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.

Dan Shur explaining Health plans
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.
Steven Knight explaining Health plans

Medicare Advantage thought leadership

From healthcare navigation to trust-building and effective gap closure, discover insights and solutions that can lead to greater success in managing senior healthcare needs.

Navigating the Future: The Crucial Role of Healthcare Navigation in Medicare Advantage Plans
Why navigation

Navigating the Future: The Crucial Role of Healthcare Navigation in Medicare Advantage Plans

Navigate the future of healthcare with confidence. Discover the game-changing impact of integrating healthcare navigation into Medicare Advantage plans. Uncover how this strategic move not only ensures positive health outcomes and elevated Star Ratings but also delivers substantial returns for health plans—both in financial gains and qualitative enhancements.

Learn more
Building Trust for Better Medicare Advantage Outcomes: The Key to Higher Star Gap Closure Rates
Trust matters

Building Trust for Better Medicare Advantage Outcomes: The Key to Higher Star Gap Closure Rates

Unlock higher Star Ratings in Medicare Advantage with trust-centric strategies. Explore the pivotal role of member trust in engagement and gap closure for elevated care excellence.

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Navigate to success: Boost member engagements, close gaps and enhance Star Ratings
Real impact

Navigate to success: Boost member engagements, close gaps and enhance Star Ratings

Discover the transformative impact of healthcare navigation on Medicare Advantage plans in “Enhancing Star Ratings Through a Healthcare Navigation Approach.”

Learn more
Webinar

Enhancing Star Ratings Through Healthcare Navigation

Medicare Advantage health plans can implement healthcare navigation to drive increased member engagement, satisfaction and improved Star Ratings. Through a human-centered approach to member experience, healthcare navigation can effectively address member needs, resulting in enhanced performance across key quality measures.

Abstract graphic with a doctor placing 5 stars

Frequently asked questions