Leadership Development within the Revenue Cycle
Healthcare Rethink - Episode 110
In the most recent episode of the "Rethink Healthcare" podcast, presented by FinThrive, Rory Boyd, Revenue Cycle...
Markets
Solutions
Featured Content
Healthcare Rethink - Episode 23
In this episode of Healthcare Rethink, host Brian Urban sits down with Sarah Rumfelt from Soda Health to delve into an exciting topic: addressing social determinants of health to revolutionize the healthcare landscape.
Brian Urban (00:22):
Yes, this is the Healthcare Rethink podcast. I'm your host, Brian Urban, and today, we are getting down with the Soda Health. That's right. This is a marketing leader that has deep background Joining us today, Sarah Rumfelt. We're going to get to know her a little bit more and exactly how Soda Health is a healthcare technology company that's, not only leading in benefit coordination, but also building solutions to eliminate health inequities. It's a tall order, so we're going to get right into our conversation. Sarah, thank you for joining our little show.
Sarah Rumfelt (00:54):
Yeah, excited to be here with you guys this morning.
Brian Urban (00:58):
So with every episode, Sarah, we like to get our audience familiar with our guests. So we just like to start off with knowing who you are and a little bit about your background and how you came to Soda. So tell us who Sarah Rumfelt is.
Sarah Rumfelt (01:13):
So my history with Soda Health started several years ago when I met Robby Knight, now one of the co-founders and CEO of Soda Health, way back when I was in grad school. So him and I met at a recruiting event and just hit it off with all of the things that he was doing at Walmart. I thought it was super cool. He was working in the healthcare space at Walmart, and I just slowly followed his journey. And when he started Soda Health, I was like, this is interesting. And so him and I started chatting and he was like, come on over and let's build something cool together. So I was one of the first non co-founders to join the team about two years ago now. It's crazy to think it's been two years.
(01:55):
And a lot of what I did at the beginning was what anyone at a startup would do. You wear multiple hats. And so I was doing all sorts of things. Right now, I'm more in the engagement marketing space. So think about how we reach out to members, what types of communications we send, what they're wanting, how do we communicate their benefits to them in a way that makes sense to them. So I've started moving more into the marketing organization, but still have a little bit of a hand in everything, same with any startup. But that just makes the day-to-day a lot more fun.
Brian Urban (02:28):
That is so exciting to hear. And the pace of your work and impact, obviously, being in a startup, much faster than other organizations that have loads of people and loads of resources. So you all are, probably, always in a sprinting type of mode. So that's exciting, exciting to hear how you got into the organization and how you're helping stand up the organization as well. So tell us about Soda Health. How have you all come to be? How do you exist and what do you do? Just start to take us through that journey.
Sarah Rumfelt (03:00):
We'll start with our name first of all, which, typically, Soda is not associated with health. It's a little sticky though. We like to think that it's a sticky name, and typically, sparks a lot of initial conversations with folks. So if you take the acronym for social determinants of health, SDOH, and say it phonetically, you get Soda. It all goes back to our DNA. SDOH is in our DNA. We wanted it to be part of our name because we're not just another healthcare company. We're, actually, truly trying to get to the root of a lot of these SDOH things that we see with members, so transportation, maybe food insecurity. Anything that would impact someone's health and day-to-day life is what we're trying to get to the root problem of and the root cause to then provide benefits that will help them live a healthier life.
Brian Urban (03:49):
That's so beautiful that you've woven in your core mission to your name in a unique way because you really think Soda and you're like, that doesn't really mesh well with health. But in this context, in these terms, phonetically sounding out SDOH, that's so creative as well. So it definitely speaks to your perspective on addressing SDOH. And we're going to get into that in just a few moments. But what I found so interesting, learning a little bit more on our pre-conversations to this episode here and more about Soda Health, is your high value retail network. So I got to learn a little bit more here, how is this done and really, why is it helpful? I mean, because people maybe could do it on their own, it's quite a labor, but how is it helpful? I want to understand how that connects into the member needs.
Sarah Rumfelt (04:43):
Great question. So a lot of players in this space work with what we're calling flex cards or benefit cards. So you can load benefits onto a debit card or credit card. They function very similarly to a gift card, where you can use these dollars at certain locations or for certain items. Now, in order to do that, you have to build out a network. So you have to integrate with the different retailers. What we've gone to market with is what we're calling the high value retail network. So rather than just saying, well, here's an abundance of retailers that you can use our card at, we're partnering, specifically, with organizations that are prioritizing healthcare. So when we start to partner with someone, we're not only going and saying, hey, we just want our cards to be used at your stores. We're saying, one, we want that, but then two, what else can we do to make the experience for the member even better?
(05:33):
So when you think about this phrase that we hear all the time, meet members where they are, a lot of times, that speaks to meeting where they are within their health journey. We're taking that even more literal, to say, we're literally meeting them where they physically are, which tends to be driving to baseball practice, going to the grocery store, dropping off at school. They're not going to the doctor every single day. And so if we're trying to get them where they are, think about how many times do you go to the grocery store, typically, once a week, sometimes even more than that.
(06:03):
And so how do we capitalize on that? And that's what we're working with our retail partners on, is, okay, we already know that consumers are in your store, so let's meet them there in the aisle at the pharmacy. Think about all of the connections that we have with our local pharmacist. And so how do we capitalize on that? And then imagine being in a retailer and you're shopping for something and then you get a text message that says, hey, don't forget to get your flu shot, if you go over to the pharmacy, you'll get a $5 benefit card. And so then you're getting someone right when they're there.
Brian Urban (06:37):
I love how you describe that because we often do... I think in the healthcare economy, those are touching something in healthcare, health service, we think about meeting them where they are, their healthcare needs, which is so funny because we're always talking about a person in a physician's office or a clinic or a health center, and health life happens outside those walls. It's never really happening in there. Some discussions, diagnosis, conversations, screenings do, but everything leading up to that is where health is. So I really love that. And going off what you said, when you were developing that core philosophy of meeting members where they are, and you gave those examples, did you pinpoint a few things top of mind that were critical to be able to have engagement connections too?
(07:35):
Food, you mentioned grocers going to a grocery store, being pickup food, children, daycare, going to different sporting events. Was there a few top of mind things, because you all were birthed in retail, that came to mind, you're like, you know what, let's start to develop some things around this area or this level and build the experience there? I'm just curious of how that started to come to be.
Sarah Rumfelt (08:04):
The story of the local pharmacist has always been something that keeps coming back. So regardless of what type of environment you live in, you typically will talk to a pharmacist, if you're going to pick up a prescription or you're going to get a flu shot. Maybe you go to a local pharmacy to get your flu shot, and that pharmacist is such a trustworthy person and it's someone who can connect you to a lot of different things. It's also someone who has that one-to-one interaction with you. It's someone who can recommend, maybe, over-the-counter medications. It's someone who can do regular check-ins via phone call perhaps. And so we've always gone back to that. And so when we're talking through with our retail partners what our strategy is, the pharmacy is a huge piece of it, just because there's a one-to-one interaction that can exist there versus just being on an aisle in the store, that's great. And that's another interaction where we might be able to interact with someone. But having that one-to-one high touch, high value interaction with the pharmacist is what we keep going back to.
Brian Urban (09:04):
I love that example because that, for me, when I think about addressing social determinants of health or social needs or engaging in a dialogue that is nonclinical in nature, I do think of pharmacists because they're always based in a very local, convenient place, like community in a neighborhood. And they're more, just my opinion, seeming closer to a person's life outside of a clinical setting than the way a lot of our primary care, our specialists, our cardiologists, et cetera, are trained. They're not trained with medical humanities. It's still medical education 1.0. So that is perfect.
(09:47):
And I think there's a lot of unifying measures between the pharmacist and then also, healthcare and other traditional clinical settings. So I love that. This brings me to another question. So Soda Health, absolutely, helps health plans address social determinants of health. And I think food, I think transportation, in terms of interventions, I feel like Soda is very close to those based on your framework building your technology. So how has Soda Health been able to help your partners and clients see more about a person's needs, whether it's related to food or transportation or otherwise? How are you helping your partners see more of that person's needs?
Sarah Rumfelt (10:34):
I love this question. So these are always the fun stories that we get to tell, is when we actually have an impact and a direct one-to-one interaction with a member. So most recent one that comes to mind, just because everyone's been celebrating this one recently, is that we had a member who traveled to and from the food bank, we met them at a local food bank in Missouri, and they were having trouble getting to and from work, so they needed some transportation. We were able to identify that within that member, and then provide them with transportation to and from work in a way that made sense to them.
(11:07):
So in this case, it was more of a ride-share situation rather than a car coming to pick someone up and having to schedule it, so they could schedule it on their own terms. And then from there, they were able to get to work. Now, that, to us, was a win already. But they actually reached out to us a few days ago and said, hey, because I've been able to get to work on time the last several weeks, I actually got a promotion at work. And so that is such an incredible one-to-one interaction that then their health plan wouldn't have known that. They would've known, oh, they need a ride to get somewhere. We can provide that. But then Soda Health is able to bridge that communication gap between the member and then the health plan.
Brian Urban (11:45):
I love that. That's got to make you have goosebumps, a rush to know that you've helped someone. And truly, healthcare isn't in a crisis mode. It's just in a malfunction mode. And I love that Soda Health, among with other great technology startups, you're bridging those gaps, because I think a lot of us, in the US, blame health plans, blame healthcare, see the conflict, but really, we can put more of a positive focus into, oh, well, how can we bridge these little things, and help this big ecosystem that was never set up to just function in two pillars. So I love that story, and it just speaks to why Soda Health exists. So data, you made me think that data is king in a lot of ways.
(12:38):
We're not there yet, from a policy standpoint, of addressing SDOH or incentives or disincentives. But we're in a really interesting place, in terms of HEDIS measures. That is like a firm ROI, if you're helping close HEDIS measure gaps, that is going to lead to quality bonus payments per member, per month, per year. And that can add up to a ton of top line monies for health plans. And I think the next steps will probably be more specific to interventions and more specific to screenings and documenting and care coordination. But where we are today is these HEDIS measures, and you've helped health plans close measures and achieve quality bonus payments. You already kind of did but can you tell me how you've been able to do that for health plans and maybe some future plans as well?
Sarah Rumfelt (13:35):
Yeah. So this story gets more into the math piece. So we see what the end goal is, to help a member to make them more successful with their health journey, more successful in life. But in order to, like you said, help with those stars, bonus payments, you have to get down to, okay, well, which ones do I focus on because health plans have a lot that they're trying to do with limited resources, limited information. And so when we started Soda Health, we thought, okay, well, that's just one piece of the puzzle, all of the SDOH data, but how do we actually help a health plan start to format and create programs that will then impact members? So we first start looking at enrollment, so how do you optimize enrollment for your member population? Then we start to look at, okay, well, which HEDIS measures should you focus on in order to get the maximum ROI because there's a few that seem like obvious choices or easy, check the box answers.
(14:32):
But when you start getting down to it, you'll realize that there are certain things that you can focus on that are actually more impactful. And so I saw a plan, recently, that we had done some analytics for, that if they had closed 315 more care gaps for a specific HEDIS measure, their ROI bonus payment would've increased by upwards of $7 million, which is crazy to think about. And so then if we're able to say, hey, let's focus on that one, now, what do we do to get you there? Who are these members that we're trying to reach out to? Who are those 315? What is it that they need? How do we communicate with them? What is the timeline that we're working with here as we think toward end of year gap closure?
(15:15):
We've got a little less time, so how do we get the most out of that amount of time that we have? So that's a huge piece that we work with health plans on before we even start issuing supplemental benefits. It all comes down to, well, let's sit down and actually start mapping out what it is that your goals are, how Soda Health can help you, and then we're going to work together as a true partnership to get there.
Brian Urban (15:38):
I like that you take a step back before you dive in with your approach. And I think it was subtle what you mentioned, but very important that I want to call out. You're actually setting goals and strategy. Before, you were just looking at what measures we need to address. So I love that because then there's more of a throughput once you start to hit those measures, and then you can actually track them in a meaningful way and say, hey, the strategy is fulfilled, when you come closer to end of year. I love the stat you threw out, 7 million. That's real money, what that can go toward for other programs and how these health plans can really do more impact for their members, the lives they serve.
(16:20):
And I'm curious, with that too, we're coming into mid, the second half of the year now, are you starting to see a sense of urgency, a sense of pressing the go button from some health plans to address these measures now? Or is it something that you see they're thinking about this much earlier on in the year? Or I guess, it could be different everywhere, private health plans versus Blue Cross Blue Shield's depending on how many lives they might be helping. So I'm just curious of what you're seeing right now in the market in terms of addressing some HEDIS measures.
Sarah Rumfelt (16:57):
We definitely see more urgency as we hit June into July, especially rolling into August. I mean, again, health plans are thinking about so many things. So from January to June, it's all about getting bids in for that June deadline for 2024. So as they get past that, it's like, okay, well, deep breath, now we can reset and start thinking about what it is we're trying to accomplish for the rest of the year. And so with what we're trying to do with health plans is say, hey, let's start thinking about this earlier and earlier. So even though it may be top of mind in July, how do we start even thinking about that in January? How do we start thinking through, well, what members did last year? So if we're thinking about who still needs to get a flu shot between now and December, well, did Susan get a flu shot last year?
(17:43):
Did she get one the year before that? Where did she go to get that flu shot? And so really working with the health plans to make a true game plan for the members rather than, okay, well, here's a go get list. Let's just throw out rewards and incentives and see what that does, because if we then start backing up and say, okay, well, that may work for some people, but for others, it could be that the motivation is there. So that reward isn't really going to do a whole lot if the motivation is already there. It could be like the instance we talked about earlier, where transportation is the barrier. So how do we start nailing down some of those things to then help them accomplish their goal?
Brian Urban (18:24):
That's great because you're seeing almost, not to get too researchy, but the causal pathway of what is impeding a member to improve their health or for health plan to improve that experience. So it's not just a simple, you lay over your technology and you improve member engagement, you improve member experience. It's deeper than that. So that's what's really cool, I think, more the sophisticated side of Soda Health, that I'm glad that you mentioned. And I can't help but keep going back to data. So SDOH data, socioeconomic data, do you see SDOH data being the leading data set to help enhance engagement for a health plan with their members?
Sarah Rumfelt (19:16):
I would actually refer to it more as the missing piece. So health plan, see what comes through in a medical claim, and that can tell you so much about a person. The example I love using is my grandmother, Francis. She's right in that Medicare advantage population. She gets to and from the doctor. So on the medical claim side, she's going to appointments, she's getting her flu shot, she's doing all of the things. But what they don't see is that every time she does have a doctor's appointment, my mom or my aunt or myself take off work that entire day to then go pick her up to drive her there, to sit there, to take her home. And so they don't see that piece. So in that situation, if she had a transportation benefit and was really comfortable using it, that would alleviate pressure from the rest of the family.
(20:05):
So those are things that then the health plan would be able to see if Soda Health has that interaction and then can help the health plan interact with the member. So when Soda Health is involved, we're not stepping in and saying, hey, member, we're Soda Health and we're here to help you. We actually white label everything. And so it would look like the health plan was sending that communication. I know that's always important, the health plan owns that member relationship, and we don't want to break that. That's not our intention. It's just to step in and provide additional support and different resources for the member and for the health plan to then interact with one another.
Brian Urban (20:44):
I think that's beautiful in so many ways, strategically, how you're partnering and you don't need to be first in line and you shouldn't. You're bridging a really strong relationship between the member and the health plan. And your technology is then supporting what else the health plan can't see. I love that you said it's the missing link too, Sarah. So you're right. And a claim, you're seeing everything that's happening in a clinical setting, in a healthcare setting. You might see some screening, some clinical documentation, but you're never seeing what's gapped outside of that, how they got there, who's in their family, adverse life events, challenges, financial stability, it's access, and yet you don't see that.
(21:34):
And often, the screening questions are very scripted. We're not yet at that medical education 2.0 or 3.0 yet that it's conversation based and people aren't going to be very forthright in telling a physician all the bad stuff or all this struggles and challenges that they're having in life. So I just love you said the missing link. It is. I couldn't agree with you more. So we've covered a good bit of ground, and I think there's, obviously, so much more we can get into with Soda. I want to keep following your growth and your impact. But I want to get your perspective, before we close, looking into the future, say, we're just 24 months, 36 months out, about three years, what is Soda Health's biggest contribution to the healthcare ecosystem?
Sarah Rumfelt (22:30):
Well, it's crazy to think about. So we've been around for just about two years and have built up a lot so far. And so I know that we're going to continue that momentum. We're nearing 50 employees, and so we've got a lot of self-starters, a lot of super motivated people that are driven by our mission. And so we're always thinking of the next thing that we can start doing. And so I know that we're going to accomplish so much. When I think about two years from now, if we were to look back and say, okay, what else have we been able to do? It's more and more of those member stories that we've mentioned. So more and more of helping people get to and from the doctor, to and from work, being able to purchase healthy foods, having the freedom and the ability to spend dollars on things that matter to them.
(23:15):
And so how do we then start customizing some of these benefits? How do we start expanding our retail network to expand beyond just maybe some core retailers? We start moving into more rural areas, maybe some of those bodegas out there. So how do we start doing that to then meet our members where they are in a more broad environment, and then just continuing to build these partnerships, learning more about our members, learning more about what matters to them. And so it's going to be a learning process. It's not going to be something that Soda Health does on our own. It's going to include our retail partners. It's going to include other startups, other health plans, other organizations like your nonprofit organization. So bringing everyone together, that's our main goal over the next two years, is just continuing to grow and expand those partnerships and relationships.
Brian Urban (24:07):
Sarah, so brilliant. I love that you said it's not just your mission, it's everybody together, and the help that you'll need in creating some more strength between health plans and their members. And then evolving toward helping different populations, your expansion. That's so well said. I love it. I'm excited for what Soda Health is going to continue to evolve into. And I thank you, Sarah, for joining our little show. And for more exciting insights and excerpts, please visit us at finthrive.com.
Healthcare Rethink - Episode 110
In the most recent episode of the "Rethink Healthcare" podcast, presented by FinThrive, Rory Boyd, Revenue Cycle...
Healthcare Rethink - Episode 109
Medical school taught Dr. Robert Lufkin the conventional wisdom of the healthcare system, but his experiences and...
Healthcare Rethink - Episode 108
Revolutionizing drug development is pivotal in today’s healthcare landscape, particularly as the patient voice grows...
Healthcare Rethink - Episode 107
As artificial intelligence (AI) weaves deeper into various sectors, AI in healthcare is experiencing a...