Digital Health Delivery Company Solera Tackles AI Governance Issues
Solera Health has created a digital platform that matches health plan members to more than 20 curated digital health solutions. Recently, two executives from the company engaged in a discussion about their business model, growth, and their approach to AI governance within their digital health partner network.
Company Overview
Glenn Alphen, Solera’s chief commercial officer, elaborated on the company’s founding under the Affordable Care Act aimed at serving Medicare Advantage members. The goal was to guide them towards diabetes prevention programs both locally and digitally, thus converting their progress into claims. Over time, commercial customers expressed interest in similar digital programs for their populations, leading Solera to expand its offerings.
The company now collects data on engagement and outcomes, monitoring conditions across various health categories. “We’re trying to make it easy for individuals to navigate and take the point solution fatigue away from health plans or employers,” Alphen noted.
Partnerships and Solutions
Solera has established partnerships with major health plans, including a recent collaboration with Blue Cross and Blue Shield of Texas, which unveiled the Unity Health Hub. This hub is designed to connect customer service and condition management resources, providing members with a seamless experience.
When asked about the vetting process for digital health solutions, Alphen explained that while health plans may recommend partners, Solera employs a thorough clinical vetting process to assess efficacy and alignment with existing care paths. This includes adopting a pay-for-performance model to ensure engagement aligns with clinical outcomes.
Behavioral Health Network Expansion
In response to the growing demand for mental health solutions, Solera announced a new behavioral health network in collaboration with companies Calm and Lyra Health. This expansion aims to provide a broader range of services for their customers, capitalizing on the success in the mental health arena.
AI Governance Framework
Mike Levin, the general counsel and chief information security officer at Solera, addressed the complexities of AI governance. He highlighted common pitfalls such as inventory drift, where organizations may not be aware of AI usage within their networks, and monitoring atrophy, which can compromise governance programs.
Levin emphasized the importance of a robust incident response plan, particularly when AI makes problematic recommendations in a clinical context. He noted that a cross-functional oversight committee has been established to manage AI governance, bringing together perspectives from engineering, legal, security, and compliance to address both clinical and compliance risks effectively.
Future Outlook
As Solera continues to navigate the evolving landscape of digital health, it is developing an AI maturity scoring capability with interactive dashboards for security and compliance. This scoring mechanism is designed to evaluate digital health providers from both security and AI risk perspectives.
Looking ahead to 2026, Levin indicated that AI governance will consume a significant portion of his team’s focus due to the dynamic and uncertain nature of the technology. The ongoing development of AI governance frameworks will be crucial for ensuring the safe and effective use of AI within healthcare.
