April 5, 2019
The Business Health Care Group (BHCG), a coalition of employers located throughout eastern Wisconsin, recently announced a partnership with Quantum Health. The Ohio company provides consumer navigation and care coordination services, based on a research-driven consumer behavioral model. The Care Coordinators at Quantum Health provide a single point of contact for health plan members—and their providers and hospitals—to improve the health care experience. This results in lower costs for employers and employees, due to a reduction in unnecessary, inappropriate and low-value care.
Quantum Health provides health plan members with a guided experience platform for a single point of entry—one phone number, one ID card, one member portal and mobile app seamlessly integrate an array of services from skilled, knowledgeable staff who advocate for patients. Services range from guidance on finding the best providers or the most appropriate treatment before care is provided to helping with billing questions and claims reviews after care is received. Says BHCG Executive Director Jeffrey Kluever, "It's amazing how much easier Quantum Health makes the journey through the health care maze for everyone—employers, plan members and providers."
The BHCG/Quantum Health partnership offers member employers preferred pricing, performance guarantees, a dedicated, multi-disciplinary care coordination and service team, and integrated reporting and data, among other benefits. The program is available to employers and their plan participants, both locally and nationally (including outside of the BHCG 22-county Wisconsin region), either through full BHCG membership or on a stand-alone basis.
The Quantum Health model uses a research-based approach that is personalized, provider-connected and tech-enabled. The BHCG-dedicated cross-functional service team will handle all medical and pharmacy claims, benefits and eligibility inquiries, and patient advocacy services. Quantum Health offers clinical and care coordination services, as well as provider selection assistance (using cost and quality information) to direct members to the highest-performing providers.
Says Dave Osterndorf, partner and chief actuary, Health Exchange Resources, "As health care benefits have become increasingly complex, patients keep getting caught in the middle of trying to navigate their way through layers of well-intended but largely ineffective vendors, service providers and siloed solutions. BHCG's vision has always been about making health care work better. The Quantum Health model, resulting in a better health care experience for all involved, is extremely well-aligned with what the BHCG and its member employers are committed to achieve."
An anticipated long-term benefit of the partnership is the robust, integrated data it will produce that can be used to improve the health care experience and health care delivery in general. "There is enormous potential to leverage the data that the Quantum Health partnership will produce to initiate meaningful conversations with health care systems, and to collaborate on identifying high-performing providers, quality improvement and getting patients to the best value providers in the area," explains Osterndorf.
Quantum Health has the ability to integrate with multiple business partners, third-party claim administrators and provider networks. It works with more than 250 vendors, such as employee assistance, second opinion decision support and telemedicine programs—including BHCG partners Navitus Health Solutions, Best Doctors and Welldoc. Through one integrated point of contact, they actively promote other solution services, to help employers increase employee engagement and maximize the value of benefit programs.
A key benefit of Quantum Health's integration of health plan components is that it provides an earlier starting point for employee engagement. When an employee or dependent first enters the health care system, Quantum Health's proprietary model, Real-Time Intercept™ (RTI), proactively engages them —an average of 60 days earlier than other navigation models, helping patients make decisions that eliminate the causes of consumer frustration and wasteful spending. "It's simple," says Kluever, "you can't change decisions about care that has already been provided."
Quantum Health's simplified consumer health care experience has been shown to improve utilization and lower costs, as independently validated for more than 17 years. Additionally, Quantum Health's member, client and provider customer service satisfaction scores rank at the top of the industry.
"For nearly two decades, we have simplified and improved countless individuals' health care journeys, resulting in independently validated savings and higher member satisfaction for employers, employees and providers. We look forward to achieving superior results for BHCG member employers," says Kara Trott, founder and chief executive officer, Quantum Health.
About the Business Health Care Group
The Business Health Care Group leverages member employer purchasing power and knowledge to lead change. The organization creates value through innovative, shared strategies to improve health care quality and cost efficiency for employers, employees and the community. BHCG membership exceeds 200,000 covered lives in the 22-county region of eastern Wisconsin. Visit BHCGWI.org to learn more.