Innovative and Personalized Clinical Navigation
Managing the ins and outs of healthcare can be incredibly overwhelming, especially for individuals facing chronic or complex conditions. Treatment options, provider referrals, and cost are just a few of the myriad of considerations people face.
At Gravie, we believe our members shouldn’t have to make these decisions alone. We also don’t think our only role in these decisions is to drive members to the least expensive option.
That’s why we’re building a new kind of clinical navigation program with a holistic view of members who face chronic or complex conditions like cancer or back pain – centering care decisions around their individual lifestyles and physical, mental and financial needs.
We believe that’s what a health plan should do.
A holistic approach to clinical navigation
The first program we’re launching this spring is designed to help members living with musculoskeletal (MSK) conditions reduce pain, mitigate the need for surgery and improve quality of life. While a traditional clinical navigation program might require that a member speak with a clinician at their health plan before scheduling surgery – which the health plan has likely only found out about from a recently filed claim – Gravie takes a more proactive approach starting at the beginning of a patient’s journey.
As early as the initial underwriting process, we’re using data to identify members most likely to need MSK intervention at some point in the future and connect them with a clinical navigator from the start. With visibility into claims data and provider and pharmacy interactions, our team can see the full picture when supporting care decisions. Imagine if a clinician from your health plan could proactively bring you treatment options and resources for second opinions, and even refer you to mental health support to help you address the stress and anxiety that can come from managing it all.
Our program makes that scenario a reality.
Beyond these early interventions, our clinical navigation program helps members in a number of other ways, including with scheduling appointments, comparing treatment plans and understanding cost implications. We pair each member in the program with their own dedicated navigator who travels the patient journey alongside them and is just as invested in a positive outcome.
Members can also expect a seamless experience between their clinical navigators and anyone they would speak with at Gravie Care – making it a breeze to sort through claims and set up appointments without having to call multiple numbers and explain their situation over and over again.
Support that goes beyond health benefits
As we prepare to launch our oncology-focused clinical navigation program on the heels of the MSK-focused program, we’re also exploring new ways to address members’ needs that fall outside of the health benefits norm. For example, we’re building elements into the program that will focus on social determinants of health, like transportation, housing, childcare, finances and community support. Our clinical navigators are poised to connect members with these external resources to ensure they can easily access their treatment and care.Helping our members live their healthiest lives is a responsibility we take seriously. A thoughtful, supportive clinical navigator in a member’s corner who is focused on the best individual outcomes is just the start of a health plan everyone can love. Want to learn more about Gravie’s clinical navigation program? Get in touch.