Solutions
Healthcare Providers
FHIR-native eligibility and enrollment embedded in clinical workflows, closed-loop referral tracking, and the social care infrastructure to address what happens outside the clinic door.
Patients Bring More Than Their Diagnoses
Every patient who walks through the door carries a full life outside the clinic — social determinants, childhood and adult traumas, and extraordinary resilience. Healthcare providers across every setting are increasingly expected to screen for and address those social factors as part of care. But the systems, workflows, and reimbursement infrastructure to do that well are still catching up.
Navigator360 bridges that gap — connecting clinical workflows to the social care infrastructure that exists in every community, and building the documentation and billing foundation so that cross-sector care coordination is sustainable, not just aspirational.
Hospitals
The Challenge
Uncompensated Care Costs
Hospitals absorb significant uncompensated care costs from patients who lack insurance coverage or cannot afford out-of-pocket costs. These costs strain hospital finances and resources, limiting their capacity to provide high-quality care to all patients.
Transition to Value-Based Care
The shift from fee-for-service to value-based care models requires hospitals to demonstrate improved patient outcomes and cost efficiencies. Many hospitals struggle with the complexity of managing patient populations, coordinating care across multiple providers, and integrating social determinants of health into their care strategies.
Opportunity
Navigator360 helps hospitals improve patient outcomes and reduce uncompensated care costs by addressing social determinants of health. By identifying and addressing social factors that contribute to uncompensated care — such as lack of insurance coverage or inability to afford medications — Navigator360 helps hospitals reduce these costs while improving patient outcomes and strengthening their position in value-based care models.
Federally Qualified Health Centers
The Challenge
Medicaid and Medicare Budget Sensitivity
FQHCs heavily rely on Medicaid and Medicare reimbursements and are highly sensitive to any cuts or changes in these programs. Budget constraints limit their capacity to invest in new technologies and services, creating barriers to adopting the infrastructure needed for modern care coordination.
Post-Pandemic Medicaid Unwinding
The COVID-19 pandemic led to temporary expansions of Medicaid coverage. As these expansions unwind, FQHCs face the challenge of managing a potential influx of patients losing coverage and needing to navigate re-enrollment processes — all while maintaining service quality for their existing patient population.
Opportunity
Navigator360 can help FQHCs navigate these challenges by providing tools to manage care coordination and social determinants of health — while also creating pathways to accelerate partnerships with hospital systems and managed care organizations. By demonstrating value through improved outcomes and care coordination capabilities, FQHCs can strengthen their position in value-based care contracts and diversify their revenue base.
Long Term Services and Supports (LTSS) & HCBS
The Challenge
Cross-Sector Care Coordination
LTSS providers often work with clients who have complex, multi-domain needs that span healthcare, social services, and government programs. Coordinating care across these sectors requires navigating disparate data systems, communication channels, and eligibility requirements — making seamless care nearly impossible without dedicated infrastructure.
Managing Multi-Domain Client Needs
Clients of LTSS and HCBS providers frequently have overlapping needs across housing, transportation, nutrition, behavioral health, and medical care. Without a unified view of the client and their services, providers cannot coordinate effectively — and clients fall through the gaps between programs.
Opportunity
Navigator360 provides LTSS and HCBS providers with the infrastructure to coordinate care across sectors — comprehensive assessments that capture the full picture of client needs, shared care plans visible to all team members, and direct connections to Medicaid LTSS enrollment workflows. By streamlining cross-sector coordination, providers can reduce administrative burden while improving outcomes for clients with the most complex needs.
Primary Care Providers
The Challenge
Managing Chronic Conditions and SDOH
Primary care providers are on the front lines of managing chronic conditions, which are often exacerbated by social determinants of health. Without tools to systematically screen for and address SDOH, providers can only treat symptoms — not the underlying factors that drive repeated utilization and poor outcomes.
MIPS and Alternative Payment Models
Primary care providers are increasingly evaluated under MIPS (Merit-Based Incentive Payment System) and Alternative Payment Models (APMs). These value-based frameworks require documentation of care coordination activities, social risk screening, and follow-up — exactly the workflows that Navigator360 is built to support and document automatically.
Opportunity
Navigator360 helps primary care providers implement comprehensive care management programs that address both clinical and social needs. By systematically screening for and addressing SDOH, practices can improve chronic disease management, reduce hospitalizations, and generate the quality outcomes data needed to succeed under MIPS and APM frameworks — turning care coordination from a cost center into a revenue driver.
What Navigator360 Delivers
FHIR-Native Integration
Connect directly to your EHR via FHIR R4. Eligibility screening and enrollment workflows embedded in the clinical record — no separate login, no data re-entry.
Closed-Loop Referrals
Every social care referral tracked from initiation to outcome. Care teams know when a referral is accepted, when services are delivered, and when follow-up is needed.
CHI & PIN Medicare Billing
Community Health Integration (CHI) and Principal Illness Navigation (PIN) billing support built directly into Navigator360. Documentation generated automatically as you work.
SDOH Screening
PRAPARE, AHC HRSN, and custom screening tools embedded in clinical workflows. AI-powered analysis surfaces social risk factors and benefit eligibility automatically.
Shared Care Plans
Dynamic care plans shared across the full care network — clinical team, social care organizations, and community partners. One plan, one view, one source of truth.
Eligibility Screening Across 300+ Programs
Screen patients for 300+ government programs in a single workflow — including Medicaid, SNAP, housing assistance, LIHEAP, WIC, and more. One intake. Every benefit the patient qualifies for.
See Navigator360 for Healthcare Providers
We work with hospitals, FQHCs, LTSS providers, and primary care practices to build the social care infrastructure that improves outcomes and unlocks value-based care revenue.
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