Proactive Care Navigation: Clsoing Care Gaps and Cutting Costs
On Wednesday, October 29, Marc Stevens, Employee Benefits Practice Leader at Main Street Insurance Group, joined a panel hosted by Wellnecity and the Northeast Business Group on Health (NBGH) to discuss how employers can take a more proactive role in managing healthcare costs and outcomes.
Marc was joined by Lauren Roberson, ANP-BC, Head of Nurse Advocacy at Connect Healthcare Collaboration; Paul Richmond, COO of Wellnecity; and Sally Pace, CEO of Connect Healthcare Collaboration, who moderated the discussion.
The Challenge: A Complex, Costly Healthcare System
The panelists explored one of the most pressing issues facing employers today — the rising cost of healthcare and the growing complexity of the system employees must navigate.
A few data points set the stage:
- 80% of employees are confused about their benefits
- 90% of U.S. employers say rising healthcare costs are their top strategic concern
- $935 billion is wasted annually due to unnecessary services, missed preventive care, and inefficient care delivery
- Just 5% of members account for 50% of total healthcare spend
As Marc put it, “Watching claims roll in and hoping next year will be better doesn’t work anymore.”
The Opportunity: Going on Offense
The conversation focused on how employers can shift from a reactive to a proactive approach — using data, technology, and advocacy to get ahead of rising costs.
Key solutions discussed included:
- Employee and patient advocacy programs: Helping employees navigate the healthcare system improves patient outcomes and reduces plan costs.
- Turning data into action: Dashboards alone don’t drive change. Tools like Wellnecity use predictive analytics to proactively identify high-risk members and intervene early — reducing preventive hospitalization risk by as much as 38%.
- Identifying and supporting high-cost claimants: Nurse advocates collaborate with physicians and employees to find cost-effective care alternatives without compromising quality.
- Medication and site-of-care strategies: The right care, at the right time, in the right place can significantly lower overall plan expenses.
The Result: Better Outcomes for Employees and Employers
By pairing predictive data tools like Wellnecity with advocacy programs like Connect Healthcare Collaboration, employers can create a system where employees receive individualized care while the organization benefits from lower costs and better outcomes.
Partnering with an advisor such as Main Street Insurance Group ensures employers understand, implement, and measure the impact of these strategies effectively.
🎥 Watch the Full Webinar: View the recording here.
