Just a decade ago, patient navigation solutions were largely call center support lines and directory tools. They answered basic questions, helped individuals understand insurance coverage and assisted in finding in-network providers. When digital platforms first entered the mainstream conversation, the concept of a "digital front door" for benefits emerged. These offerings created more convenience for health care consumers and better integrated a growing number of point solutions. Though the focus – improve the experience for individuals seeking support — was noble, the approach was largely reactive.
Many organizations stop the evolution there, but a smart approach to navigation does more than serve as an effective front door to help people find care — it also unlocks meaningful value. Modern navigation actively manages costs and improves health outcomes. It can be an advocacy-based solution, serving as a guide to individuals to achieve the best outcomes for cost of care, quality outcomes and experience.
To maximize the impact of next-generation navigation models for your population, consider the six opportunities below.
1. Aim for holistic impact. Navigation services should not only improve the experience for individuals seeking care, but should also make a meaningful impact on the quality of health care outcomes, while driving down total costs. After years of innovation, you now have the ability to achieve all of these goals via the latest navigation models.
2. Support your population's specific needs. Navigation is no longer a one-size-fits-all solution. Consider these two scenarios. Employer A is a retail-centric enterprise with a widely dispersed workforce across hundreds of locations. It has multiple strategic health system partners and needs to create a unified experience for employees despite geographic differences. Employer B has a highly concentrated and highly educated workforce largely served by a single strategic provider partner. These two employers have very different needs when it comes to serving their population. Make sure your approach to navigation is dialed in to your specific needs and that your partners in this area can respond to the challenge.
3. Find creative ways to embed navigation services. Historically, employers considered navigation as a frontline solution, but in reality the idea of navigation as a service can impact a variety of specific use cases. One example is including a navigator or advocate as part of the experience for patients who are participating in a focused health event.
This has been a critical source of value for Vanderbilt's MyHealth Bundles program. Our embedded patient navigators help individuals at every step of the way for clinical experiences such as maternity; hip, knee and shoulder surgeries; and weight loss surgery. Employer Solutions also works with employers to offer navigation support following health screenings and as part of an executive health program catering to the busy lives of top talent. The possibilities are endless to embed guidance and advocacy at every step of care.
4. Integrate deeply with providers. Many navigation solutions are separate and distinct from the clinical care being provided to individuals. As a result, their effectiveness in impacting overall health care outcomes is limited. The better approach is to ensure navigation support is deeply integrated into the provider networks who care for your employees. At the same time, leveraging actual clinicians can also level up impact. In partnership with one of our strategic employer partners, our team built a specific navigation solution that deploys clinical professionals to work with employees and ensure they get to the right level of care. This dedicated team also includes a licensed social worker to address mental and behavioral health needs.
5. Maintain the human element. While there is tremendous opportunity to leverage technology, specifically Artificial Intelligence, to fuel navigation support, it is important to remember that health care is personal and human, by nature. If you lose the personal component, no navigation approach will fully accomplish what you desire. The goal should be making interactions between clinicians and individuals as efficient as possible, not fully replacing them.
6. Be proactive and prescriptive. Another hallmark of a cutting-edge navigation solution is its ability to not only reactively direct individuals to desired services and benefits, but to proactively recommend the right next step. As an example, consider an employee who reaches out for direction on a weight loss solution, but in the process of an interaction with an experienced clinical navigator, the expert determines this individual has a serious behavioral health need. A less sophisticated model would simply serve up a recommendation for weight loss, while a more effective model would recommend specific support for the behavioral health need first.
The Takeaway
Navigation is no longer simply a digital directory or a wayfinding solution. It is now a guided journey to the best care. Surrounding your employees with this type of advocacy and support will dramatically improve the health care experience, while ensuring they have better health outcomes at a lower cost. Is your organization fully deploying the power of navigation and allowing it to open new doors to more value?
For more information on how Vanderbilt Health Employer Solutions embeds navigation services in our Total Health portfolio, please contact us for a personal consultation at employersolutions@vumc.org.