The healthcare industry has recently seen a surge in healthcare navigation solutions aimed at simplifying the member experience. Although some health plans offer embedded care navigation services, they fail to address the complexity of the healthcare ecosystem. These programs frequently struggle with low engagement, gaps in integration, and poor member satisfaction.

Rightway takes a different approach, transforming care navigation to provide a seamless, comprehensive experience that improves healthcare outcomes. Below, we explore some of the most common challenges and how Rightway’s approach stands apart.

Challenge 1: Ineffective programs.

Despite having access to valuable member insights, most health plans fail to turn this data into actionable care navigation strategies. They also fail to establish a trusted relationship with members, resulting in distrust and low adoption of their solutions.  

A study revealed that 43% of U.S. consumers distrust their health plans, finding them impersonal and complex. Meanwhile, 87% of Americans turn to the internet for healthcare information, often relying on sources that can mislead them or result in improper care decisions.

Rightway’s Approach: At Rightway, members are guided by a dedicated team of clinicians, social workers, and health guides who build long-term relationships. Using our proprietary Advocate platform, we create detailed member profiles that include claims history, self-reported data, benefit plans, and partnerships with third-party solutions. This comprehensive view paired with clinical navigation helps us deliver personalized care and enhance benefits utilization.

Challenge 2: Low engagement.

Engagement is a major issue for many commercial health plans, caused by a lack of awareness, difficult to access technology, or other barriers. A 2023 study by J.D. Power revealed shockingly low adoption of digital tools offered by health plans:

• 8% of members use chronic disease management tools.

• 10% utilize online triage or nursing support.

• 6% adopt remote monitoring programs.

Rightway’s Approach: Rightway’s omnichannel communication strategy drives higher adoption rates. Whether through a mobile app, web portal, or phone, members engage directly with our care team—real people, not bots. This personalized approach has resulted in higher engagement, better satisfaction, and lower costs.

Challenge 3: Integration gaps.

Successful care navigation requires seamless integration across appointments, medical records, referrals, and wellness programs. Unfortunately, many health plans do not integrate their systems with third-party solutions, leading to a fragmented experience that increases administrative burdens.

Rightway’s Approach: Rightway simplifies the healthcare journey by centralizing all benefit offerings in one platform. We integrate seamlessly with all major carriers—medical, dental, and vision—and partner with third-party solutions like specialty care management and telemedicine providers. With Single Sign-On (SSO) capabilities, members enjoy a smooth experience across systems, ensuring efficient care coordination.

Challenge 4: Poor member satisfaction.

Embedded care navigation services frequently fall short when it comes to offering transparent information on provider quality, costs, and member reviews. This lack of transparency impacts member satisfaction, particularly among younger generations. According to J.D. Power, satisfaction has declined significantly among members born between 1977 and 2004—a critical segment of today’s workforce.

Rightway’s Approach: Rightway connects members directly with clinicians, offering personalized navigation, guidance, and support through every step of their healthcare journey. Our care teams are experts in a client’s specific benefits offering, ensuring that members maximize their coverage. Services include:

• Benefits education and optimization: helping members understand care options, coverage, and alternatives.

• Care access: Recommending high-value care and scheduling appointments.

• Clinical guidance: Supporting members in making informed decisions about their health.

• Billing advocacy: Assisting with claims questions and resolving billing disputes.

Benefits leaders invest time and effort into creating healthcare programs that meet the needs of their teams. However, relying on embedded care navigation solutions from health plans often results in poor engagement and satisfaction, which fails to improve outcomes and lower costs.

Rightway was built to address these shortcomings. Our dedicated health guides, innovative technology, and seamless integration with members’ benefits ecosystems ensure that employees get the most out of their healthcare experience—without the frustration of navigating it alone.

By building trust, engaging members, lowering costs, and delivering better outcomes, Rightway is setting a new standard in care navigation. Learn how Rightway can maximize benefits activation for your team today.