Portico leverages healthcare navigation to improve the member experience and reduce healthcare costs

Challenge

Revamping past benefits strategies

Portico Benefit Services is a nonprofit incorporated ministry of the Evangelical Lutheran Church in America. They recognize the roles that financial, emotional and physical wellbeing play in helping members live out their vocations and serve their communities. To enhance the healthcare experience, Portico collaborated with Quantum Health to execute on their benefits strategy, resulting in reduced costs and improved access to care for 17,000 covered lives.

Solution

Putting strategies in motion with healthcare navigation

Delivering a better member experience

For over six years, we have served as the dedicated healthcare navigator for Portico, providing personalized support for their members. Rather than relying on automated systems and self-service options, our Care Coordinators work closely with members to understand their individual needs and guide them to the most appropriate healthcare programs and resources. This individualized attention contributes to Portico’s superior member satisfaction and engagement.

Enhancing digital behavioral health

Portico noticed a rise in behavioral health claims and recognized the urgency to offer virtual benefits services, including a text-based primary care app and digital cognitive behavioral therapy solution. Because we are uniquely positioned to drive utilization and engagement of the vendor ecosystem, Portico’s members quickly received personalized and at-home behavioral health care, resulting in improved clinical outcomes and reduced healthcare costs.

Minimizing MSK spend

Portico identified musculoskeletal claims as a rapidly increasing cost. In response, we helped Portico address this problem proactively by utilizing our Real-Time Intercept® model to engage with members and providers up to 120 days before the first claim is received. Guiding members toward appropriate care at the right time, including engagement with Sword’s virtual physical therapy program, resulted in cost savings, improved health outcomes and higher member satisfaction.

Results

Maximizing outcomes with a refined benefits strategy

I love hearing stories from members of how helpful the Quantum Warrior was on their behalf and what they helped them work through. In addition to the benefits we have available, Quantum has access to community-based programs, getting meals to our members at times when they are coming home from a long stay at the hospital, or helping them get access to transportation back to a doctor’s appointment. These are things that we as a benefits provider no longer have to worry about because they’re already taken care of.