Clinical Navigation is a Necessary Benefit

Why employers need care navigation to simplify healthcare.

For decades, consultants in the health and benefits space have worked to help employers design programs that reduce costs, increase engagement, and improve health outcomes. Despite their best efforts, one recurring challenge remains: employees often do not use the solutions available to them. When participation is low, investments cannot be justified, and responsibility frequently falls back on the consultants who recommended those programs.

The core issue is the overwhelming complexity of the healthcare system. A recent survey by Maestro Health found that 70% of respondents feel today’s healthcare system is difficult to navigate, and 39% said they lack the support needed to understand their healthcare options.

The pitfalls of point solutions.

Employers often adopt multiple point solutions—covering areas such as family planning, musculoskeletal health, telemedicine, or mental health. However, without clear guidance, many employees never engage with these tools. As a result, innovative programs may go unused, wasting resources and failing to deliver measurable value.

This disconnect highlights the need for a central solution: a single access point that helps employees understand and use their benefits effectively.

The role of care navigation.

Care navigation provides this critical bridge. Unlike individual point solutions, clinical navigation is a platform that connects employees with the right support at the right time. Led by clinicians, these programs guide employees through the healthcare ecosystem, simplifying decision-making and maximizing the value of available benefits.

Industry research shows that care navigation is not only effective but also cost-saving. Three-fourths of consultants believe independent navigation specialists are best positioned to deliver these services, and 90% say employers offering a single access point for benefits see meaningful claims savings.

Health guides within these systems serve as more than advocates; they act as trusted educators. Employees can turn to them for direction, whether that means finding the right provider, understanding treatment options, or identifying cost-effective medications.

A healthcare system at a crossroads.

Employers are spending more on healthcare than ever before, yet employees remain confused and disengaged. The health benefits market has become increasingly crowded, making it harder for individuals to know where to turn. Care navigation addresses this challenge directly by bringing order to the chaos, ensuring employees understand their options and access high-quality care at the lowest cost.

The future of care navigation.

The pandemic accelerated a broad reexamination of healthcare, forcing organizations to rethink how employees access and use benefits. The industry is now moving toward solutions that are more consumer-centric, empowering individuals to make better healthcare decisions.

New models of clinical navigation are at the forefront of this transformation. These platforms are reshaping the way healthcare is delivered, offering employees the clarity and support they need while driving down costs for employers.

Care navigation is more than a passing trend—it represents a lasting shift in how healthcare benefits are designed and experienced. Organizations that adopt navigation models today are positioning themselves to meet both employee needs and business goals in the future.