Meritain Health: Navigation Partners

Join our host, Bridgette Cassety, as she speaks with Stacey Meade, Head of National Sales and Account Management, Dan Day, Head of Sales for Middle Market, and Shelly Wines, Navigation Partners Program Manager. to discuss the benefits leveraging navigation partners. 

Transcript

Speaker 1 (00:06):

Welcome back for another edition of in the booth. My name is Bridgette Cassety and I'm head of broker engagement here at Meritain health. And today I'm pleased to be joined by Stacey Meade. And Stacey is our head of national sales and account management Dan Day, who is our head of sales for middle a market, as well as Shelly Wines, who is our navigation partners program manager. And it's great to have all of you with me, Stacey and Dan, welcome back. You've had the opportunity to join me before. It's always great to have you with me and Shelly. Thanks for joining us for the first time for our in the booth podcast series today, we're here to talk about how Meritain health works with navigation partners. And certainly we have a lot of brokers and consultants and customers that are considering navigation partners. And so with that, Stacey, I thought you might be the perfect person to kick us off and talk a little bit about what the navigation partner actually is and why would someone wanna work with one?

Speaker 2 (00:54):

Sure, thanks for having me, Bridgette. I appreciate the opportunity excited to talk about our relationships with navigation partners. So these are firms that are out there selling a different way to engage with employees. And typically what they're trying to do is two things. One is offer a higher level of member service, think white glove, high touch kind of service with the intention of making sure that members can use all, all facets of their healthcare plan effectively. And so the second thing that navigation solutions are often trying to accomplish is intervention and care management. The idea is if members are engaging with these firms as an independent entity, they have a greater ability to influence at the right time getting to high quality, low cost providers. And so there's that dual benefit of the member experience combined with the opportunity to influence the clinical care members are receiving.

Speaker 1 (02:00):

So Stacey, when I hear you describe it in that way, what comes to mind is a similar conversation that we had in another podcast around point solutions. Are they philosophically the same from your perspective?

Speaker 2 (02:12):

You know, they're actually very similar. Where we started as an organization is, you know, point solutions have been around in some form of fashion for a long time, but really navigation was a great way for us to get in there and get deep. What I would say the difference is that point solutions in general are intended to target individual conditions or solve individualized problems. Navigation and advocacy solutions are really looking to improve the healthcare experience for all members. And so what what's needed from a TPA is just really different, you know, certainly claim speed eligibility things you would expect from a point solution, but what's important is a deeper level of integration because the more that members can build trust in navigation partners and be comfortable with them, the greater their opportunity is to steer to the right point solutions and deliver that higher level of member care.

Speaker 1 (03:15):

And I think it's something that you mentioned Stacey too, is that, you know, navigation partners have been around for a while. And sometimes I think what I've heard out in the market is sometimes people think that navigation partners are only for those really large or jumbo size accounts. And so I thought, Dan, it might be good for you to maybe jump in here and share your perspective from a middle market perspective, you know, how, how do you see navigation partners and how they're trending down into those smaller employers that maybe haven't considered navigation partners in the past?

Speaker 3 (03:45):

Well, Stacey was mentioning not only does it enhance care, but I think the results are very solid. They're validated in that the navigation firms are very successful at mitigating risk and lowering the total cost of care. And then when the navigation model also became more scalable entity within the captive space, for example, saw this as a great way to mitigate their risk for their members. So not only does it enhance the member experience, but it gives the client the benefit of lowering their trend and lowering the total cost of care while enhancing their care. So to us, when the model goes down market, it becomes more scalable and more adoptable by more clients.

Speaker 1 (04:24):

And, and do you find that the that the member experience that goes along with that? Like how, how are, how are people talking about that in some of these smaller employers,

Speaker 3 (04:34):

Many small employers look to the national market or the large employers as a model that they want to follow. And in, in a very competitive employee environment, these navigation models are becoming more and more important when it's providing that great healthcare experience where their members, those smaller employers in down market want that too, because they're a star for employees as everyone else. So we see this as a trend that is gonna only continue and broaden out into the market.

Speaker 1 (05:02):

I think that's a good point because obviously all benefits are there for employee retention and growth and navigation partners can certainly play a big role in the customer experience that, that Stacey and you both were talking about. And I, and I think that Shelly, it might be a great time to bring you into the conversation. You know, we talked a little bit about the experience and reducing total cost of care and so forth, but what be great for you to share with our listeners from your position here is just how specifically do we work with this partner, with these partners? You know, can you talk a little bit about your role and the operational support that you provide in this relationship to really accomplish the things that Dan and Stacey were talking about?

Speaker 4 (05:42):

Sure. First off, we try to make it as easy as possible for our clients. As Stacey mentioned, we've been partnering in this space since 2005. So we're fully integrated with our partners with established file feeds. We've got processes down between the partners and there's a lot of open communication to keep things moving. We see value in this space. My role is completely focused on ensuring one point of contact and a seamless experience, not only for our navigation partners, but also for our internal team. One thing I would love to highlight is our navigation community tool. We saw an opportunity to work better, smarter, more efficiently with our navigation partners and created this proprietary system that allows our teams to communicate on individual member, like having a claim reprocessed. This tool allows the navigation partner to contact directly the Meritain team. Making it a total game changer. Both teams have access to the tool. They can see where the claim is and the process and communicate back and forth. So it, it really makes for a dynamic experience.

Speaker 1 (07:03):

And I think, you know, Shelly Dan Stacey, the, some of the things that I heard in our conversation that I hope our listeners take away with is that, you know, working with a navigation partner, there's integration, there's good communication. It's really for employers of, of all different sizes and shapes, maybe it was in the past and that the opportunity to maximize the benefits and drive those better clinical outcomes really supports our overall mission here, which is to reduce the total cost of care as we're advocates for healthier living. So I wanna thank you all for joining me in the conversation around navigation partners and how we work with them for the benefit of our brokers consult to and our customers. So thank you to our listeners for joining us today for another edition of, in the booth. And we look forward to joining us again next time until then be well.