CAN VIRUTAL CARE EVOLVE INTO THE NUCLEUS OF CARE NAVIGATION?

Data shows that only 10% of consumers are savvy enough to navigate the U.S. healthcare system. Over a decade ago, the care navigation industry was born to address this complexity and to help patients manage their healthcare journey. As the navigation sector matures, its role will evolve to encompass broader functionalities. The question is in what direction.

Care navigation folds multiple tasks in one place. These include care coordination, member engagement/activation, utilization management and patient advocacy. The large employer market first embraced this concept, putting companies like Accolade and Grand Rounds on the map. Insurers were next to enter the ring, realizing the work is a mutually beneficial exercise. Providers have also dabbled in care navigation, and we see early signs that even government-run payer programs could be next.

We believe as care moves toward integrated and holistic approach, virtual care could essentially act as the epicenter for the care navigation industry. The combination of Doctor on Demand and Grand Round is just a kick off for a bigger trend. Virtual care could allow navigation layers to route members to virtual-first platforms and at the same time simplify benefit programs and save significant costs. Some care navigation companies will likely choose to move towards generalist virtual care providers and some others will settle for the verticalized tele-health providers such as those covering MSK, LGBT, children or senior care population.

With virtual care at the center, care navigators can be better embedded in the workflows of providers, plans as well as employer markets. And enhance health literacy along the way. Uncoordinated care costs our nation $300B a year. If we can offer coordinated support on all fronts- physical, behavioral, financial, administrative- and we’ll do it for everything from acute care to life-long health, we will have a chance to delight patients and improve outcomes.

Ecosystems functions as powerful forces that reshape and disrupt industries. Care navigation + virtual care has a chance to be one such ecosystem. Look for robust M&A activity to fulfill that vision.