The Geography of Health: How Care Navigation Brings Healthcare Home

If there’s one thing modern medicine has taught us, it’s that healthcare isn’t one-size-fits-all. This is especially true when you consider where someone lives – a key social driver of health. Geography plays a powerful role in shaping access to care, health outcomes, and even life expectancy.  

The Unequal Map of Health 

A recent study published in The Lancet highlights just how stark geographic disparities are. It found in the United States, life expectancy can vary by more than 20 years just depending on the county you live in. These differences are deeply entangled with other social drivers of health like race, income, and access to healthcare. Simply put, where you live can determine how long you live. 

This finding reinforces the idea that a person’s environment is one of the most influential social drivers of health. Where someone lives profoundly shapes how they access care, their ability to manage chronic conditions, and their overall health outcomes.  

For employers, this matters. Geographic health disparities can drive up healthcare costs, lead to inconsistent health outcomes across your workforce, and affect absenteeism and productivity. By recognizing these gaps and implementing solutions like care navigation, employers can help bridge access issues. It’s not just the right thing to do for your people — it’s a smart investment in the health and performance of your business. 

The Urban vs. Rural Divide in Healthcare 

In metropolitan areas, people often have too many choices for where to receive healthcare. Should someone go to the urgent care clinic that’s found on every street corner, or the major health system that sits downtown? This may not sound like a problem, but with dozens of clinics and hospitals available, navigating these choices — figuring out who’s in-network, who provides quality care — is confusing and time-consuming. Another barrier for those living in urban areas is finding a doctor they can see in a timely manner. That’s because the denser the population, the more likely you’re going to have a long wait to see your preferred provider. In fact, one survey found the average wait time for an appointment across six different medical specialties in 15 metro areas is 31 days.  

In contrast, rural populations face a different kind of healthcare barrier: a shortage of care and limited access. Choices for a primary care doctor, specialist, and even a pharmacy may be limited or located hours away, making it harder to stay healthy and get timely treatment. This lack of nearby, reliable care can lead to delayed diagnoses, unmanaged chronic conditions, and preventable health crises. It can also lead to higher costs for employers — individuals who delay preventive medicine are often more expensive for organizations because of costly downstream care. What’s more, employees in rural areas often need to take time off work to travel long distances to receive care, costing both them and their organization time (and money).  

Why Direct Healthcare Works, No Matter Where You Live  

Enter direct healthcare, a solution that allows both urban and rural populations to access the healthcare they need, when they need it. Direct healthcare models are designed to eliminate friction, no matter your location. Through onsite, nearsite, and virtual care delivery, employers and unions can give their people access to preventive care services, same-day appointments, 24/7 care, pharmacy services, including overnight prescription delivery, and wraparound support like behavioral health, occupational health, and care management.  

Care Navigation: Tailored Healthcare by Geography 

As part of an advanced primary care model, care navigation is the bridge between people and the specialty care they need. Care navigation is a referral coordination solution that takes a hands-on approach to helping members seamlessly navigate the healthcare system. Care navigators are there to offer a guided experience for members looking for high-value specialists and facilities. From the moment specialty care becomes necessary, through referral coordination, to receiving that care, and any necessary follow-up, members are never left alone on their health journey. This is true whether they’re receiving care in-person at an onsite or nearsite center, virtually, or in the community.  

How does care navigation support people in completely different geographies? In urban areas, care navigation filters out the noise. It guides members to high-quality, cost-effective providers, reducing wait times by finding specialists who are available, and avoiding unnecessary or duplicative care. For rural areas, care navigation is a lifeline. It helps members identify the highest-quality facility and providers, ensuring every visit counts. Care navigators can also help coordinate virtual care when possible, cutting out the need for a lengthy drive altogether. 

Two Stories of Impact 

Premise Health’s care navigation solution is helping members across the country get the right care at the right time, whether they live in a city of millions or a town of hundreds. Here are two examples of how care navigation at Premise helped address environmental challenges for two unique employers. 

Urban: At a large mortgage lending company based in a major city, Premise implemented its care navigation solution to guide members with better referrals and help them make smarter healthcare choices. By guiding individuals to high-quality, cost-effective providers and away from low-value care, members experienced improved health outcomes and greater ease navigating the healthcare system.  

The impact was measurable: the company saw an average savings of $1,082 per person that worked with care navigation for their referral, totaling an estimated $540,000 in annual savings. Members who engaged with care navigation also spent 13% less year-over-year on outpatient surgeries, in contrast to a 2% increase in spend among those who received care in the community. In just its first year, the care navigation program helped guide half of all referrals to high-quality, cost-effective care. That number continues to grow, showing how powerful personalized support can be in improving outcomes and lowering costs.  

Rural: In northeast Georgia, a food production company with a large, primarily Spanish-speaking workforce, wanted to address the barriers its people were facing when it came to accessing specialty care. Many employees were first-generation Americans unfamiliar with the U.S. healthcare system, making navigation especially difficult. To address this, Premise and the employer added a bilingual care navigator to the onsite wellness center, offering hands-on support with everything from referral coordination to appointment scheduling and record transfers.  

This personalized, culturally competent approach ensured members not only found the right specialists, but also received timely, appropriate care. The results were transformative. In just one year, 69% of referrals were directed to high-value, cost-effective providers, leading to more than $1.2 million in estimated annual savings for the employer. 

It’s important your organization’s direct healthcare solution is designed to flex with the local realities of your unique population, from dense urban environments to remote rural communities. In cities, it means helping people make smarter choices from many options. And in rural areas, it means supporting employees and their families in making the most of limited choices. By using care navigation to meet members where they are — physically, culturally, and medically — we can build a more equitable healthcare system, one tailored solution at a time. 

Learn how Premise can meet your people wherever they are, no matter the ZIP code. Contact us today.