How care navigation reduces costs

What is Care Navigation?

Care navigation is a hybrid solution that combines human guidance with smart technology to simplify healthcare access and decision-making. Beyond benefits support, care navigation combines personalized guidance with advanced tools to help members:

Understand their health benefits
Find high-quality, in-network providers
Schedule appointments
Understand costs before care
Get support with billing and authorizations

This end-to-end approach improves outcomes, boosts satisfaction, and significantly reduces healthcare costs. In this blog, Rightway explores the importance of offering care navigation services to your teams. Benefits of care navigation include:

Catching conditions early, saving costs later.

Care navigation isn’t just about fixing health problems, it’s about preventing them. Health guides proactively schedule preventive screenings and regular check-ups, helping employees detect chronic conditions early, when they’re most manageable and cost-effective to treat.

This approach reduces avoidable ER visits, advanced treatments, and hospitalizations, ultimately driving lower total cost of care. By improving early detection and disease management, employers see stronger ROI through reduced claims, healthier teams, and long-term population health improvements.

High-value care starts with the right navigation provider.

Improving quality of care means more than just reducing urgent care or ER visits. Navigation providers help employees make better decisions by guiding them to high-value care options that align with clinical need and benefits design.

Health guides close care gaps, coordinate follow-ups, and reduce unnecessary treatments, all of which improve outcomes like treatment adherence and prevent readmissions. When employees choose better care the first time, employers avoid wasteful spending, resulting in lower costs.

Removing barriers to care with guided support.

Many employees face real obstacles when trying to access care—from language barriers and financial constraints to lack of transportation or provider availability. These disparities can lead to delays in care, unmanaged conditions, and poor health outcomes.

Care navigation acts as a bridge between members and the healthcare system. Health guides help overcome systemic barriers by:

Finding accessible, in-network care
Coordinating transportation and interpreting services
Supporting culturally sensitive care

Creating smoother journeys with member-centric navigation.

Healthcare can feel overwhelming. Care navigation alleviates that burden by handling complex tasks—such as prior authorizations, billing questions, and follow-up coordination—on behalf of members.

The result? Happier, more engaged employees who are more likely to use their benefits effectively. Care navigation contributes to higher satisfaction and stronger Net Promoter Scores (NPS). For example, resolving an incorrect medical bill to save the member thousands of dollars or expediting a specialist referral can turn a frustrating situation into a positive experience.

Navigation saves money—and improves outcomes.

Educated, supported members make smarter, more cost-conscious healthcare decisions. With the help of health guides, employees are steered toward:

In-network, high-quality providers
Lower-cost care settings
Clarity on treatment costs and billing

These smarter decisions prevent unnecessary services and low-value care, helping employers avoid costly claims. Real-world outcomes show that care navigation consistently reduces total healthcare spend while improving clinical outcomes—a win-win for members and companies alike.

Why employers need a navigation provider.

In an environment where healthcare costs are rising and benefits are growing more complex, navigation isn’t optional—it’s strategic. A trusted navigation provider helps HR teams: