Health Plans

naviHealth manages post-acute care management on a delegated, full-risk basis for health plans.

The naviHealth Approach

naviHealth manages post-acute care (“PAC”) for health plans and health systems on a delegated at-risk basis. We focus on Skilled Nursing (SNF), Inpatient Rehab (IRF), Long-Term Acute Care (LTCH), Home Health, and Readmissions. With a balanced portfolio, naviHealth is positioned to help patients discharge to the most appropriate setting, navigating them through their care and stewarding them as they transition safely back to the community without readmitting.

Proven Clinical Model

  • Dedicated in-market clinical staff tracks patient recoveries and manages hospital discharges to reduce readmissions and drives change management overall.
  • Concierge-like experience to guide members through post-acute care.
  • Enhanced processes and best practice post-acute care coordination increases patient and family engagement.

Proprietary Decision Support Technology

  • One-of-a-kind assessment tool, nH Predict, captures data and manages patient care and therapy utilization at multiple points of the patient’s journey.
  • nH Predict generates custom post-acute care plans for each patient based upon >4M patient records.
  • naviHealth uses real patient, data-driven outcomes to set expectations for patients care: Functional Gain, Care Giver Burden, Therapy Provision, Risk for Readmission, Discharge Disposition, and Length-of-Stay.

Unparalleled Scale and Experience

  • 6+ years’ experience partnering with skilled nursing facilities, inpatient rehab facilities, and long-term care hospitals, on a full-risk basis for Medicare Advantage plans.
  • Currently manages post-acute care for ~3.5 million Medicare Advantage and ACO members.
  • Manage care transitions for ~1K acute hospitals and over 12K post-acute care facilities.

Expertise with Both Payers and Providers

A leader in care transitions and post-acute care management, naviHealth is Guiding the Way to better patient outcomes and generating cost savings through our unique set of clinical services, scalable technology and advisory solutions. We provide a distinctive suite of capabilities and savings to match needs for payer and providers.

  • naviHealth is at the forefront of the transition to value-base care resulting in >20% savings for health plan partners, and >8% for health system partners participating in CMS’ Bundled Payments for Care Improvement Initiative (BPCI)
  • ~108,000 episodes annually across 26 of the 32 unique episode groups

Results Through Custom Solutions

Significant improvement in patients’ functional recovery

>15% reduction in readmissions from post-acute facilities

>20% reduction in post-acute medical expense

Improved member satisfaction


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