Lowering healthcare costs through clinically-meaningful engagement with navigation


By Ami Parekh,
Chief Medical Officer,
Included Health

With rising inflation, the ongoing COVID-19 pandemic, and increasing economic uncertainty, healthcare challenges are skyrocketing. Employees struggle to find the right benefits and high-quality, in-network care in a fragmented healthcare system, leading to poor care outcomes and contributing to a 6.5% projected year-over-year increase in employer health benefits spend1. Unchecked, these challenges will continue to grow.

Healthcare navigation solutions offer the potential to guide employees – from the healthy to the highly-complex – to the right care and benefits at the right time. However, while many navigation vendors market their ability to drive savings, the reality is that most fall short when put under a spotlight, leaving employers struggling to sort fact from fiction.

With that in mind, we partnered with Validation Institute to validate the savings impact of Premium Navigation, which is a guidance and advocacy solution that provides employees and their dependents with a personalized, single point of entry to healthcare. The solution – powered by self-serve digital services and live support from in-house clinicians and our non-clinical Care Team – makes care easier to access, understand, and use, driving better outcomes and reduction in healthcare costs.

Based on a study of Included Health clients, The Validation Institute validated:

  1. Our methodology for measuring healthcare cost trend and impact on employers’ healthcare costs
  2. The fact that Premium Navigation delivered a statistically significant cost reduction
  3. That groups with Premium Navigation had lower cost growth than comparable groups with fewer Included Health services, showing that not only does Premium Navigation lower healthcare costs overall, but it also does so compared with other, less fully-featured Included Health products

We are proud of the financial validation described above. We also know that without the ability to attribute results to specific services, it can be difficult to trust the impact a navigator actually had on healthcare cost trend vs. other factors like clients switching to a TPA or changing plan designs.

To ensure that the clinical measures and book of business cost savings from specific clinical services provided by Premium Navigation were consistent with the validated financial outcomes, we completed additional analyses to supplement Validation Institute’s findings. This analysis confirmed that, unlike other navigation solutions that may skew towards engaging members primarily for basic administrative support, about half of engaged households in our study utilized clinical services that improve outcomes and have a quantifiable impact on savings.

For example, our provider matching service connects members to the highest quality providers with dynamic, personalized matching based on each members’ unique needs. In the study Validation Institute reviewed, this led to a >100% year-over-year increase in new, high-quality primary care physician relationships. These connections drive real savings – across our book of business, each connection we make to a high quality provider drives an average of $2,100 in savings.

To learn more about Premium Navigation and how Included Health is integrating navigation and virtual care to create a fully connected healthcare experience, visit or email

Read Included Health’s summary report detailing the savings validation HERE.

1 Aon, 2022