• 62% of consultants who guide their clients to independent healthcare navigation say it offers a better member experience through dedicated care coordination services
• 84% of consultants report that digital health point solution fatigue continues among their clients, with 63% reporting that clients are considering consolidating their digital offerings under a single healthcare navigation solution

MedCity News, the leading online news source for the business of innovation in healthcare, and Quantum Health, the industry-leading healthcare navigation and care coordination company, announced today the results of their second annual Benefit Consultant Sentiment Index (The Index): Benefit Consultants’ Perspective on the Shifting Employer Healthcare Landscape.

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The ongoing changes in the healthcare landscape continue as high costs dominate companies’ strategic priorities, putting pressure on organizations to find value through efficiencies and digital transformation. To find long-term cost savings, employers are struggling to balance value and quality in their employee health benefits to attract, engage and retain talent, while also improving affordability and lessening health disparities. Prescription drug management and new condition management are also specific top concerns this year.

The Index survey, conducted in the spring, tapped into the unique perspectives and experiences of over 100 skilled benefits consultants to gauge healthcare benefits trends and to better understand the needs of self-insured employers amid industry changes. The study went deeper into revealing condition management and health benefits services as the focus when guiding their clients on benefits plan solutions. Topics included the cost impact of cancer care, prescription drug management, the evolving role of virtual care/telehealth, benefits considerations for GLP1 drugs, carrier navigation, digital point solution fatigue, and AI’s role in optimizing patient interactions.

Increased interest in the potential of artificial intelligence (AI) in healthcare benefits is reflected in The Index, with 47% of consultants surveyed reporting that they advise their clients on AI applications. AI-driven technology is poised to optimize patient interactions, enhance data utilization, streamline workflows, optimize costs and improve decision-making in healthcare benefits implementation.

Key Findings in the 2024 Benefit Consultant Sentiment Index:

• 84% of consultants surveyed report that digital health point solution fatigue continues among their clients, with 63% reporting that their clients are considering consolidating their digital offerings under a single healthcare navigation solution.
• Consultants report counseling clients on AI, particularly on its value in facilitating personalized decision support to help employees make better benefits decisions (50%) and in reducing administrative burden (49%).
• With cancer being the most complex and costly chronic condition, the survey showed that consultants are recommending alternative condition management solutions for their clients. 38% of consultants surveyed are recommending proactive high-touch case management support networks and extended expertise through preferred partners or centers of excellence (COEs) – with 41% of leading-edge client employers using best practices like care navigation tools and services to support their employees with cancer.
• As prescription drug costs continue expanding employers’ overall health benefits spend, 61% of consultants surveyed are advising clients more often on new drug costs and pricing strategies for their self-funded employer plans. Growing areas of counsel include helping clients evaluate their existing pharmacy contracts, moving to active formulary management, creating new strategies for managing PBM reform-related costs, and helping ensure client compliance with new and existing regulations.
• Innovative healthcare navigation platforms are helping employers support and manage these priorities and shifts. 23% of consultants surveyed are actively guiding employer clients to an independent healthcare navigation offering because “the status quo is not good enough anymore.” 62% are doing so because it offers a better member experience with access to dedicated care coordination services.
• 36% of consultants surveyed report that healthcare navigation through a carrier doesn’t meet a self-insured employer’s needs. Consultants report it doesn’t allow for new and more innovative solutions. Traditional carrier-based offerings don’t evaluate ROI or eliminate unsuccessful programs, and they lack coordination across medical/pharmacy/specialty pharmacy components. They also lack needed advocacy, care navigation and price transparency.

“Quantum Health is pleased to partner again with MedCity News for this year’s Benefit Consultant Sentiment Index to share health benefit consultants’ most urgent priorities in this highly complex healthcare benefits market,” said Shannon Skaggs, President of Quantum Health. “The study not only reflects how independent healthcare navigation is increasingly becoming the strategic platform to support employee healthcare benefits engagement throughout the complexity of a healthcare journey, but it can help drive reduced healthcare costs, increase value on investment, and utilize new AI-based tools and other mobile technologies to support human-based support.”

“MedCity News is proud to collaborate with Quantum Health on this report, now in its second year," said Ken Montgomery, publisher of MedCity News. "The findings reflect some of the trends we've seen on our news desk and at our conferences. Self-insured employers face tough decisions on managing healthcare costs, whether to cover life-changing but expensive drugs, help employees navigate cancer care, invest in wellness programs, or ascertain ROI for virtual care. Tools that can help companies make more informed healthcare benefit decisions are highly valued."

The findings of this survey also include consultant perspectives on healthcare benefits programs and services including the latest treatment and benefits considerations for GLP1s and the role of virtual/telehealth. See The Index full survey.

About MedCity News

MedCity News is the go-to digital destination for B2B healthcare innovation news, informing decision-makers of trends in the healthcare industry. MedCity News produces dynamic and unique innovation-focused events for the entire healthcare ecosystem, gathering experts from across disciplines to address the challenges facing the industry. MedCity News also produces the Debunked videocast, as well as several podcasts: MedCity Pivot, MedCity Moves and MedCity FemFwd.

MedCity News is owned by Breaking Media, a network of websites, e-newsletters, events and social media channels for influential, affluent business communities. To learn more visit MedCity News.

About Quantum Health

Quantum Health celebrates its 25th year as the industry-leading consumer healthcare navigation and care coordination company that delivers an unparalleled consumer experience to its members, as well as validated claims savings and high satisfaction rates for its self-insured employer and payer clients. Quantum Health’s proprietary Real-Time Intercept® capability identifies opportunities for early intervention in a member’s healthcare journey, resulting in better engagement, outcomes and cost efficiencies.

Founded in 1999 and based in Dublin, Ohio, Quantum Health has earned numerous awards and honors, including being named among the Fastest-Growing Private Companies by Inc. 5000, a Great Place to Work by FORTUNE Magazine and Entrepreneur Magazine, and one of FORTUNE’S Best Workplaces in Healthcare. The Women Presidents’ Organization has also ranked Quantum Health as one of the 50 Fastest-Growing Women-Owned/Led Companies for over 15 years.

To learn more about the company, visit Quantum-Health.com, and connect with us on LinkedIn and X (formerly Twitter).

View source version on businesswire.com: https://www.businesswire.com/news/home/20240605187539/en/

“The study not only reflects how independent healthcare navigation is increasingly becoming the strategic platform to support employee healthcare benefits engagement, but it can help reduce healthcare costs and increase value on investment."