Comparing Care Navigation Vendors: Accolade, Quantum Health, and Included Health

Introduction

Care navigation services are increasingly vital for self-insured employers seeking to improve employee health outcomes and manage healthcare costs. This analysis compares three prominent vendors: Accolade, Quantum Health, and Included Health. We will evaluate each company's model, pricing structure, and reported outcomes to help CFOs, HR directors, and benefits consultants make informed decisions.

Care Navigation Models

Understanding the care navigation models of each vendor is crucial for evaluating their effectiveness.

Accolade

• Model: Accolade provides personalized care support through a combination of health assistants and advanced technology. Their platform leverages AI to match employees with the most appropriate care resources.
• Services Offered:
  • 24/7 access to health assistants
  • Personalized health assessments
  • Integration with existing health benefits
• Target Audience: Primarily large employers with diverse employee health needs.

Quantum Health

• Model: Quantum Health focuses on an “end-to-end” care coordination model. They emphasize real-time support for employees navigating complex medical situations, particularly for high-cost claims.
• Services Offered:
  • Patient navigation for high-cost procedures
  • Real-time claims support and communication
  • Care coordination across multiple providers
• Target Audience: Employers with significant claims data who want to manage high-cost conditions.

Included Health

• Model: Included Health combines care navigation with a focus on mental health and chronic condition management. Their model is built around providing comprehensive support for both physical and mental health needs.
• Services Offered:
  • Virtual mental health support
  • Chronic condition management
  • Telehealth integration
• Target Audience: Employers looking to address both physical and mental health challenges in their workforce.

Pricing Structures

Pricing for care navigation services can vary significantly based on the vendor and the services provided. Here's a breakdown of the pricing models:

Accolade

• Pricing: Typically charges on a per-employee-per-month (PEPM) basis.
• Estimated Cost: Ranges from $12 to $25 PEPM, depending on the services selected and the size of the employer.
• Contract Terms: Most contracts are structured as multi-year agreements, with performance guarantees based on utilization and satisfaction metrics.

Quantum Health

• Pricing: Offers tiered pricing based on the number of employees and the complexity of care needed.
• Estimated Cost: Starts around $15 PEPM, with additional fees for high-cost claim management services.
• Contract Terms: Contracts are often annual, with options for renewal based on performance benchmarks.

Included Health

• Pricing: Similar PEPM model but with a focus on integrated mental health services.
• Estimated Cost: Generally ranges from $10 to $22 PEPM, varying based on the inclusion of mental health services.
• Contract Terms: Typically annual contracts with the option for multi-year agreements based on utilization metrics.

Employer Outcomes Data

Outcomes data are essential for evaluating the effectiveness of care navigation vendors. Here’s how each vendor stacks up based on available metrics:

Accolade

• Utilization Improvement: Employers have reported a 20% increase in the use of preventive services.
• Cost Savings: Clients see an average reduction in healthcare costs by 15% annually.
• Employee Satisfaction: 85% of users reported high satisfaction with care navigation support.

Quantum Health

• Utilization Improvement: 90% of high-cost cases reported improved care coordination.
• Cost Savings: Clients have experienced a 10-12% reduction in overall claims costs.
• Employee Satisfaction: 78% satisfaction rate reported by employees utilizing their services.

Included Health

• Utilization Improvement: 25% increase in engagement with mental health services among employees.
• Cost Savings: Employers report a 5-10% decrease in overall healthcare spending.
• Employee Satisfaction: 88% of employees expressed satisfaction with the support received for both physical and mental health needs.

Bottom Line

When selecting a care navigation vendor, consider the specific needs of your workforce, as well as the pricing and outcomes associated with each vendor. Accolade excels in preventive care utilization, Quantum Health shines in coordinating high-cost claims, and Included Health offers robust mental health support alongside chronic condition management.

For self-insured employers, the choice may come down to the specific health challenges faced by employees and the budget available for these services. Evaluating these factors will help ensure that you select a vendor that aligns with your organizational goals and improves employee health outcomes effectively.