Helping patients is a virtue

Quantum Health’s consumer behavior research clearly showed that patients chronically misuse the healthcare system. No wonder. It’s intricate, intimidating and not at all intuitive. Oh, and all those ‘solutions’ that are meant to make benefits plans better… most of the time they just make matters worse. Talk about irony.

Because patients (and even providers) are befuddled by the system they aren’t using healthcare in the most efficient manner. As a result, wasteful spending happens. A lot.

In fact, experts estimate that 30-40% of all medical events are unnecessary.

Armed with this knowledge, we created a program that reorganizes benefits delivery to get patients (and providers) through the complex healthcare system in a much more effective way. Rather than let patients continue to stumble and grope their way through an ever-changing maze, Quantum Health steps in to guide them through the healthcare system and, ultimately, empower them to make smarter decisions.

Think about it: By figuratively holding the patient’s hand – and helping them understand and use their benefits better – Quantum Health literally reduces healthcare confusion. Which reduces misuse. Which reduces waste. Which reduces spend. Which, for better or worse, is the holy grail of healthcare.

Here’s how we make it happen.

We give healthcare a human touch

Getting plan participants to become engaged and knowledgeable users of their health benefits (not to mention accountable for their own health) requires consistent, if not constant, hand-holding.

Quantum Health provides this human touch through its Care Coordinators—an empathetic, resourceful and highly responsive team of nurses, social workers, patient service reps and benefits experts.

Grouped in ‘pods’, our Care Coordinators work together to help plan participants get through the confounding healthcare system with confidence. Indeed, Care Coordinators are the single go-to resource for all customer service and care management requests. Plan participants need only to call one toll-free number or visit a dedicated website to chat with Care Coordinators when they have questions about their benefits, claims or healthcare in general.

With Care Coordinators, plan participants can rely on one source (of real people!) to resolve countless issues and eliminate countless hassles. It’s that simple.

Making things even simpler is PIVIT^TM – our proprietary technology platform that pulls together essential healthcare data (e.g., benefits, eligibility, claims, clinical information, patient comments, etc.) and puts it right at the fingertips of our Care Coordinators.

This powerful combination of high tech and high touch care is the foundation of our program’s success. It’s what enables us to build a “Virtual Medical Home” for each of your plan participants.

Virtual Medical Homes open the door to real results

With PIVIT as its foundation, a Virtual Medical Home is able to bring the plan participant’s pertinent medical information – along with the fragmented healthcare process and siloed customer service functions – all under one roof.

So, when a plan participant calls, our Care Coordinators have a dashboard view of the relevant data for that individual. This holistic perspective enables Care Coordinators to see all patient activity, benefits, medical information, everything of importance—in one convenient spot.

The benefit? Care Coordinators can take immediate action and intervene in real-time when a plan participant has a healthcare problem, reducing the likelihood of healthcare misuse and waste.

Virtual Medical Homes are beneficial to medical providers as well. During real-time conversations with plan participants and other providers, Care Coordinators gather and assess information and then use it to help physicians get a complete picture of what’s happening with their patients. For instance, if a medical test or procedure is redundant our Care Coordinators can step in, contact the patient’s doctor as well as the patient, and keep the unnecessary expense from ever happening.

Reduction, reduction, that’s our function

To be sure, these small daily interventions add up to help keep healthcare costs down.

By overseeing all aspects of benefits delivery, our Care Coordinators can intercept redundant, delayed and questionable treatment in real-time and then help plan participants, their families and their physicians work together to ensure proper care—literally driving unnecessary medical events (and costs) out of the system.

But we don’t stop there.

You see, our approach is designed to reduce healthcare costs in two ways. First, we make healthcare more efficient by coordinating care for plan participants. Next, we work with plan participants to reduce the amount of services they use in the future by actively helping them become healthier over time.

This one-two punch delivers an effective way to knock costs down. Then keep costs down for the count.

The bottom line is this: By reducing waste inherent to the complex healthcare system, we’re able to reduce your healthcare spend by an industry-leading 5-8% without cutting benefits.

Best of all, we back it up with a 100% guarantee. So there’s absolutely no risk to experiencing the rewards of Quantum Health.