Tidelands Health utilizes healthcare navigation to prioritize the member experience and engagement

Challenge

When a culture of care doesn’t translate to the workforce 

Tidelands Health is a large regional healthcare system that has always worked to make their state healthier by being a health-minded role model. However, healthcare employees didn’t always pay attention to their own health, causing a high claims cost trend.  

Tidelands added wellness and safety programs, but benefits complexity and low utilization of the system’s own providers (i.e., “domestic utilization”) called for another solution.

Solution

Turning strategy into action with personalized health advocacy

Quantum Health collaborated with the Tidelands HR Team to support their culture of employee wellness.

DOMESTIC UTILIZATION SUCCESS  

Driving members to providers within Tidelands’ own system was a primary focus to reduce costs and improve health outcomes.  

Because Tidelands negotiates pricing with providers at its own facilities, they can keep healthcare spending in-house and at typically lower rates than when members seek outside care. Now, Quantum Health consistently refers members to Tidelands’ in-house providers and services.  

CHRONIC-CONDITION MANAGEMENT  

Claims and clinical data analyses enable Quantum Health to target clinical engagement for members at high risk and/or with chronic conditions, such as diabetes and hypertension.  

Our Care Coordinators guide Tidelands’ members to core benefits, point solutions and healthier choices, reducing costs and improving outcomes.  

REDUCED HR WORKLOAD  

Tidelands’ HR team started to see a significant decline in benefits-related questions and workload once Care Coordinators became members’ single point of contact for benefits answers and guidance.  

They’ve also seen and valued our Care Coordinators’ ability to recognize opportunities to boost awareness and referrals for the organization’s in-house healthcare services and wellness programs. 

Results

Driving long-term value through employee engagement 

Since the partnership with Quantum Health began, Tidelands Health has seen a steady decline in year-over-year healthcare claims costs, indicating that members are receiving the right benefits guidance and care at the right time to avoid future expenses caused by care gaps and preventable complications. 

“There’s been great unison between Quantum Health and our organization. They recognize our unique needs and have been a collaborative partner.”