Roster the Company

Roster works to improve the social determinants of health via coordinated community health workers.

+ What is Roster’s mission and vision?

Roster’s mission is simple: we help patients stay healthy, happy, and home. We create trusting, culturally-relevant relationships with our patients by meeting them directly in their homes and communities.

+ Who are community health workers? What makes a good community health worker?

Per the American Public Health Association, a community health worker (CHW) is a “frontline public health worker who is a trusted member of and has an unusually close understanding of the community served.” CHWs’ trusting community relationships make them uniquely able to serve as liaisons between under-served, high-risk patients and the health system.

At Roster, we employ Roster Health Advocates (RHA) that function in this role within the existing care delivery system. Our core belief is that healthcare is best delivered locally by members of the community they serve through meaningful, trusted relationships with patients.

By meeting the neediest, most underserved patients directly in their homes and communities, RHAs form the “last mile” of care delivery between patients and the care system, serving as a critical resource for helping patients manage their medical care and address their social determinants of health.

+ What types of things do Roster Health Advocates help with?

Roster Health Advocates focus on a patient’s strengths and challenges that have presented in their lives. We personalize our plans based on what living healthy, happy, and home looks like for the individual. We recognize that patients suffer from all types of non-medical “social determinants” that directly affect health outcomes. Roster is built to support patients in addressing those non-medical barriers that most affect their specific health and well-being needs. Notably, we do not help with clinical issues, but rather escalate these issues back to the existing clinical team.

+ How is this different than a home health aide or a visiting nurse service?

Visiting nurses and home health aides are usually employees of home health agencies. Their work in the home is skill- or task-based and usually on fee-for-service arrangements not specifically tied to value-based outcomes. Licensed registered nurses deliver very skilled hands on care and medical treatments in the home, and home health aides deliver critical services such as bathing, dressing, cleaning or cooking in the home. But while nurses and home health aides do important work, they are not focused on the non-medical, social determinants needs of patients.

Roster Health Advocates are empathic caregivers living directly in the communities they serve. Our RHAs are focused on building trusting, long-term relationships with their patients and communities, making them uniquely positioned to address patients' social determinants needs.

+ What types of things do Roster Health Advocates help with?

Roster Health Advocates focus on a patient’s strengths and challenges that have presented in their lives. We personalize our plans based on what living healthy, happy, and home looks like for the individual. We recognize that patients suffer from all types of non-medical “social determinants” that directly affect health outcomes. Roster is built to support patients in addressing those non-medical barriers that most affect their specific health and well-being needs. Notably, we do not help with clinical issues, but rather escalate these issues back to the existing clinical team.

+ How does Roster add value to the overall healthcare ecosystem? Are Roster Health Advocates just another cost to the system?

Our RHAs improve the overall healthcare ecosystem by helping shift needed attention and care towards the social determinants of health for high-risk, high-cost patients, determinants we know can impact 40% of a person’s health outcomes yet are often left unaddressed.

By addressing social determinants in partnership with the existing health system, we allow other health professionals, such as licensed social workers, registered nurses, and physicians, to focus their energy on their core competencies, while we provide support in managing patients’ non-clinical issues.

Finally, we have structured our business model for maximum alignment with our patients and partners: we only succeed when our patients’ outcomes improve and medical costs go down. We are excited to help drive the healthcare sector’s continued evolution toward financially-aligned, value-based models.

+ How does Roster use technology?

Roster’s business is built around people, processes, and technology, in that order. The core of our business will always be our RHAs and their direct, local patient relationships. Our investments in process and technology are all oriented around our north star goal of facilitating deep RHA-patient relationships.

We have built workflow management technology used by our RHA’s in patient visit scheduling and dispatch, patient and partner communications, intervention planning, clinical escalations, and more. Our technology is designed to work in the background in support of RHA’s in-person patient integrations.

We’ve also built an analytics platform that incorporates clinical data provided by our partner and social determinants data collected on the field by ou RHAs. This gives us a holistic view of our patients’ health used by our RHAs in planning and triaging interventions and is available to our partners as insights for managing their populations.

+ What is Roster’s business model?

We’ve structured our business model for maximum alignment between Roster, our patients, and our partners. We can work with any risk-bearing provider or payor who believes in using a CHW-based solution for addressing the social determinants of health.

Our business model contains two main components:

Program Fees: Our Program Fees include an Upfront Fee, usually priced as a percentage of expected total medical spend, and a Management Fee, usually priced as a percentage of our operating costs. Our Program Fees help us cover the costs of building and operating our programs and, more importantly, help our partners feel they have “skin in the game” and are invested alongside us in the success of the program.

We price our total Program Fees to be below what it would cost a partner to build and manage a CHW program internally. We are committed to accelerating the adoption of CHW programs and strive to make it as easy and frictionless as possible for plans and provider groups to begin utilizing CHWs.

Pay-for-Success: We recoup our costs through Pay-for-Success (PFS) payments contingent on better patient outcomes and medical cost savings. We believe that focusing on PFS helps us ensure true alignment with our patients and partners. Our PFS model can include payments for achieving quality metrics and gain-sharing on cost savings against benchmarks.

At contract start, we work with our partners to identify cohorts of high-cost, high-need patients with persistent poor outcomes such as costly hospitalizations and ED visits. Once a patient cohort is identified, we work with our partners to set expected quality and cost benchmarks around outcomes such as total medical expenditures, hospital days, ED visits, care gap closures, STAR ratings, and others. We receive PFS payments if we achieve target patient outcomes or medical cost savings against benchmarks.


Roster the Partner

Roster partners with a variety of organizations in a number of ways. Read more to find out how.

+ How does Roster add value to the overall healthcare ecosystem? Are Roster Health Advocates just another cost to the system?

Our RHAs improve the overall healthcare ecosystem by helping shift needed attention and care towards the social determinants of health for high-risk, high-cost patients, determinants we know can impact 40% of a person’s health outcomes yet are often left unaddressed.

By addressing social determinants in partnership with the existing health system, we allow other health professionals, such as licensed social workers, registered nurses, and physicians, to focus their energy on their core competencies, while we provide support in managing patients’ non-clinical issues.

Finally, we have structured our business model for maximum alignment with our patients and partners: we only succeed when our patients’ outcomes improve and medical costs go down. We are excited to help drive the healthcare sector’s continued evolution toward financially-aligned, value-based models.

+ Why should I use Roster instead of building my own community health program internally?

Roster is solely focused on being the best possible operator for hiring, training, and managing community health workers. We’ve created Roster Heart, our proprietary processes for training and empowering our RHAs to do their best work, and Roster Logic, a technology and data infrastructure that supports our RHAs in the field.

We understand that standing up a CHW program is hard and requires capabilities that are not typically part of a health plan or provider group’s core competencies. We aspire to make it as frictionless and accessible as possible for any partner to offer their neediest patients CHW care.

+ Can Roster help us increase STAR Ratings and close care gaps?

Yes. Through the trusted relationships we form with patients and ability to solve social determinants such as transportation, we are well positioned to help organizations and plans close care gaps such as preventative cancer screenings, annual well visits and medication adherence measures, among others.

+ Can Roster help my organization determine which patients are best suited for Roster's services?

Yes. Roster has deep expertise in helping partners analyze claims and clinical data to identify the patients most likely to benefit from Roster's services.

+ How does Roster work with health plans?

Roster provides health plans a human-centric, technology-powered solution for managing their highest-cost, highest-need patients. We collaborate closely with plans’ existing medical teams, helping them address the non-clinical barriers to their patients’ lives. We can augment health plans’ case managers or, in certain cases, take over the role of case manager for patients that require more culturally-competent, locally-situated attention.

+ How does Roster work with healthcare providers?

Roster partners with healthcare provider organizations, management services organizations, clinically integrated networks, hospitals, health systems, and independent practice associations that are engaged in value-based contracts. We center contracts around high-cost, high-need patients facing non-medical, social determinants of health issues. We deliver value to our partners in their value-based contracts through lower medical spend and improved quality scores.


About Social Determinants

Social determinants play an enormous role in an individual’s overall health. Read to learn more.

+ What is a social determinant of health (SDOH)?

According to the World Health Organization, “the social determinants of health are the conditions in which people are born, grow, live, work and age.” These determinants play a large part in someone’s overall well-being, and unequal access to resources supporting the social determinants of health can lead to significant health disparities. Roster addresses all forms of social determinants but with a particular focus on:

  • Food insecurity
  • Access to transportation
  • Social isolation
  • Loneliness
  • Medication adherence

+ What percent of someone’s health is dictated by the social determinants of health as compared to their medical issues?

The American Hospital Association estimates that around 40% of a person’s health outcomes are dictated by the social determinants of health.

As we like to say at Roster, ZNA (zip code) is as important as DNA (genetics) in accounting for one’s ability to lead a healthy, happy life. While the traditional medical community has put great effort into addressing patients’ medical issues, Roster applies the same energy and focus into solving the critical non-medical issues that we know drive health outcomes.

+ Are members of the existing care team such as clinicians, social workers or care managers aware of the impact of social determinants? Aren’t they already addressing these issues?

Members of existing health care teams are acutely aware of their patients’ social determinants and the impact they have on their patients’ health, but they often don't have the bandwidth to address all their patients' non-clinical social determinants.

Roster is built solely to assist patients whose health and happiness are severely impacted by their social determinants of health. These high-cost, high-need patients typically suffer from multiple chronic medical conditions, multiple social determinants issues, and often have frequent hospitalizations and emergency room visits.

Roster serves as an extension of the existing care team by providing high-touch, locally-relevant care management for the most vulnerable patients in a community. Roster prides itself in building tightly integrated working relationships with clinical teams so that both sides can focus on their core competencies in the common goal of helping patients remain healthy, happy, and at home.


Additional Questions

+ What else can Roster help with?

In addition to helping patients solve their social determinants of health, Roster also helps high-risk, high-need patients improve their digital literacy to increase their comfort in engaging with the health system.

As former clinicians, we’ve seen how poor patient adoption of digital technology can be. We know that access to innovation is not evenly distributed, and that technology adoption rates are poorest in the patient populations who would benefit the most. Through their local, personal relationships, our RHAs can help patients access their online patient portals, understand how to access their medical data, and feel comfortable interacting with their medical care teams.

+ How can I get involved?

If you are interested in learning more, discussing a partnership with Roster, or working for Roster, click here to let us know. We’d love to hear from you.