Five-year study evaluates entire Quantum Health client base; third-party validated actuarial analysis indicates market-leading 3.3 to1 ROI in year one and 5.3 to 1 ROI (4.8 ROI net of reductions to administrative fees) after year three of deploying Quantum Health’s navigation platform

Company introduces new study methodology comparing individual clients’ claims performance with their claims forecasts

DUBLIN, OH (November 2, 2023) Quantum Health, the leading consumer healthcare navigation and care coordination company, today announced the results from its most recent  actuarial study measuring the cost-savings ROI for its entire client base using its navigation platform. The five-year study (2018-2022), which was conducted and verified through an independent actuarial analysis, indicated that utilizing Quantum Health’s navigation and care coordination platform generated a market-leading 3.3 to 1 ROI in year one and a 5.3 to 1 ROI after three years for employer clients leveraging the company’s offering for its employee population.

In this first market study of its kind, Quantum Health introduced a new methodology that aligns to its client ROI evaluation by leveraging client-specific claim projections, as well as incremental administrative fees analysis. This research enhancement accounts for cost impacts at a client-specific level, including Covid-19 effects, plan design changes and network changes. Edward M. Pudlowski, founder and president of MorningStar Actuarial Consulting, conducted the analysis and subsequent report. Mr. Pudlowski has over 40 years of experience conducting analyses of healthcare claims for Fortune 500 corporations, unions, health plans and innovative healthcare solutions and most recently served as president of the Conference of Consulting Actuaries (CCA).

“Self-insured employers are attempting to negotiate an increasingly complex healthcare benefits landscape during a period of global insecurity and while managing through inflation, escalating costs and digital health point solution fatigue – at the same time keeping their employees healthy and happy with benefits tailored to their personal health journeys,” said Scott Doolittle, chief financial officer for Quantum Health. “Quantum Health’s newly published results not only verify the direct impact our navigation platform makes in significantly affecting claims cost reduction year after year, they’ve been analyzed against client-specific criteria, including plan design and COVID-19 impact. While other navigation solutions can provide case study comparisons that focus on one or two clients, only Quantum Health reports this level of claims savings and ROI impact across the full breadth of client business and eligible populations.”

The methodology considered multiple years of a client’s historical claims experience, client-specific pooling points, client-specific claims trends, as well as adjustments for anything outside Quantum Health’s purview that could impact claims. For each client’s claims experience, Quantum Health and the client’s consultant develop an annual claims projection that represents the claims costs expected in the absence of Quantum Health’s services. The client reporting methodology and projections follow industry-accepted forecasting methodology. In previous studies, a more general approach was used comparing Quantum Health clients with broad industry benchmarks. This new approach compares client actual claims with their claim projections created in partnership with leading consultancies.

“This new study from Quantum Health demonstrates that its consumer healthcare navigation platform delivers significant ROI and sustained year-over-year savings for employer-sponsored benefits programs. Ensuring an ROI scale across populations is critical for employers as they increasingly focus on cost control, sources-of-savings analysis and the factors that drive cost trend like unit cost, utilization and mix of services. Quantum Health has consistently demonstrated the ability to positively influence these factors along with enhancing members’ overall healthcare experience,” said Mr. Pudlowski.

Among the key findings the data analysis shows are that companies using Quantum Health’s consumer healthcare navigation realized significant and sustained cost savings across all group sizes.

The actuarial study measured the cost-savings ROI for the entire client base using the navigation platform, with and without administrative fees considered.

ROI and Claims data table

To obtain a copy of the full report and methodology visit here.

Quantum Health Announces Results of New 2023 Healthcare Navigation Cost-Savings Impact Analysis

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