Why Better Navigation May Matter More Than Adding More Benefits
Employers put enormous effort into building competitive benefit programs. They negotiate medical plans, evaluate pharmacy strategies, add wellness resources, expand behavioral health support and introduce new programs designed to improve employee health.
But there is another question worth asking:
When an employee actually needs help, can they figure out what to do next?
That question is becoming increasingly important as benefit programs grow more sophisticated. An employee may have access to excellent coverage and valuable resources but still struggle to find an appropriate provider, determine whether a service is covered, understand where to go for care or resolve a claim that does not look right.
In those moments, the challenge is no longer simply benefits education. It’s benefits navigation.
And improving navigation may be one of the most practical ways employers can increase the value of benefits they already provide.
The Gap Between Having a Benefit and Using It
Consider an employee who develops persistent back pain.
Depending on the employer’s benefit program, that employee might have access to a primary care physician, urgent care, telehealth, physical therapy, an orthopedic specialist, a musculoskeletal program or even a center of excellence.
Having choices is valuable.
Figuring out which choice makes sense can be considerably harder.
The employee may wonder whether a referral is required, which providers participate in the network, how much different options will cost and whether a specialized program offered through the employer is appropriate.
Faced with too many questions, employees may choose the most familiar option, choose a more expensive option than necessary or postpone care altogether.
That is where navigation can change the experience.
Instead of expecting employees to become experts in their health plan, effective navigation helps them answer the practical questions standing between a health concern and appropriate care.
Navigation Is Becoming a Benefits Strategy
Employers increasingly recognize that helping people reach the right care can be just as important as adding another benefit to the package.
The Business Group on Health’s 2026 Employer Health Care Strategy Survey found that 82% of responding employers identified navigation to higher-quality sites of care as an action that could meaningfully improve quality. Improved transparency around quality was also cited by 82%, while 79% pointed to better coordination of integrated care teams.
Those priorities share an important theme: employers are looking beyond what the health plan covers and focusing more closely on how employees move through the healthcare system.
That matters as employers continue searching for ways to improve quality while controlling rising healthcare costs.
Where Employees Commonly Get Stuck
Navigation problems rarely begin because an employee does not care about their benefits. More often, the healthcare system simply asks people to make complicated decisions at inconvenient times.
An employee might need to:
- Determine whether a physician or facility is in-network
- Find a specialist accepting new patients
- Understand why a claim was denied
- Compare potential sites of care
- Locate an appropriate behavioral health provider
- Determine whether prior authorization is required
- Understand the difference between urgent care, an emergency room and other available options
- Find the right person to call when something goes wrong
These are not necessarily questions employees think about during open enrollment.
They arise on a Tuesday afternoon when a child is sick, after an unexpected medical bill arrives or when someone has just received a diagnosis and is trying to understand what comes next.
At that point, another benefits brochure may not be the answer. The employee needs a clear path forward.
BENEFITS NAVIGATION: FOUR QUESTIONS TO ASK
- Do employees know where to start?
There should be an obvious first stop when someone has a benefits or healthcare question. - Can they get help from a person?
Digital tools are valuable, but complicated claims, coverage questions and care decisions may require individual assistance. - Are employees being directed to value, not just availability?
Navigation should help members consider quality, network participation, appropriate sites of care and cost when possible. - What happens when the issue isn’t resolved immediately?
Effective advocacy includes follow-up rather than leaving the employee to restart the process with another phone call.
The “Front Door” Matters
One of the biggest challenges in modern benefit programs is fragmentation.
Employers may offer separate resources for medical care, pharmacy benefits, behavioral health, wellness programs, chronic-condition management, telehealth and other services. Each may be worthwhile individually, but employees can be left wondering which door they are supposed to enter.
A better approach is to create an easily identifiable starting point.
That could be a benefits portal, navigation service, advocacy team or combination of technology and personal support. The specific model may differ by organization, but the objective is the same: reduce the number of steps employees must take before reaching the right resource.
The U.S. Department of Health and Human Services has increasingly emphasized this concept through organizational health literacy, which focuses not only on an individual’s ability to understand health information but also on how effectively organizations enable people to find, understand and use information and services.
In other words, complexity should not automatically become the employee’s problem.
Navigation Can Also Be a Cost Strategy
Better navigation is not simply an employee-experience initiative.
Where employees receive care can have a significant effect on what both the employee and the health plan ultimately pay.
Helping someone locate an appropriate in-network provider, understand alternatives to a higher-cost setting or access preventive and primary care earlier may help avoid unnecessary spending. Better guidance can also connect employees with existing programs that employers are already paying for but that employees may otherwise overlook.
For employers facing continued healthcare cost pressure, that creates an important shift in perspective.
Before adding another solution, ask whether employees are fully utilizing the solutions already available.
Sometimes the opportunity is not another benefit.
It is a better road map.
Technology Helps. Human Support Still Matters.
Digital tools have dramatically improved employees’ ability to access benefit information. Provider searches, cost-comparison tools, benefit portals and mobile applications can make routine questions much easier to resolve.
But healthcare is not always routine.
A disputed claim, complex diagnosis or difficulty locating appropriate care may require someone who understands the benefit program and can help untangle the issue.
That is why an effective navigation strategy should consider both technology and human support.
MSI Benefits Group’s Member Advocacy services, for example, provide employees with live assistance for issues including claims, coverage questions, provider outreach and billing concerns, with follow-up on unresolved matters. MSI’s Enrollment and Eligibility services also combine technology with personalized support to help employees understand and manage their benefit choices.
The goal is not to replace technology with people or people with technology. It is to make sure employees have the right kind of help for the problem in front of them.
Measure Whether Benefits Are Usable, Not Just Available
Employers routinely evaluate premiums, claims, participation rates and utilization. Navigation adds another useful lens.
Where are employees encountering friction?
What types of questions generate the most requests for assistance? Are particular claims issues appearing repeatedly? Are employees struggling to locate certain types of providers? Are valuable programs consistently underutilized?
Those patterns can reveal opportunities that may not be obvious from plan design alone.
They can also help employers and their benefits advisors determine where better communication, vendor coordination, advocacy or plan changes could improve the employee experience.
Make the Benefits You Already Have Work Harder
A competitive benefits package remains an important tool for recruiting, retaining and supporting employees. But adding programs year after year does not necessarily make a benefits strategy stronger.
Sometimes simplicity creates more value than expansion.
Employees should not need a working knowledge of healthcare administration to use their health plan effectively. They need clear information, an obvious place to begin and knowledgeable support when the situation becomes complicated.
Employers that make benefits easier to navigate can help employees reach appropriate care, reduce frustration and potentially make better use of healthcare dollars already being spent.
Before asking what benefit to add next, it may be worth asking a simpler question: How easy is it for our employees to use the benefits they already have?
Helping Employees Find the Right Path
MSI Benefits Group helps employers build benefit programs around more than coverage alone. Through benefits consulting, enrollment support, technology and personalized Member Advocacy, MSI helps employees understand their options and navigate benefit and healthcare issues throughout the year.
If your organization is looking for ways to reduce friction, improve the employee experience and get more value from your existing benefits program, contact MSI Benefits Group to start the conversation.
External Resource:
For additional insight into employer strategies for improving healthcare quality and navigation, visit the Business Group on Health 2026 Employer Health Care Strategy Survey.