Electronic Health Reporter

Grand Rounds announces the launch of Premium Navigation, Grand Rounds’ population health solution that simplifies the healthcare experience by providing one place to go for all healthcare needs—clinical and beyond. In addition to comprehensive care management, Premium Navigation can replace traditional health insurance member services to give users a single entry point to access all employer-sponsored benefits.

Premium Navigation helps employers improve health outcomes and reduce costs by guiding employees to high-quality, personalized care throughout their entire healthcare journey. This encompasses everything from connecting members with a multidisciplinary clinical care team for acute case management, to guidance around clinically appropriate benefits and claims advocacy support.

Within Premium Navigation, members also have access to Grand Rounds’ Connected Care Program (CCP), a physician-led, comprehensive care management program that integrates traditional care and case management for those with complex health needs who face an array of health challenges. Grand Rounds’ PhD level team of data scientists continuously work alongside the clinical team to build CCP’s predictive models, which identify the members who need help.

“We know that a member’s non-clinical needs—financial, administrative, etc.—often dictate how they will address their clinical need, if they engage at all,” said Dr. Ami Parekh, chief medical officer at Grand Rounds. “That’s why our model is built on the idea that we have to meet the member where they are and help with their main concern which, at times, may be managing the financial or administrative burdens of the healthcare system. By first earning their trust, we can help members manage their ongoing medical needs. This comprehensive care approach allows us to deliver more personalized and impactful care that will lower unnecessary emergency department visits and inpatient hospitalizations and raise the standard of care for an entire population.”

Consistent, clinician-led teams coordinate personalized care plans for members within CCP in several key stages to help change the trajectory of an individual’s healthcare journey. Using actionable data, predictive models identify members at critical health moments (ex. emergency room visits) and which of those members have the greatest potential for health improvement outcomes.

The care team then engages those individuals via outbound calls or messaging, connecting the member with a clinician to develop a longitudinal care plan that meets the member where they are. The Grand Rounds clinical team, alongside the member’s local physician, then help implement that plan through education, medical advice and coordination of other services or care.

“In working with our clients and members, it became clear that many people need much higher levels of support than what is offered by traditional health insurance member services. We must all do more to simplify healthcare access and put the individual and their goals at the center of care,” said Nupur Srivastava, senior vice president of product for Grand Rounds. “Since day-one, Grand Rounds has always put members first and it became clear there is a huge need for integration across longitudinal care management and acute case management programs. Taking what we learned from treating complex patients over the years, we built this new solution for the total population, accessible via web, mobile app or a phone call.”

As of January 1, 2020, Walmart employees in North Carolina and South Carolina on all medical plans have access to Grand Rounds Premium Navigation. Grand Rounds serves as a personal healthcare assistant for those members, addressing health needs such as billing and appointments, understanding a complex medical diagnosis, or utilizing the network to find in-network physicians that provide high-quality care.

Grand Rounds serves over five million members across more than 130 employers.