Validated Provider Report

2022 Validation Report

Review for: Quantum Health

Validation Achieved: Savings

Savings Valid Through: September 2023

Company Profile

Category:
Care Coordination
Public or Private:
Public
Year Established:
1999
President:
Kara Trott
Company Contact:
Description:

Category:

Care Coordination

Website:

Public or Private:

Public

Year Established:

1999

President:

Kara Trott

Company Contact:

Description:

Quantum Health is an award-winning consumer healthcare navigation company that delivers an unparalleled consumer experience based on empathy and trust, enabling employers to achieve industry-leading satisfaction rates and independently validated claim savings. Launched in 1999, Quantum Health’s model is based on years of consumer research and the insights learned from guiding millions of consumers and their providers through their healthcare journey.

Claim Assertion

Comprehensive health navigation/care coordination.

Intervention Link to Outcome

  • Summary of intervention
    • Comprehensive health navigation/care coordination.
  • Describe the outcome being measured.
    • Overall savings vs. trend for the entire population managed.
  • Has the applicant shown with published literature or other credible sources that the outcome being measured is correlated with the intervention being described?
    • No credible published literature on health navigation/care coordination exists. (All articles on the topic are vendor-sponsored in non-credible journals.)
  • Comment, if no published literature is available, on the reasonableness of the intervention-outcome correlation.
    • The outcome is exactly what would be expected from the intervention.

Method/Calculation/Examples

Data Source

  • Describe the data source.
    • Multiple years’ actuarial reports have been reviewed and critiqued. Quantum’s actuarial reports are highly credible.
  • Did the applicant have adequate data from a credible, reliable source?
    • Yes.
  • If the data source is a survey, are there validation studies available?
    • Not applicable.
  • Is the data source appropriate for the outcome being measured?
    • Yes.
  • Comment on the overall quality of data source.
    • Quantum’s actuarial reports are highly credible. They contrast sharply with (for example) Springbuk’s reports.

Findings & Validation

Overall savings vs. trend for the entire population managed. This approach avoids all regression to the mean and participation bias by including the entire population for all periods.

While they “average” a higher reduction, for validation purposes we are looking for a figure that most companies should be able to achieve. Therefore, the figure is lower than the figure in their actuarial reports.

Outcome Measure

  • Describe the outcome measure.
    • Overall savings vs. a credible and sourced estimate of spending trend for the rest of the country.
  • Is the outcome measure reflecting something important to health improvement, quality of care, and/or value/ financial savings?
    • Yes.
  • List any measure steward or other published source for the measure.
    • Not applicable.
  • Describe the overall approach – a trend from pre- to post-, comparing similar groups, etc.
    • This approach avoids all regression to the mean and participation bias by including the entire population for all periods.
  • Did the applicant use the data source correctly to compose the measure?
    • Yes.
  • Comment on any issues with compiling the measure, such as missing or incomplete data or lack of data on non-participants.
    • Non-participants are included. The performance of participants is not distinguished from the performance of non-participants.

Bottom Line

  • Did the applicant clearly trace a correlation between the intervention, the outcome, and the measure?
    • Yes.
  • Were there significant flaws in the data source, measure approach, or other aspects of the application?
    • The application was the strongest received by VI.
  • Highlights of analysis
    • Full population
    • No regression to the mean
    • No participation bias

Limitations

Conflated average results with results that can be expected 90% of the time. The validation percentage is lower than the actuarial report describes for that reason. The trend is sourced and reasonable. However, it is not a pure cost reduction across the population. Changing the trend assumption would change the savings. Results over time have weakened noticeably, though still the best in the field.

Validation and Credibility Guarantee

Quantum Health’s Health Navigator/Care Coordination Model achieved validation for Savings. Validation Institute is willing to provide up to a $25,000 guarantee as part of their Credibility Guarantee Program. To learn more, visit https://validationinstitute.com/credibility-guarantee/

Program Validation

Program has strong evidence of significant impact on both patient outcomes and on medical costs. Evidence is assessed based upon the certainty it provides that the result is due to the program and not to other factors, such as recruiting people to participate in the program who are most likely to succeed.

Savings

Can reduce health care spending per case/participant or for the plan/purchaser overall.

Outcomes

Product/solution has measurably improved an outcome (risk, hba1c, events, employee retention, etc.) of importance.

Metrics

Credible sources and valid assumptions create a reasonable estimate of a program’s impact.

Contractual Integrity

Vendor is willing to put a part of their fees "at risk" as a guarantee.

About Validation Institute

Validation Institute is a professional community that advocates for organizations and approaches that deliver better health value - stronger health outcomes at lower cost. We connect, train, and certify health care purchasers, and we validate and connect providers delivering superior results. Founded in 2014, the mission of the organization has consistently been to help provide transparency to buyers of health care.

Validation Review Process

Validation Institute has a team of epidemiologists and statisticians who review each program. The team focuses on three components:

  • Evidence from published literature that a similar intervention had similar results.
  • The reliability and credibility of the data sources.
  • The rigor of the approach to calculating results
 

To achieve validation, the program has to satisfy each of these components. VI’s team then summarizes the review into a report which is publicly available. Details of VI’s review are available with the program’s permission.

VALIDATION INSTITUTE
500 West Cummings Park
Woburn, MA 01801

Validation Expiration: September 2023

Certificate of Validation

Applicant:

Quantum Health

Product:

Health Navigator/Care Coordination Model

7450 Huntington Park Dr Columbus, Ohio, 43235

Claim:

Savings achieved with their model overall

Validation Achieved:

Validated for Savings

Validation Award Date:


Linda K. Riddell, MS

VP, Population Health Scientist

Validation Institute


Benny DiCecca

Chief Executive Officer

Validation Institute

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