To start, let’s explain what healthcare navigation is. In non-emergency situations, healthcare navigation is a service to help patients research the best care options for their unique situation. Healthcare navigators consider several factors such as the patient’s payment option (insured or self-pay for example), their location, their care need, the price for care, and more. For health plans of all types, healthcare navigation is a necessary tool to keep costs low for members and the plan. What plan wants their members to go to the most expensive option when they can get the exact same care (if not better) for half the cost down the street? In fact, one study found that “on average, patients bypassed 6 lower-priced providers between their homes and treatment locations.”
Since members often pay for a portion of their care, they’re going to be upset if they get an expensive bill. Even if it’s not your fault as a healthcare payer, members often point an angry finger at their health plan when it comes to expensive bills. And an angry member is a member that will leave when they get the chance.
With healthcare navigation though, you’ll ensure members go to the best option for their care and renew their membership with you.
When your health plan offers healthcare navigation tools, it leads members to cost-effective care solutions. Even if it’s a third-party organization that provides patient advocates to help your members find their ideal care, that’s still a service you’re offering through your health plan. Everyone loves a good deal, so if your members’ medical bills are consistently lower after utilizing healthcare navigation they’ll stay loyal to your plan. Plus, your members will feel cared for and supported. In fact, health plans that offer a patient advocacy service, like healthcare navigation, saw an average NPS growth of 16.5%.
Let’s face it: healthcare is confusing for everyone. It’s bad enough that you feel sick or in pain, but then extra stress and frustration are added because of the maze we call the U.S. healthcare system. Healthcare navigation guides your members through that maze quickly and easily. When members have an easy-to-use tool, such as an app to shop and compare medical services, they’ll have an easier time finding the right care. It’s great for you too; no more groaning when you see that members continue to choose the most expensive option available. Or that they went somewhere with poor care and will have to go to another provider and thus send another bill. Healthcare navigation not only guides members to the best options but also lays those choices out in an understandable format so members are sure to choose a quality provider who charges a fair price. When your plan makes healthcare simple, members will want to stay with you.
Whether you’re a health sharing organization, a discount medical plan, a limited benefits medical plan, or a health plan, we can all agree that saving money is a win. For example, one of our clients realized potential cost savings of 61% from healthcare navigation between 2015–2019. For a limited benefits plan client, our Healthcare Navigator service saved members an average of 56% on provider, prescription, and facility cost comparisons in 2019.
Savings of 56–61% gives your organization a lot more room in your budget to improve plan offerings, hire more support teams for members, or even implement more digital solutions for members. All of which will help you retain members and acquire new ones. Plus, you’ll be making these upgrades without increasing members’ individual costs, which is another factor that makes members choose whether or not to leave a health plan.
Healthcare navigation makes healthcare easy to find, easy to understand, and easier to afford for your members. When members see that it’s your plan offerings that are giving them great deals on their medication or quickly finding the best place to get an MRI, they’ll renew their membership year after year. Not to mention a happy member is one of the best ways to get word of mouth advertising, so you’ll likely see new member growth along with better member retention.
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