Higher deductibles. Narrower networks. Bigger employee contributions. These are the levers most companies pull first when healthcare costs climb.
They all share the same flaw: none of them actually reduce spending. They just move it from the employer’s balance sheet to the employee’s paycheck.
Care navigation tools take a different approach. Instead of shifting who pays, they change where and how care gets used in the first place: which doctor an employee sees, which prescription gets filled through a cheaper channel. That’s a meaningful distinction when the average family health plan now costs employers $26,993 a year, up 6% from 2024.
Not every navigation tool reduces cost the same way, though. Some steer employees toward better providers before a claim is ever filed. Others manage utilisation or consolidate fragmented vendor contracts after the fact. Here are the 5 doing it most effectively, ranked by the actual mechanism behind the savings.
1. Garner Health: Cost Savings Through Quality-Based Steering
Doctors in the same speciality, seeing similar patients, produce wildly different costs. That’s the premise Garner Health is built on, and it holds up under scrutiny: a doctor who over-treats or takes longer to reach the right diagnosis costs more, even when the sticker price of the visit looks identical to a better doctor’s.
Garner’s claims data analysis identifies which physicians actually deliver better outcomes at lower total cost, once complications and repeat procedures get factored in. Then it reimburses employees’ out-of-pocket costs when they choose those doctors, instead of leaving it to a random pick from a network directory.
That second part is what separates Garner from a glorified provider list. Identifying good doctors is analysis. Getting employees to actually see them is behaviour change, and behaviour change is where the real savings show up on a claims report. That’s the reason Garner tops this list: the mechanism moves people toward the better, cheaper choice.
2. Quantum Health: Cost Savings Through Utilisation Management
Quantum Health’s savings case rests on four specific interventions rather than one big idea. It intercepts unnecessary ER visits before they turn into a $2,000 claim.
Also, it manages high-cost member journeys- the small share of employees who generate most of a plan’s spend- so their care stays coordinated instead of duplicated across providers. It steers routine care to high-value, in-network options. And it catches chronic conditions early, before they become expensive complications.
An independent, five-year actuarial study of Quantum Health’s client base backs this up with numbers instead of a pitch: a 3.3-to-1 return in the first year, climbing to 5.3-to-1 after three years. That’s the kind of figure that survives a CFO’s scepticism, because it came from a third party, not the company’s own marketing.
For a large employer juggling dozens of point solutions, that’s often the more urgent problem to solve. Vendor sprawl carries its own cost: forgotten contracts, overlapping coverage, and a benefits team spending more time managing vendors than managing outcomes. Consolidating around one navigation team cuts both the waste in the claims data and the administrative overhead of running the program in the first place.
3. Rightway: Cost Savings Through Combined Pharmacy And Navigation
Most navigation platforms leave pharmacy alone. That’s an expensive blind spot. Speciality drug costs are on track to jump another 32% by 2028, and for a growing share of employers, prescription spend now rivals or exceeds what they pay for procedures and hospital stays.
Rightway combines pharmacy benefit management with clinical navigation under one roof, treating drug spend and care spend as a single cost problem instead of two separate contracts with two separate vendors reporting two separate sets of numbers. A member on an expensive speciality medication also tends to be a member with a complex diagnosis, meaning the pharmacy conversation and the care conversation are usually about the same person at the same time. Splitting them across two vendors means neither one sees the whole picture.
For a benefits leader trying to get one clear view of where healthcare dollars actually go, that consolidation is the whole point.
4. Transcarent: Cost Savings Through Direct Employer Contracts
Every layer between an employer and a hospital adds cost. Transcarent’s approach is to cut a few of those layers out entirely. Its WayFinding platform pairs AI-driven navigation with direct contracts between the employer and health systems, routing employees to care that isn’t marked up by a traditional insurance network in the middle.
A pharmacy pricing transparency partnership adds a second lever, aimed at the same problem from the drug side instead of the care side, cutting out markups the same way the care-side contracts do.
This is a genuinely different cost strategy than steering or utilisation management. Garner and Accolade change behaviour within the existing system, working around the markups baked into a traditional insurance network. Transcarent tries to change the system itself, negotiating a more direct path between employer and provider, since fewer markups mean less to work around in the first place.
5. Accolade: Cost Savings Through Advocate-Led Utilisation Triage
A human advocate catches things software misses: the unnecessary second MRI, or the ER visit that a phone call could have redirected to urgent care instead. Accolade’s model pairs every employee with a dedicated advocate who can intervene before those costs happen, not after the claim lands on a spreadsheet.
That timing matters. A steering model like Garner’s works by pointing employees toward better choices in advance. Accolade’s works by catching bad ones in the moment, which is a different kind of value and one that tends to matter most for large, complex employee populations with a lot of moving parts to track.
It also depends on how much an organisation trusts automation versus a human judgment call. Some benefits leaders want a person reviewing the edge cases instead of an algorithm flagging them. Accolade is built for that preference, at the cost of scaling less cheaply than a software-only model.
How To Evaluate Cost Savings Claims Before You Buy
Every vendor in this space will show up with a savings number. Not all of those numbers hold up. Before signing anything, ask three questions.
Is the figure independently or actuarially verified, or is it self-reported? Quantum Health’s third-party study is the standard to compare against.
What specific mechanism produces the savings: steering, utilisation management, pharmacy consolidation, or direct contracting? A vague answer here is a red flag. And does that mechanism actually match your organization’s biggest cost driver, or does it solve a problem you don’t have?
The “right” tool depends entirely on which cost problem is biggest for your workforce. Provider quality variation points toward Garner, unmanaged utilisation toward Quantum Health, and fragmented vendor contracts toward Rightway or Transcarent. Pick the mechanism that matches the leak in your own numbers.
