Why navigation

Improved outcomes. Reduced costs. Easy implementation.

Quantum Health revolutionized healthcare in 1999 by creating the navigation industry, offering self-insured employers a solution that delivers better results than traditional health plans. 

Lady smiling facing to the left
Our solution

A better benefits experience with healthcare navigation is within reach

Traditional health plans promise convenience ­­– a unified solution for network management, claims administration, member services and clinical reviews. However, this model often comes with more silos than solutions, evidenced by Net Promoter Scores® historically less than 20.

We offer a holistic solution that provides a better experience and sustained cost savings. Our comprehensive model delivers:

  • Member services
  • Provider interactions
  • Clinical reviews
  • Utilization and care management

of consultants say navigation through an employer’s existing carrier does not meet all their clients’ needs.¹

Building a best-in-class benefits model

Traditional models require the use of several member contacts, which are transactional, siloed departments that don't communicate with each other. Quantum Health, on the other hand, serves as the single connection point for you, your members, providers and partners. This creates a unified and more satisfactory experience for your members, as well as a more customized and cost-effective plan for you.

Before Quantum Health

Traditional carrier bundled model

Member services
(XXX) XXX-XXXX #1
Care management
(XXX) XXX-XXXX #2
Provider services
(XXX) XXX-XXXX #3
Network
Claims administration
Partnership with Quantum Health

We serve as the single point of contact for you, your members, providers and partners.

One numberOne appOne team of experts
  • Member services
  • Care management
  • Provider services
  • Navigation
  • Advocacy
  • Early intervention
Network
Claims administration
Real-Time Intercept®

Our human-centered, tech-empowered approach

Call quotas aren’t a factor for us. We do what it takes to guide individual members on their personal healthcare journeys, rooted in empathy and backed by AI-driven insights.

Our proprietary Real-Time Intercept® (RTI) technology helps us engage with 84% of member households, intervening an average of 120 days before the first claim is received. This enables us to address issues before they become more serious and expensive.

Our Founder, Kara Trott, standing at attention with the office behind her
Value

Delivering real results across your organization

This human-centered, tech-empowered approach is what allows us to provide a caring and empathetic experience for your members and cost savings and efficiency for your organization.

70+

Engagement and experience
Member and provider Net Promoter Scores®

4.8%

Outcomes
Declining medical and surgical inpatient admissions per 1,000 members annually

$3.53 PEPM

Workforce productivity
Per employee per month (PEPM) financial gain for 10,000-employee organization

5.9%

Claims savings and ROI
Cost reduction in year one vs. expected, producing a 3.3:1 ROI

Value on Investment (VOI)

Quantum Health delivers meaningful results at a consistently higher, more holistic level than other healthcare navigation providers. It starts with financial return on investment from sustained claims savings, and it extends to productivity gains through a healthier workforce.

The result is a comprehensive solution delivering significant value across your organization.

5.5:1

Year 3

“We had some concerns about making a change to independent navigation, but during our site visit we realized the culture match with Quantum Health. We loved how they offer all employees a ‘one-stop shop’ for benefits answers and support. Our previous partner had only identified seven high-cost cases. Within 60 days, Quantum Health was proactively managing 390 high-cost cases. We also achieved a member NPS of 97 and avoided the cost of hiring more HR staff.”

CFOof a national retailer
Implementation

Getting started is easier than you might think

Quantum Health has more than two decades of experience leading implementations with minimal disruption.

You can either maintain or change your current carrier network. We can take on member and clinical services while a third-party administrator continues to handle claims administration and provides the same network access and discounts you were receiving with the carrier.

25-year track record of leading implementations

900+ healthcare and benefits relationships

90% icon

of Quantum Health clients say implementation went smoother than expected.