MedCity News Report Reveals Employers are Turning to AI-Powered, Clinically Integrated Independent Healthcare Navigation to Combat Rising Costs
"Independent navigation is accelerating as a central benefits strategy, not only to improve the member experience, but to lower costs, improve value on investment and seamlessly integrate AI-driven innovations with compassionate, human-centered care."
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Now in its third year, the Index surveyed more than 120 experienced benefit consultants and uncovered a growing demand for independent, clinically integrated navigation models and a rising dissatisfaction with traditional carrier-provided services. Among the key findings:
68% of surveyed consultants guide clients away from navigation solutions tied to insurance carriers, instead recommending independent partners citing the need for a stronger member experience, clinical integration and transparency in cost savings.
87% of surveyed consultants report advising on GLP-1 drug coverage, with most recommending restrictions and measurable outcomes to ensure cost-effectiveness.
The influence of AI continues to grow, with 72% of consultants surveyed counseling clients on its use in benefits — up significantly from the prior year.
'We're excited to once again collaborate with MedCity News on the Benefits Sentiment Index, bringing forward the key priorities shaping the healthcare benefits landscape,' said Dayne Williams, CEO of Quantum Health. 'This year's findings highlight how independent healthcare navigation is accelerating as a central healthcare benefits strategy — not only to simplify and improve the member healthcare experience, but also to lower costs, improve value on investment and seamlessly integrate AI-driven innovations with compassionate, human-centered care.'
Williams added, "As the only navigation solution that engages continuously with providers from the member's first moment of need, we take immediate action to guide care decisions in real time. Leveraging advanced AI and our proprietary Real-Time Intercept® platform, we proactively identify members at critical moments and connect them to the right care at the right time. This approach combines clinical expertise with accelerated intervention — delivering independently validated results, improved health outcomes and a better experience for members.'
The report also calls attention to gaps in engagement and personalization, with half of consultants reporting that their clients struggle with fragmented care coordination, lack of centralized access and difficulty engaging employees. Consultants are increasingly seeking solutions that integrate clinical care teams, embed AI for proactive risk detection, and provide seamless connections to behavioral health and social determinants of health support.
'At MedCity News, we're committed to surfacing insights that drive smarter healthcare decisions, and this year's Index does exactly that,' said Ken Montgomery, publisher of MedCity News. 'The data reveals a clear call to action: self-insured employers and their consultants are demanding more from navigation solutions — more clinical integration, more actionable data and more alignment with evolving technologies like AI. We're proud to partner with Quantum Health to spotlight these critical shifts and help advance the conversation on what effective benefits strategy looks like today.'
'The takeaway is clear,' said Williams. 'Employers are no longer satisfied with the status quo. The next chapter of healthcare navigation must be clinically integrated, AI-enabled and relentlessly focused on driving measurable results.'
The full 2025 Benefits Sentiment Index is available for download here.
About MedCity News
MedCity News is the go-to digital destination for B2B healthcare innovation news, informing decision-makers of trends in the healthcare industry. MedCity News produces dynamic and unique innovation-focused events for the entire healthcare ecosystem, gathering experts from across disciplines to address the challenges facing the industry. MedCity News also produces the Debunked videocast, as well as several podcasts: MedCity Pivot, MedCity Moves and MedCity FemFwd.
MedCity News is owned by Breaking Media, a network of websites, e-newsletters, events and social media channels for influential, affluent business communities. To learn more visit MedCity News.
About Quantum Health
Celebrating 25 years of innovation, Quantum Health is a leading consumer healthcare navigation and care coordination company. Its Real-Time Intercept® platform identifies early intervention opportunities to improve engagement, outcomes, and cost efficiency. Based in Dublin, Ohio, Quantum Health has earned national recognition for growth and workplace culture, including honors from FORTUNE, Inc. 5000, and the Women Presidents' Organization.
To learn more, visit www.Quantum-Health.com and connect on LinkedIn.
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