UnitedHealthcare debuts data-driven health navigator program for Medicare Advantage members

Through UnitedHealthcare's Navigate4Me program, nurses or highly trained customer service advocates will work with individuals who have complex health issues to provide services like creating a personalized care plan. (Getty/Wavebreakmedia)

As part of a broader, tech-powered effort to improve healthcare for seniors outside of traditional clinical settings, UnitedHealthcare has unveiled a new program that offers personalized concierge services to its Medicare Advantage members.

Through the program, called Navigate4Me, nurses or highly trained customer service advocates will work with individuals who have complex health issues to provide services like creating a personalized care plan, coordinating care, resolving claims issues or addressing social support needs such as transportation or housing.

“People receive needed care when they’re at the doctor’s office or inside a clinic or hospital, but they often lack the support, coordination and guidance they need in navigating the system,” Brian Thompson, CEO of UnitedHealthcare Medicare & Retirement, said in a statement.

Health navigators, he added, “step into those moments of vulnerability and uncertainty to provide personal, compassionate guidance to the people we serve.”

UnitedHealth is currently piloting the program for members with diabetes and congestive heart failure, Efrem Castillo, M.D., the company’s chief medical officer of Medicare & Retirement, told FierceHealthcare in an interview.

Next year, though, the insurer plans to expand Navigate4Me to serve Medicare Advantage plan participants who experience sudden health events such as serious injuries or new diagnoses.

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And while the program right now mostly centers on navigators connecting to members via telephone, in the not-too-distant future, it will draw more heavily on data from wearable devices and other digital therapeutics. In that effort, Castillo said, UnitedHealth is focused on making its wealth of data as useful as possible.

“One of the issues is that a lot of data can be overwhelming to not only the patient, but the doctor and to us, so we have to become much smarter about utilizing and translating that data into actionable intervention,” he said.

Thus, the insurer aims to have the data it collects from various sources—ranging from claims to wearables—flow through a virtual “nerve center,” which aggregates and analyzes it before passing it on to trained navigators.

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The ultimate goal is to provide a more personalized member experience—and treatment plan—that takes into account all the factors that make individuals unique, even if they share the same diagnosis, Castillo said.

That, in turn, could help set UnitedHealth apart in the increasingly competitive Medicare Advantage sector.

“To me, it’s really about distinction and creating a distinctive experience,” Castillo said. “And once you can create a distinctive experience for people, it drives a better outcome.”