How Deep Analytics Is Proving What We’ve Always Known About Healthcare Navigation

Research and analytics have been part of Quantum Health’s DNA from its foundation. In fact, our healthcare navigation company was built on the outcomes of a research project I conducted—a longitudinal study of 3,200 patients over two years that revealed healthcare had a classic consumer pathway problem. Back then, the research was done using spreadsheets and contact management systems. I was a bit of a spreadsheet jockey, spending hours combing through data in Excel. Today, we’re still a research-driven company, but that research looks very different.

Action to Impact, Quantum Health’s new intervention and value-reporting capability, is powered by an AI-driven engine and informed by 26 years of proprietary data. With this tool, we’ve connected specific navigation actions to quantifiable results, demonstrating unequivocally what we’ve long known: healthcare navigation reduces costs, improves outcomes, and enhances the patient experience.

Dollars and cents used to be the most straightforward quantitative metric we had at our disposal: “You used to spend X, now you spend Y.” Now, as AI unlocks our ability to categorize and quantify specific interventions in detail, we can go beyond money saved and concretely identify X action (for example, reducing inpatient days) that led to Y outcome (savings). In doing so, the power of human-centered navigation has become clear.

Action to Impact: Bringing Together 26 Years of Data and AI Analytics Capabilities

I’ve always respected the power of data. However, even as I was conducting the longitudinal study that would become Quantum Health’s foundation, I knew data can’t be taken at face value. Data might give you facts, but you need to peel back the layers to understand how those facts inform the actual lived human experience.

Over our decades of service, we’ve amassed a great deal of proprietary data, giving us an accumulation advantage — a competitive edge that reflects the adage, “Knowledge is Power.” Now, based on that data and with the use of new tech tools, we’re able to definitively demonstrate that our human-led approach to healthcare navigation works.

AI enables us to categorize everything we do in the context of relationships and, subsequently, to link each action to the relevant outcome. Relying on our 26 years’ worth of data, we can identify specific interventions taken and subsequently work with actuaries to put dollar values on those actions and outcomes.

Intellectual honesty has been a core value of Quantum Health’s from the beginning, and that hasn’t changed. That’s why I’m adamant about data integrity: Rather than cherry-picking success stories, I want to show the complete picture. AI allows us to do just that, enabling a full-dataset approach that analyzes our entire book of business, not just select case studies.

Actuarial validation allows for independent verification of our claims and methodologies, ensuring transparent reporting that our clients can rely on. This feedback loop further enables us to continuously improve our interventions and deliver even better outcomes for future members.

Actionable Outcomes for Improved Future Care

Our clients have long asked, “I see the impact in the cost savings, but what exactly did you do to achieve that impact?” Now we can give them an answer, as we’ve created four pillars of measurable impact:

● Clinical and supportive interventions: Actions that improve care quality and member experience.

● Direct financial impact: Dollar savings from reduced inpatient days, better provider choices, avoided procedures, etc.

● Satisfaction enhancement: Measurable improvements in member and provider experience scores.

● Quality improvements: Better health outcomes correlated with specific navigation actions.

This structured approach provides a more granular view of healthcare navigation’s actual impact. It results in actionable intelligence that we can use to determine what happened in the past and how to maximize future results. For example, we can see where the greatest value is created by pinpointing the most complex journeys.

The industry likes to talk about “return on investment,” but I prefer to see this as a demonstration of value creation: Where are we saving money? How are we enhancing the member experience and empowering people to make better healthcare decisions? And most importantly, how are we supporting improved quality of care? That’s why we named this initiative Action to Impact—highlighting how each action has an impact.

Action to Impact: A Testament to the Power of Human-Led Healthcare Navigation

Action to Impact is coming at a time when our clients really need it. Self-insured employers—Quantum Health’s clients—are under increasing pressure. According to the State of Healthcare Survey 2025: The Transformative Power of Trust in Healthcare by Arizent and Employee Benefit News (EBN), sponsored by Quantum Health, 79% of employers identified company cost as a top concern they plan to address in their latest annual benefits cycle.

HR and benefits departments are under pressure to do more with less and demonstrate the value of every dollar spent. The EBN State of Healthcare survey shows that while 88% of employers trust utilization data and 84% trust insurance claims data, only 53% are confident their navigation partner can demonstrate how this kind of engagement delivers cost savings.

Action to Impact seeks to eliminate this kind of uncertainty, going beyond basic engagement metrics and connecting them to real savings and better care. Now we can answer the question, “I see the impact in the cost savings, but what exactly did you do to achieve that impact?”

The high level of transparency resulting from these data-driven insights generates trust, an invaluable asset in healthcare, where relationships and outcomes are deeply personal. Our clients no longer need to rely on member testimonials or general cost trends to see how value is created. They can receive specific, actionable insights that justify each dollar spent, giving them confidence in their navigation partner.

That confidence and trust can also trickle down to the individual member level. For example, people who trust their care advocates are more likely to engage in preventive care. If our clients see the impact preventive care can have and then convey this to their employees—encouraging them to get regular checkups—that can mean fewer emergency room visits, earlier detection of health issues, and ultimately better health outcomes at lower costs for everyone involved.

At the Core of Quantum Health’s Value Creation: The Real-Time Intercept® Model

At the heart of Quantum Health’s approach is its proprietary Real-Time Intercept® (RTI) platform, which enables member engagement an average of 90 days before the first claim. Given that the average diagnosis-to-treatment timeframe is about 100 days, that’s a powerful differentiator. You don’t want to miss out on the intervention opportunities within that timeframe, from provider selection to treatment decisions and surgeries.

Engagement is the first step in action. RTI allows for that engagement by connecting with patients at provider- and consumer-initiated contact points in real time before a claim occurs. For example, if someone calls us seeking preauthorization for a procedure, we can use that opportunity to find out what’s happening for that patient. We provide guidance early in the journey, while important decisions are being made. AI-powered analytics are showing how effective that approach is, as we can identify these inflection points and the value they generate.

As our dataset matures, our insights will become more predictive, opening up new opportunities for improvement. Continuous learning is one of my values, and this feedback loop—tracking what works and what doesn’t, and optimizing as needed—is critical to Quantum Health’s success.