Health plans

Increase member satisfaction and boost star ratings

Provide an exceptional member experience and close Medicare Star Ratings gaps.

Jaunita smiling in her kitchen
Revolutionize

True care navigation

Your Medicare Advantage members have diverse needs, from billing questions to complex condition management. Care navigation delivers an improved member experience and clinical outcomes by guiding members to the resources and care they need.

For over 20 years, Quantum Health has connected key stakeholders in a way no one else does, to ensure appropriate care, member satisfaction and Star Ratings improvement.

Warrior™ smiling and preparing to help members
Year-Round Care Navigation

Provide your Medicare Advantage members with continual and proactive care year-round and helps you improve quality ratings.

Gap Closure

Maintain or improve Star Ratings by launching data-driven, multi-channel outreach campaigns for targeted interventions aimed to close gaps faster.

Member Check-In

Comply with CMS requirements and gather annual member health status data to proactively close care gaps and find opportunities to improve outcomes.

Benefits

Health Plan

Early interventions to avoid care delays
Gives benefits and scheduling support
Provides care guidance throughout the year
Avoids costly ER stays
Targets and closes open care gaps
Assists with scheduling and follow-up
Improved member compliance and outcomes
Orientation about coverage and benefits
Schedules PCP to establish care
Better understands conditions and care

Member

Early interventions to avoid care delays
Gives benefits and scheduling support
Provides care guidance throughout the year
Avoids costly ER stays
Targets and closes open care gaps
Assists with scheduling and follow-up
Improved member compliance and outcomes
Orientation about coverage and benefits
Schedules PCP to establish care
Better understands conditions and care

Provider

Early interventions to avoid care delays
Provides care guidance throughout the year
Avoids costly ER stays
Targets and closes open care gaps
Improved member compliance and outcomes
Schedules PCP to establish care
Better understands conditions and care

Improvements across all Star categories

We facilitate comprehensive support for general health, particularly in the effective management of chronic conditions. By addressing communication issues, we ensure seamless interaction and superior customer services, fostering a more holistic healthcare experience for all.

General Health

Chronic Conditions

Communication

Issue Resolution

Customer Services

A unified approach to improved outcomes

Quantum Health Pods

  • A client-dedicated Pod team comprised of 30+ Care Coordinators, including clinical teams and member support teams working together to exclusively support members of an MAO
  • They have direct provider engagement with strong relationships built throughout 24 years of experience.
  • This manifests in-the-moment activity by intervening earlier on health signals.
  • It also drives clinical strategies and informs solutions that help determine the most effective course of action.
Coworkers working together at a table

Frequently asked questions