Brenda Schmidt, MS, MDA: Self Care Platform Paid by Medical Claims

In Game Changers 17, Health by Mary Kurek

Brenda Schmidt, MS MBA is the Founder and CEO of Solera Health. She believes that there is no one-size-fits-all approach to getting and staying healthy. She founded Solera in 2015 to change that paradigm, creating a technology platform that matches a person’s unique risks, goals, and preferences with tools proven to help them improve their health and prevent, treat, or reverse disease. This approach, combined with performance-based medical claims payments, has transformed a previously chaotic landscape into a consumer marketplace tailored to help people holistically manage their health. Brenda has received numerous awards, including the MedTech Breakthrough Award for “Best MedTech CEO” in 2018, 2019 finalist for the EY Entrepreneur of the Year, and was named by Becker’s Hospital Review as a “Woman Health IT Leaders to Know” in 2019. Brenda serves as a mentor/advisor to several emerging digital health startups and serves on several boards including the StartUp AZ Foundation, the Arizona Bioindustry Association, and the Healthcare Executive Group.

Q & A with Brenda:

Q:  What was your reason for starting Solera?

A:  Prior to founding Solera, I was the CEO of a company focused on delivering evidence-based healthy living programs for organizations with diverse employee populations with the goal of improving employee health and productivity. I first learned about the National Diabetes Prevention Program (DPP) in 2011 and realized the opportunity that existed within community organizations to impact the cost and quality of care, but the community organizations delivering the program were totally disconnected from the healthcare system.  Most of the evidence-based programs delivered in local communities were grant-funded with the goal of recruiting participants and delivering the program within a very defined community. These programs needed to be able to scale it to the millions of people who could benefit from them. So, I shut down the former company, formed Solera, and developed a tech platform that would support a marketplace to organize the highly fragmented program providers, match consumer to the best program for them, and develop the infrastructure to create a sustainable revenue model for community providers by paying them for outcomes through medical claims.   Our goal is to privatize these proven public health programs at scale and get people to the right programs for them.

Q:  Who partnered with you initially to get this rolling?

A:  Our first health plan client was Anthem Colorado. They were our pilot client to prove Solera’s business model – that we could organize community providers, match consumers to programs, and payout network partners through medical claims. We knew we needed a major National anchor partner who also recognized the opportunity to prevent type 2 diabetes through lifestyle changes – when I started the company, digital DPP providers were not eligible for insurance reimbursement.  Our first partner was Weight Watchers and we were contracted like a doctor to provide our services. But, we were able to bill on a claim. In Colorado, we also had smaller local community organizations in the network. One-by-one we began educating the community partners so that they could meet all of the government compliance and regulatory requirements to be paid through medical claims. Solera also provided our technology to track their classes and participants at no cost to them.  Our goal was to create a sustainable revenue model for previously grant-funded organizations. For our health plan clients, we were able to give them the opportunity to help their members get and stay healthy in their community paid through their health plan benefits. The health plans now cover programs like weight management, tobacco cessation, falls prevention, social connectedness, and nutrition counseling.

Q:  How does Solera get paid on medical claims?

A:  Solera submits a medical claim to our health plan client when a program participant achieves ongoing participation and outcome milestones. The outcome metrics are specific to the clinical eligibility of the participant and the program that they are matched to. For diabetes, for example, Solera and our network partners are paid for weight loss greater than 5%, systolic blood pressure improvement, blood sugar control, and medication reduction.

Q:  What else are you incorporating and what’s next for Solera?

A:  Solera is expanding our platform and business model to allow consumers to create their own self-directed care plan. By curating a network of high-performing community and digital partners, Solera is providing both accessibility and trust for people who want to get and stay healthy who may not be sick enough to see their doctor. By matching people to the program or service that meets their unique goals, needs, and preferences, we believe that not only will consumers engage in their health, but they will also be much more likely to achieve their goals by offering choice and value. We always start with the consumer and ask them “what do you want to work on?”  If they tell us “sleep,” then we start there. We are flipping the typical paternalistic approach to healthcare to a consumer-focused approach to good health. 

Solera would like  to be the “LegalZoom” or “TurboTax” of healthcare – through our trusted network of community and digital providers, consumers can take control of their health where they live, work, play, pray, shop  – or on their phone, and trust that they are likely to meet their health goals. We’re really democratizing healthcare for those who aren’t sick enough to have to regularly see their doctor or have a nurse care manager.  Solera’s network currently includes over 10,000 community sites and over 70 digital therapeutic partners. One of the values we add to the market is our ability to objectively and transparently communicate the outcomes of the various programs and match people to the best intervention for them.

Brenda’s Networking Interests:

  • International experts (clinicians or companies) committed to Lifestyle Medicine to reverse chronic health conditions

  • Media influencers to create a movement around chronic disease prevention