Q&A: How Soda Well being plans to alter ‘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 laborious 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 can be experiencing very foundational challenges of their lives each day,” he stated.

Final yr, Soda launched with the aim of creating it simpler to entry advantages for wholesome meals, over-the-counter medicines and transportation. The startup just 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 a few of 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 gotten 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 determine what they need, fill out a type and mail it again. Utilization of that’s abysmal, proper? It isn’t an excellent member expertise. All the best way from that to name middle base achievement, to retail base achievement. 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 concern is that sooner or later you do not want extra Tylenol. You do not give a ravenous individual a blanket, you give them meals.

It is a one-size-fits-all method, the place persons are simply getting OTC and utilization is actually low and engagement is low, as a result of it would not truly tackle the quick 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 determine 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, we’ve what we name a flex card. So we ship out member communication with that card – by means of our well being plan companions – after which members obtain that card and a welcome equipment within the mail, each bodily mail they usually additionally obtain different notifications as effectively. The member then prompts it and goes on to our member portal to determine what further sources they’re eligible for after which see how they’ll use their present advantages in a much more simple and consumer-oriented means.

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

Knight: One of many fascinating issues about the best way this course of presently works is it is too typically the gross sales pitch. And what we see on this house is, OTC is necessary. It’s factually right to say that for those who’d have an OTC profit or any profit versus not having a profit, you are most likely going to be more healthy. The query is, what is the actuarial worth? And what is the ROI [return on investment] related to ensuring 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, primarily based available on the market in your area, and primarily based on the forms of members you’ve gotten and their wants that we see right here, these are the varieties of advantages packages that we are available on the entrance aspect and advocate to you. Here is how the maths works. And this is how we are able to optimize every little thing else downstream to ensure, from a value profile, what you are doing is sustainable, it is aggressive out there, and that it permits for extra funds that we unlock later, as soon as we determine members’ wants that exist.

So we may be actually versatile serving to members once they have a housing concern or once they have a transportation concern. They don’t seem to be going to their annual wellness go to, as a result of they cannot truly get to the physician, as a result of there isn’t any transportation. For us, it is how we are able to determine what these factors are, and make it possible for 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 right now. Primary, my expertise as a social employee understanding actually intimately the wants on a regular basis folks have, and that I skilled as effectively rising up. 

In my time at Walmart it was actually useful, as a result of it allowed me to grasp scale and the way completely different markets transfer. Walmart offered a extremely compelling understanding of the nuances of various enterprise fashions, and the way scale works in a means 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 couple of yr after you launched. How do you propose to make use of that funding?

Knight: What we’re doing for our Collection A is continuous to increase 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 determine new sources that they are eligible for.