Make navigation a care decision, not a member perk

A low score in navigation and employee experience is a signal that employees may be left to decode a complex plan at the exact moment they need care. Navigation is more than a help line or a communications campaign. It is the practical system that helps people understand their options, find appropriate care and follow through with confidence.

Start in the Roadmap’s Diagnose phase by mapping the moments that create the most confusion: choosing primary care, locating behavioral-health support, receiving a specialist referral, addressing a complex diagnosis, resolving a claim or accessing a benefit. Review employee feedback, call patterns, abandoned care and avoidable utilization alongside the benefit design.

In the Design phase, define a connected experience rather than a collection of point solutions. Consider how communications, primary care, advocacy, clinical programs and vendor handoffs work together. The objective is to make the next best step obvious for an employee while preserving the information leadership needs to improve the system.

Then establish measures and ownership for the experience: access, engagement, resolution, care progression and the outcomes connected to key journeys. Reviewing those measures on a recurring cadence turns a high-priority Score result into a Roadmap capability that supports better care, stronger trust and more sustainable plan performance.