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Care navigation: The next frontier in managing healthcare costs

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It’s been a challenging year for employers, to say the least. Already facing steep increases in employee health costs, many companies are navigating reduced revenues, accommodating a newly remote workforce, and making difficult decisions about furloughs and layoffs. In this new reality, employers must consider innovative benefits strategies that meet the moment.

One of those strategies is care navigation. Sometimes called “concierge” care services, care navigation refers to services that help patients access and coordinate healthcare — particularly when multiple providers, sites of care and types of healthcare services are involved.

These kinds of high-touch services were once considered an elite offering available only to individuals willing to pay out-of-pocket for personalized attention. But as employers and health plans have realized the value of ensuring patients receive coordinated care from high-quality providers, these services are becoming more readily available.

Read more: 10 ways telemedicine has transformed healthcare in 2020

Here is a look at some of the benefits associated with this growing trend.

Improved experience: For employees or health plan members, care navigation can dramatically improve the healthcare experience. That’s because care navigators shoulder the responsibility of coordinating the many, often surprisingly difficult logistics that surround healthcare encounters — such as researching doctors and hospitals, scheduling appointments, transferring diagnostic test results or medical records, and coordinating follow-up care. This creates a simple and seamless experience for the member, who can also rely on their care navigator to answer questions and work through any problems that might occur along the way.

Reduced costs: With access to the right tools, care navigators not only ensure coordinated care, but also help guide patients to the healthcare providers and settings that high-deliver quality care at a reasonable price. For example, data shows that quality and costs can vary by as much as 700 percent among healthcare facilities in the same market, and the choice of facility is the greatest cost driver. This is especially true for certain “shoppable” procedures, yet the lack of transparency across the industry makes it difficult for people to access this kind of information on their own.

When armed with objective data, care navigators can provide patients with valuable quality and cost information prior to their procedure — allowing them to make smarter healthcare choices. By steering patients to a higher quality provider or a less expensive setting such as an outpatient surgery center, care navigation helps limit out-of-pocket costs while reducing employer spend.

Better outcomes: The most important — yet often overlooked — factor in reducing employer healthcare costs is improving patient outcomes. When care is highly coordinated and delivered by high-quality providers, patients experience better outcomes with fewer complications. This creates important downstream savings and fuels employee and member satisfaction.

While it may seem ironic that a high-touch benefit can produce significant savings, care navigation is emerging as a cost savings strategy of choice for companies eager to reduce costs by connecting employees with high-quality care.

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Healthcare plans Employee benefits Healthcare innovations Healthcare guidelines
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