Care Navigation

Care Navigation refers to the routing of care through high value networks. Generally this involves management of referral processes to ensure patients are receiving the right services from the right providers for optimal clinical outcomes with minimized cost. Care Navigation products range from software-only solutions that enable existing care teams through services including teams of patient-facing care coordinators. Companies that provide Care Navigation services often also provide Network Designservices.

Criteria:

  • Software or services oriented around impacting referrals

  • Products that enable greater price and quality transparency for patients and referring providers.

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Company Info
Founded: 2020
Headcount: 11-50
Customers
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System, Health Plan, Employers, Government
Product Overview
The Denniston Data Provider Ranking System ranks healthcare providers based on data such as procedure volume and geographic comparisons. It helps users identify high-volume, experienced providers for specific procedures and make informed decisions within a given area. The system uses transparent grading criteria based on provider experience and other relevant metrics.
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Ribbon

Ribbon

Company Info
Founded: 2016
Headcount: 51-200
Customers
Verified Customers: 1
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System, Health Plan
Product Overview
2 Reviews
Security and Compliance Certifications: SOC 2 Type 2, SOC 2 Type 1, HIPAA
Ribbon Health offers a healthcare data platform that consolidates provider information, including location, insurance coverage, cost, quality, and experience, to improve care decision-making. It integrates with existing systems, offering automation and data management solutions to maintain accurate provider directories and support informed healthcare decisions.
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Amino Health

Amino Health

Company Info
Founded: 2013
Headcount: 51-200
Customers
Verified Customers: 1
Customers Served: Employers, Health Plan
Product Overview
Security and Compliance Certifications: HITRUST CSF, SOC 2 Type 1, HIPAA
Amino Health provides a digital platform that helps members make informed healthcare decisions by guiding them to cost-effective, high-quality care options. It integrates with existing health solutions to enhance engagement and reduce unnecessary healthcare spending. Amino Health is used by self-insured employers, health plans, third-party administrators, brokers, and HR technology providers to improve health outcomes and ensure plan members receive the right care at the right time.
Care Continuity logo
Care Continuity

Care Continuity

Company Info
Founded: 2014
Customers
Customers Served: Hospital / Health System
Product Overview
Security and Compliance Certifications: HITRUST R2, HIPAA
Care Continuity offers a cloud-based platform focused on patient navigation and care coordination. Their services include an Emergency Discharge Program to ensure timely follow-up care, Inpatient Discharge Services, High Touch Care Management Support and Referrals Workflow to improve care continuity within provider networks.
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CareJourney

CareJourney

Company Info
Founded: 2014
Headcount: 51-200
Customers
Verified Customers: 1
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System, Health Plan, Life Sciences
Product Overview
Security and Compliance Certifications: HITRUST CSF
CareJourney is a healthcare analytics platform that specializes in offering pre-packaged claims data alongside data integration capabilities. The platform features advanced tools for benchmarking physician performance, providing insights into cost, quality, referral patterns, and patient volume. CareJourney provides analytics for patient segmentation and other value-based care models, helping organizations adapt to evolving payment structures.
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Conifer Health Solutions

Conifer Health Solutions

Company Info
Founded: 2008
Headcount: 5001-10000
Customers
Customers Served: Ambulatory Practice, Hospital / Health System, Health Plan, Risk-Bearing Providers
Product Overview
Conifer Health Solutions provides revenue cycle management services and value-based care solutions for health systems, provider groups and employers to improve financial outcomes. Conifer’s value-based care solutions include data and analytics tools to support population health management, risk analysis and outcome measurement. They also offer care navigation, care management and utilization management services provided by registered nurses. Conifer Health Solutions is a subsidiary of Tenet Healthcare Corporation.
Company Info
Founded: 2017
Headcount: 51-200
Customers
Customers Served: Health Plan, Employers
Product Overview
Security and Compliance Certifications: HITRUST CSF, HIPAA
Embold Health is a provider data and analytics company that specializes in assessing physician performance. Embold evaluates physician adherence to evidence-based medicine, patient outcomes, and cost-effectiveness. They are primarily used by employers and health plans for network design and care navigation tools and services. Additionally, they offer provider engagement tools to provide feedback to physicians on value-based care performance.
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Garner Health

Garner Health

Company Info
Founded: 2019
Headcount: 51-200
Customers
Customers Served: Digital Health Provider, Ambulatory Practice, Employers, Health Plan, Risk-Bearing Providers
Product Overview
Security and Compliance Certifications: SOC 2 Type 2
Garner Health uses a claims database with over 60 billion records from 320 million patients to identify healthcare provider quality for use in care navigation. They offer products for care navigation, as well as the dataset for use in other applications.
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Health Cost Labs

Health Cost Labs

Company Info
Headcount: 1-10
Product Overview
Health Cost Labs offers a data-driven platform that provides access to comprehensive healthcare cost information. It features a cost comparison tool mandated by the 2021 Consolidated Appropriations Act, which helps users identify the most affordable providers. The platform is used by employers, health plans, hospitals, and consumers. Subscriptions to these rates are available to a variety of stakeholders, including brokers and self-funded businesses.
Pager Health logo
Pager Health

Pager Health

Company Info
Founded: 2014
Headcount: 51-200
Customers
Customers Served: Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
Pager Health is a virtual care platform that brings together care and service teams, allowing for unified communication with consumers. It offers a cloud-based Command Center that supports chat, voice, and video interactions to assist members in making health and benefits decisions.
Company Info
Founded: 2000
Headcount: 1001-5000
Customers
Customers Served: Hospital / Health System, Risk-Bearing Providers
Product Overview
Security and Compliance Certifications: HIPAA, ONC Health IT (2015 Edition)
PointClickCare’s solutions for hospitals and risk-bearing providers support effective care navigation and coordination to facilitate transitions of care from acute to post-acute settings. PointClickCare PAC Network Management is a data exchange platform that facilitates clinical data sharing between hospitals and risk-bearing providers with post-acute partners. PointClickCare Intelligent Transitions is a data and analytics platform for hospital case managers to support care collaboration and monitoring of post-acute outcomes through insights such as encounter notifications and predictive readmission scoring.
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ReferWell

Referwell

Company Info
Founded: 2015
Headcount: 51-200
Customers
Customers Served: Ambulatory Practice, Health Plan, Risk-Bearing Providers, Hospital / Health System
Product Overview
Security and Compliance Certifications: HITRUST CSF, HIPAA
Referwell is a care coordination platform that facilitates patient referral processes for health plans and health systems. Referwell enables booking during the referral process to improve follow through and offers data sharing infrastructure to support care team coordination. Referwell’s analytics and reporting systems help health plans and providers operating in value-based structures monitor quality and value-based care performance outcomes.
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Strata Health

Strata Health

Company Info
Founded: 2012
Headcount: 11-50
Customers
Verified Customers: 12
Customers Served: Ambulatory Practice, Hospital / Health System
Product Overview
Strata Health offers a comprehensive transitions of care management platform designed to optimize patient flow and enhance care coordination. Its software uses real-time data and intelligent algorithms to match patients with the most appropriate post-acute care providers. The platform supports case managers by automating the referral process, managing provider networks, and ensuring compliance with patient choice regulations. It also features integrated patient-facing tools for better communication and data sharing among all parties involved in the care transition.