As the healthcare landscape becomes increasingly complex, it's vitally important that individuals have the necessary support, guidance, and solutions to simplify their healthcare journey. As an agency committed to fostering wholeness, The Board of Pensions of the Presbyterian Church (U.S.A.) has taken a significant step to help improve the healthcare experience for Benefits Plan members. Starting April 1, 2022, the Board will provide care navigation services to Medical Plan enrollees through an agreement with its newest partner, Quantum Health.
"Part of good stewardship means finding the best business partners who share our values and can create positive health outcomes for our members," said the Reverend Frank Clark Spencer, agency President. "We believe Quantum Health is the right partner to help usher in a new level of care for our Medical Plan members."
As part of the new care navigation offering, members enrolled in the Medical Plan's three coverage options — PPO, EPO, and HDHP — and their covered family members will have access to Quantum's team of dedicated, highly trained nurses, clinicians, and benefits specialists. Care Coordinators will assist with coverage questions, such as providing clarification on deductibles and other out-of-pocket expenses, as well as with more complex challenges. Care Coordinators will also be available to help with navigating all aspects of an upcoming surgery, from determining coverage to understanding preoperative instructions to planning for a member's needs before and after discharge.
"Care navigation is designed to make things easier for our members," said Executive Vice President Pat Haines, Chief Benefits Officer for the Board. "Quantum will clear the way, so members travel more smoothly through their healthcare journey."
The care navigation benefit will not result in additional costs to members or employers or change the medical or prescription drug benefits. Highmark Blue Cross Blue Shield will continue to process medical claims, and Express Scripts will still administer the prescription drug benefit. Members will still call the Board of Pensions with questions about pension, death and disability benefits, and the Medicare Supplement Plan as well as the Assistance Program and Education offerings. "The Board has a strong relationship with our members," Rev. Spencer said. "That is not changing. Members and employers can still call us with any questions or concerns."
"We will always be here to serve, and we look forward to collaborating with Quantum, a healthcare partner who is equally committed to supporting members along their journey," Ms. Haines said.
As a recognized expert in the field of care navigation for more than 20 years, Quantum brings the specialized clinical expertise and healthcare industry knowledge the Board of Pensions needs to carry out its mission.
"No one should have to navigate the healthcare journey alone," said Kara Trott, Founder, Chairman of the Board, and Senior Advisor of Quantum. "Our Care Coordinators will take plan members by the hand and walk through the healthcare journey with them. Whether it's finding a specialist, accessing medication, or straightening out a bill, our team will approach the work with unmatched empathy and dedication."
"Care navigation is the next step in the Board's healthcare evolution," Rev. Spencer said. "At one time, we were processing medical claims in house. Now, Highmark does that, and does it far more efficiently than we ever could. Quantum Health will do the same for guidance around care and, we expect, at a high standard that members will welcome."