Innovations in healthcare: Exploring the impact of navigation

The healthcare process is complicated and costly. It’s a problem that has existed for decades, but there is a proven solution.

Healthcare navigation delivers reduced claims costs for employers while also providing a significantly better member experience that leads to improved clinical outcomes.

Identifying the problem
Employers face a growing number of challenges these days, from retaining talent and managing multiple worksites to handling increased inflation. In the last year, healthcare costs rose an average of 8.2%, impacting the bottom line of employers and everyone using their benefits.

The complexity of healthcare presents other challenges. New digital solutions designed to tackle specific problems add value, but they’ve also made the landscape harder than ever to navigate.

In a recent survey* of large employers, the No. 1 healthcare concern is a siloed care experience for employees due to lack of coordination between virtual and community-based providers. The second biggest concern is the lack of integration between vendors.

There’s an inherent demand for a solution that brings everyone together and makes the healthcare process simpler and more cost-effective.

Providing a solution
Quantum Health created the navigation industry more than two decades ago, addressing a need that no one else knew how to solve. At its core, our model is simple — we advocate for patients, helping them navigate their healthcare journey by providing expert guidance to support their unique needs.

The solution begins with a single point of contact for the patient, the provider and the payer, so experienced navigators can guide all parties to the right resources. Simplifying the process saves everyone time while reducing stress and anxiety, leading to a vastly improved user experience.

Having a single point of contact also frees up an average of 30% more time for HR professionals**, who are no longer required to answer benefits and claims questions. From verifying eligibility and resolving billing errors to helping members understand their benefits and leverage existing point solutions, we make sure everyone gets the support and information they need.

The impact of a navigation partner is felt across the board. Employers save money by providing members with improved care, leading to reduced claims costs and fewer avoidable ER visits. Quantum Health delivers annual cost savings of $750 per employee, based on data gathered from groundbreaking analysis conducted in 2019.

When you add it all together, it’s easy to see why more and more organizations are turning to navigation. Seventy-four percent of large employers* say they either currently use or plan to offer improved navigation to higher quality sites of care. That number has continued to climb during recent years, and the message is clear: navigation is becoming essential for companies that strive to offer a competitive benefits plan.

Leading the industry
Quantum Health is the most trusted navigation partner in the country, serving over two million members nationwide.

Armed with real-time data, our experienced, in-house clinical experts — including nurses, pharmacists and more —guide members and their dependents through everything from simple pharmacy-related questions to chronic conditions or major health events such as a cancer diagnosis or stroke.

Using proactive engagement, we also intervene earlier in a member’s journey than any other partner, improving clinical outcomes by addressing issues before they progress.

This comprehensive approach is built on a foundation of love and care. We don’t just point members down the right path, we take their hand and walk alongside them throughout every step of their healthcare journey.

*Business Group on Health, 2023 Large Employers’ Health Care Strategy and Plan Design Survey.
**Quantum Health market research (2021).