Q&A: How Soda Well being plans to vary ‘patchwork’ supplemental advantages

Even with a background in social work, Soda Well being CEO and cofounder Robby Knight stated it was a battle to assist his father arrange supplemental advantages when he grew to become eligible for Medicare.

“What actually hit me arduous there was that despite what we do to make our lives higher and actually have an effect on well being extra broadly within the U.S., the problem is we nonetheless have lots of people which might be experiencing very foundational challenges of their lives day-after-day,” he stated.

Final 12 months, Soda launched with the aim of creating it simpler to entry advantages for wholesome meals, over-the-counter medicines and transportation. The startup lately raised $25 million in a Collection A funding spherical. 

Knight sat down with MobiHealthNews to debate how Soda’s mannequin works, why beneficiaries typically cannot entry these packages, and the way the corporate plans to make use of its Collection A funds.

MobiHealthNews: What are among the issues you are seeing with accessing supplemental advantages as a Medicare Benefit or Medicaid member?

Robby Knight: It relies upon. It is a patchwork of companies. So you’ve got something from an over-the-counter catalog, the place well being plans ship it within the mail to members every year. And as part of that course of, members establish what they need, fill out a type and mail it again. Utilization of that’s abysmal, proper? It isn’t an incredible member expertise. All the way in which from that, to name heart base success, to retail base success. It is actually complicated on which retailers to make use of, and even what objects are eligible. 

So what occurs is, for Medicare Benefit for OTC particularly, solely 30% is getting used. The opposite situation is that sooner or later, you do not want extra Tylenol. You do not give a ravenous particular person a blanket, you give them meals.

It is a one-size-fits-all method the place persons are simply getting OTC and utilization is admittedly low and engagement is low, as a result of it does not really tackle the speedy wants folks have in entrance of them.

MHN: Are you able to inform me just a little bit about how Soda Well being works, from each a affected person perspective and a well being plan perspective?

Knight: Well being plans have subpopulations of members they wish to present these advantages to. We work with them to establish what advantages they need to offer most effectively from their perspective and to ensure members have probably the most {dollars} that they want. 

As part of that course of, now we have what we name a flex card. So we ship out member communication with that card — via our well being plan companions — after which members obtain that card and a welcome equipment within the mail. Each bodily mail and so they additionally obtain different notifications as nicely. The member then prompts it and goes on to our member portal to establish what further sources they’re eligible for after which see how they will use their current advantages in a much more simple and consumer-oriented approach. 

MHN: While you’re working with well being plans to determine what advantages they need to offer, how do you identify that? 

Knight: One of many attention-grabbing issues about the way in which this course of at present works is it is too typically the gross sales pitch. And what we see on this house is, OTC is vital. It’s factually right to say that in case you’d have an OTC profit or any profit versus not having a profit, you are in all probability going to be more healthy. The query is, what is the actuarial worth? And what is the ROI [return on investment] related to guaranteeing trade-offs {that a} well being plan has to make to handle their P&L [profit and loss statement] and assist their members to enhance their well being outcomes?

And so we are saying, hey, well being plan, based mostly available on the market in your area, and based mostly on the kinds of members you’ve got and their wants that we see right here, these are the varieties of advantages packages that we are available on the entrance facet and suggest to you. Here is how the maths works. And here is how we will optimize every part else downstream to ensure, from a value profile, what you are doing is sustainable, it is aggressive out there, and that it permits for added funds that we unlock later, as soon as we establish members’ wants that exist.

So we could be actually versatile serving to members once they have a housing situation or once they have a transportation situation. They don’t seem to be going to their annual wellness go to, as a result of they can not really get to the physician, as a result of there isn’t any transportation. For us, it is how we will establish what these factors are, and be sure that the well being plan most effectively spends these sources to assist that human being on an individualized foundation.

MHN: You used to work at Walmart. How did that have an effect on the event of Soda? 

Knight: So I would say two experiences got here into the attitude that I’ve at present. Primary, my expertise as a social employee understanding actually intimately the wants on a regular basis folks have, and that I skilled as nicely rising up. 

In my time at Walmart, it was actually useful as a result of it allowed me to know scale and the way totally different markets transfer. Walmart offered a extremely compelling understanding of the nuances of various enterprise fashions, and the way scale works in a approach that nobody else actually can due to the purview that they’ve out there. 

MHN: So that you simply introduced your $25 million Collection A increase a few 12 months after you launched. How do you propose to make use of that funding?

Knight: What we’re doing for our Collection A is constant to develop the organizations and retailers that we join with, so that individuals can have locations to make use of these playing cards, to entry these sources and to establish new sources that they are eligible for.