Quantum Health Introduces Expanded Solution Suite Built on a New Agentic AI Platform

New platform combines agentic AI, clinically validated provider steerage, and human-led coordination to drive action and accountability across healthcare

DUBLIN, Ohio--(BUSINESS WIRE)--Quantum Health, the leading healthcare navigation company, today announced the launch of an expanded solution suite built on a new agentic healthcare technology platform designed to deliver the most efficient, personal and effective healthcare experience for employers and their employees.

Agentic AI refers to intelligent systems that don’t just answer questions, but initiate actions, coordinate workflows, and ensure follow-through across people and systems. At Quantum Health, this technology is paired with trusted human support to guide care decisions, reduce friction, and deliver measurable clinical and financial outcomes.

Unlike traditional tools that primarily respond to individual requests, Quantum Health’s platform proactively identifies risk, initiates timely interventions, and connects digital guidance with human expertise, ensuring members receive high-quality care and the right support at the right time. Individual AI agents are deployed across the platform to focus on capabilities such as:

• Detecting emerging clinical risk before claims are incurred
• Automatically initiating outreach and intervention
• Recommending high-quality providers, facilities and other point solutions relevant to the member’s situation
• Scheduling appointments with providers
• Managing provider communication and coordination
• Estimating costs for upcoming procedures or surgeries
• Resolving billing and claims issues

The new solution suite marks the next phase of Quantum Health’s evolution, giving self-funded employers more flexibility in how they deploy healthcare navigation while ensuring every member interaction, whether digital or human, is connected to a broader system of coordinated care, clinical governance, and accountability.

“The traditional healthcare models fail people every day, not because they make bad choices, but because the system gives them no chance to make the right ones. Poor-quality providers, conflicting guidance, and zero coordination create avoidable harm. Our agentic platform changes that by intervening early, steering members to top-performing providers, and ensuring nothing falls through the cracks. When a moment requires judgment, advocacy, or compassion, our Care Coordinators and clinicians step in. This is the accountability and human support the healthcare system has been missing,” said Dayne Williams, Chief Executive Officer of Quantum Health.

Three Flexible Solutions Designed to Meet Employers Where They Are

Building on more than two decades of category-defining leadership in healthcare navigation, Quantum Health is expanding from a single flagship offering to a flexible suite of three solutions. Each solution deploys the platform’s capabilities at a level of depth and clinical integration aligned to the employer’s strategy. The expanded solution suite includes:

• Quantum Signature: Quantum Health’s most comprehensive offering, delivering the highest level of clinical integration, provider engagement and return on investment.
• Quantum Flex: A configurable solution that allows employers to select capabilities that align with their benefits strategy, budget and timeline.
• Embold Plus: An easy-to-implement entry point to healthcare navigation that provides members with clear digital guidance and access to Care Coordinators when needed.

Each solution features a new digital member experience that uses agentic AI to guide members through their healthcare journeys and access the highest quality providers for their needs.

A New Member Experience Built on Agentic AI

Central to all three solutions is Quantum Health’s next-generation digital member experience. The experience features always-on agentic AI capabilities that understand each member’s benefits, health history and prior interactions, helping them evaluate options, complete tasks, and seamlessly access human support when needed.

Quantum Health’s agentic AI maintains continuity between digital guidance and human support, and goes beyond answering questions and completing simple tasks. Modeled after the expertise and workflows of Quantum Health Care Coordinators, the experience allows members to use voice or text to select high-quality providers, schedule appointments, estimate costs for upcoming procedures or surgeries, resolve billing issues and take the right next step with confidence.

Early results are promising, with many member requests now addressed in real time by AI agents supporting benefits, eligibility, claims and billing workflows, allowing Quantum Health’s Care Coordinators and clinicians to focus on higher-acuity needs and moments that require personal advocacy. Members benefit from:

• Personalized, guided care across providers, virtual care, Centers of Excellence, and point solutions
• Clear explanations of claims and benefits, including what to pay and why
• Real-time visibility into healthcare costs and savings opportunities
• A consolidated view of health information, preventive screenings, and medications

Advancing Provider Steerage Through Embold Health and AI

The new platform and member experience fully integrate technology from Quantum Health’s 2025 acquisition of Embold Health, embedding peer-reviewed, clinically validated provider quality insights directly into member and care team workflows.

With Embold integrated, Quantum Health becomes the system of record for provider quality decisions, strengthening provider steerage while improving outcomes and managing healthcare spend. Embold’s AI-powered technology operates within the company’s HITRUST r2 Certified systems, reflecting the highest standards of security, privacy and compliance.

Putting Predictive Analytics to Work to Improve Outcomes

Building on Quantum Health’s recently launched Action to Impact reporting, the platform deploys intelligent agents that analyze client data, map member journeys, identify high-cost claimants, and forecast future risk to provide HR teams with clear, prioritized recommendations. These agents continuously compare performance against relevant benchmarks, translating complex trends into practical guidance that employers can act on with confidence.

Quantum Health is the only solution that enables agents to communicate directly with one another, allowing seamless integration of engagement and outcomes data from point solution partners through secure, agent-to-agent collaboration. The result is a more complete, connected view of member behavior and program impact that turns insight into action faster, and drives measurable outcomes for employers and their members.

“Since partnering with Quantum Health for healthcare navigation, we’re not seeing the big year-over-year cost increases other employers are facing. What we are seeing is more engaged, productive employees. Keeping our teams focused is important, and Quantum Health removes the barriers that get in the way so our people can do their best work,” said Michelle Johnson, Senior Director of Total Rewards and HR Operations at MAG Aerospace.

A New Alternative to Traditional Health Plan Offerings

Also available in the solution suite is a new option that works together with traditional health products to simplify the member’s healthcare experience. Powered by Embold Health’s clinically validated provider quality analytics, the solution aligns benefit design, financial incentives, and digital guidance to guide members toward the highest-performing providers and facilities.

It complements any existing carrier, TPA, or network, guiding members to clinically sound, high-value care without requiring plan redesigns, network disruption, or complex operational lift. Unlike other models, the solution is designed to drive impact across an employer’s full population, enabling meaningful cost savings and improved outcomes for both employers and members.

An Evolution of the Brand

Alongside the new solutions, Quantum Health is unveiling an updated brand identity that reflects the company’s evolution and momentum. The refreshed look reinforces Quantum Health’s legacy of leadership while signaling its continued focus on innovation, technology, and a more connected member experience.

About Quantum Health

Quantum Health’s flexible suite of solutions sets the standard for healthcare navigation, simplifying care journeys, improving outcomes and controlling rising costs for organizations of all sizes. Quantum Health provides more than 8 million members with a single point of contact throughout the full journey, delivering compassionate guidance and clinical expertise enhanced by predictive AI based on 26 years of proprietary consumer healthcare data.

In 2025, Quantum Health acquired leading healthcare technology company Embold Health, further strengthening its AI and provider search capabilities to guide members to the right care. Only Quantum Health engages continuously with providers to take immediate action at a member’s first moment of need, ensuring healthier members, more productive employees and smarter healthcare spending.

To learn more, visit quantum-health.com.