The power of Smart Benefits to drive greater health equity
Soda Health exists because, even as health plans invest more and more in supplemental benefits and other incentives to keep members healthier while reducing costs, the tools for managing those investments have been, in a word, dumb: It might be a flex card that’s intended to encourage healthy eating by paying for dairy products, but can’t tell the difference between skim milk and vanilla ice cream. A prepaid gift card, the value of which is wasted if it is lost or forgotten. A benefits structure that’s locked on Jan. 1, with no way to adjust if a member’s health or life situation changes in the middle of a plan year.
The value of nonclinical supports, such as over-the-counter drugs, nutritious food, housing modifications, transportation and more, are proven. For example, SNAP (food stamps) is linked with reduced health care costs.[1] On average, after controlling for other factors expected to affect spending on medical care, low-income adults participating in SNAP incur about $1,400, or nearly 25%, less in medical care costs in a year than low-income adults who aren’t receiving SNAP benefits. The difference is even greater for those with hypertension (nearly $2,700 less) and coronary heart disease (over $4,100 less). Yet, 40% of Medicare Advantage/Medicaid members are eligible for SNAP but not enrolled.
Effective work on social drivers of health also can unlock additional health plan revenues via improved quality ratings in Medicare and better performance in quality withhold programs in Medicaid. We also know that providing a better member experience and engaging members in using their supplemental benefits makes them more likely to reenroll when the plan year ends.
The challenge has been in the implementation: How do we encourage members to use their supplemental benefits and incentives? How can we ensure that the funds we provide are used only for the healthy interventions the member needs? How can we make it as convenient and simple as possible?
That’s why Soda Health created Smart Benefits — a platform purpose-built for health care, with integrated member engagement designed to simultaneously improve health outcomes and lower the total cost of care. The key is a nimble, instantly programmable and infinitely adaptable Smart Benefits platform members can use to pay for whatever goods and services the plan has authorized for them.
The card is accepted by our many retail partners, including Kroger, Albertsons, CVS and Hy-Vee, among others. Our direct integration with retailers’ point-of-sale systems means purchases can be adjudicated and restricted at the item level in real time. At checkout, benefits are applied only to approved items. Not that those approved items are cast in stone for the entire plan year; if the member’s needs change or if, say, the Centers for Medicare & Medicaid Services approve a new type of supplemental benefit, changes can be made dynamically in seconds.
And because the card is infinitely customizable, it can support other benefits and interventions. For example, Soda Health’s partnership with Uber Health makes it easy for members with transportation needs to quickly schedule a ride to the pharmacy or to a doctor’s appointment.
The Smart Benefits platform also has integrated survey capability, allowing plans to monitor and adjust to members’ changing needs, by asking the right question at the right time — such as, “Have you had enough to eat this week?” If the answer reveals a food insecurity, the member can immediately be granted funds to meet the acute need in the moment. It can also connect that member with a caseworker who can help with an application for SNAP benefits to address the pervasive issue and stave off future health care issues.
The Smart Benefits platform is also an indispensable, integrated tool for closing gaps. Health plans use the platform to prompt members to complete health risk assessments and annual wellness visits and get needed vaccinations and A1C tests, with direct pharmacy integrations enabling the real-time delivery of rewards and incentives, all on the same Smart Benefits card.
Soda Health’s Smart Benefits platform meets members where they are, in the aisles of their local retailers. Most patients see their doctors an average of just five times per year. But they see their pharmacist 35 times and go to the grocery store 86 times.[2] Those are the venues where we can be most effective at empowering and encouraging the actions that improve health.
The net result is better health outcomes, greater health equity, and an improved member experience — powerful competitive advantages and differentiators for health plans.
We’re honored to be the event sponsor for OAHP’s Annual Convention & Trade Show in September
and excited by the prospect of helping build greater health equity in the Buckeye State.
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[1] CBPP, SNAP is Linked with Improved Outcomes
[2] Centers for Disease Control Characteristics of Office-based Physician Visits, 2018
National Library of Medicine, Time Allocation in Primary Care Office Visits
Statista, Consumers’ weekly grocery shopping trips in the United States from 2006 to 2022
Credit Donkey, Grocery Shopping Statistics: 23 Fun Size Facts to Know
DrugTopics, Pharmacists Want More Time With Patients
