A PERSONALIZED, GUIDED JOURNEY FOR MEMBERSThe 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.
A CONSUMER EXPERIENCE THAT DRIVES RESULTSQuantum 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.