LOS ANGELES—Healthcare navigation and care coordination company Quantum Health is teaming up with Vanderbilt Health Affiliated Network to help self-funded health plans better manage employee health.
VAHN is a network of providers, hospitals and health systems in the mid-South that includes more than 7,000 providers, 66 hospitals, 12 health systems, and hundreds of physician practices.
Through the collaboration, which was announced Monday at the ViVE conference, Tennessee employers of all sizes can send their employees to Vanderbilt providers with the support of the Quantum Health navigation and care coordination platform, the companies said.
The regional provider network tie-up marks a new market for Quantum Health and the company will look to replicate the model with other leading health systems over time.
"It's the first of its kind, where you're putting together the best capabilities out there from a navigation perspective, utilizing Quantum Health's early intervention capabilities, and what we call 'Real-Time Intercept', and marrying that with a great academic medical center network and taking Vanderbilt's footprint across Tennessee and surrounding states to create a high-performance network first for self -insured employers," said Zane Burke, chief executive officer of Quantum Health, in an interview.
The organizations contend that the collaboration marks the first time a national navigation company has linked with a regional provider network to improve health across the care continuum. Quantum Health currently has 70,000 lives under management in the VHAN footprint.
By connecting Quantum Health’s navigation platform capabilities with VHAN’s network in Tennessee and surrounding states, Quantum Health will have additional capabilities to help the region’s self-funded employers combat the high cost of traditional managed care networks. The collaboration also has the potential for the organizations to deliver better member experiences, less unnecessary care, improved clinical outcomes and better cost management, executives contend.
The two organizations intend to design a value-based care model that will ensure they are jointly accountable to their clients for reduced healthcare costs and an improved healthcare experience.
Quantum Health, a 25-year-old company, offers a simplified navigation experience that connects member services, provider services and clinical care coordination in one place. Quantum Health works with 500 employer clients, covering 3 million lives with more than 1,000 "healthcare warriors," or what the company calls its workers, according to the company.
Quantum Health traditionally supports self-insured employers like Delta, Target and Abbott.
In the coming months, VHAN and Quantum Health will align their operations and capabilities to leverage the best of both organizations in new, innovative ways, executives said. The goal is to connect Quantum Health’s early intervention capabilities, enabled by its proprietary and proven Real-Time Intercept (RTI) technology and team of "healthcare warriors,", to identify patients in VHAN’s footprint who need access to high-quality care or would benefit from additional clinical support from the VHAN care management team, such as pharmacy, care management, behavioral health and wellness programs.
"Vanderbilt has a number of medical bundles that they offer to self-insured employers. Those bundles ensure a reduced cost but in a high-quality setting, and wrapping it with navigation ensures that we can do appropriate steerage to those networks so that those members have full visibility to what thee capabilities are in their benefit plans," Burke said.
In the future, self-insured employers in the region will be able to link Quantum Health’s navigation platform with a tiered network design powered by VHAN.
The healthcare navigation market has become crowded as employers struggle with rising medical costs.
"Employers are seeing increasing health costs, without the ability to control it. The experience is very poor, typically from a typical health plan perspective, and it's leading to where players are paying a bunch of money, but they get their employees get bad experiences," Burke said. "And, the outcomes, both clinical and financial, are challenging. Employers are looking for ways to control their costs and ensure that their employees are getting a good service along the way. Navigation is the best tool out there to connect the disparate pieces of healthcare today."
Burke says Quantum Health stands out in the industry with validated claims savings and high satisfaction rates for its self-insured employer clients.
'It's about how do we make it simple and easy, and serve up the information and the relevant data at the right time. Employers are looking for platforms that allow them to optimize that health benefit infrastructure and provide a better employee healthcare experience, and control costs, plain and simple," he added.
Vanderbilt Health Affiliated Network launched 12 years ago and sees the partnership with Quantum Health as an opportunity to improve how it manages patient populations, noted Brent McDonald, senior vice president of Population Health for VHAN.
"We know that large, self-insured employers are increasingly adding navigation models to their benefits strategies, and we see nothing but added value when we align our different organizations in the pursuit of the same goal," McDonald said in an interview.
For VHAN, teaming up with Quantum Health opens up opportunities to integrate into a navigation platform.
"What interested us about Quantum Health is that they are also very focused on how helping to manage the spend in healthcare but we come about it from two very different ways, two ways that are quite complementary," he said. "While we as a network of health systems and physician practices and care providers focus on the delivery of care and the management of the full continuum of care, Quantum works upstream to focus on the navigation to high-performance networks and they work on the appropriateness of making sure that an individual gets to the right side of care," McDonald said. "When we look at both of our successful track records and how we focus on managing populations, we saw an opportunity for additive value and so that's what we're exploring and that's what we're pursuing."
VHAN also wants to work with Quantum Health to develop new models and approaches to managing populations.
"It's not just about how do we take our off-the-shelf solutions and mesh them together, but how do we look for opportunities for collaboration and make it even more impactful?" McDonald said.