Americans are unaware of the direct link between diabetes and cardiovascular disease. According to the World Heart Federation, if you have diabetes, you are two to four times more likely to develop cardiovascular disease than people without diabetes. Indeed, cardiovascular disease is the leading cause of mortality for people with diabetes.  Even more alarming are statistics from the CDC that show that 90 percent of people with prediabetes -- roughly 86 million Americans, or one in three adults -- don’t know they have the condition. 

Click here for more: http://www.soleranetwork.com/?p=1113 
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