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Board hears vendor landscape for care navigation, narrows RFI scope to musculoskeletal, expert opinion and navigation
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Summary
Aon presenters outlined care navigation and care-management models—point solutions, advocacy, concierge and digital platforms—and the board agreed to an RFI focused on musculoskeletal services, expert opinion and navigation options to inform potential procurement and plan integration.
Aon consultants Juan Anderson and Dr. Neil Mills presented care-management best practices and a vendor landscape to the San Francisco Health Service Board, describing a range of navigation models from point solutions to full concierge services and digital engagement platforms.
The presenters organized capabilities into six pillars—member experience, program navigation, provider selection, clinical guidance, appointment support and decision guidance—and mapped vendor examples for each. They described a spectrum of delivery models (live-first support, digital-first hubs, advocacy/carve-outs, and concierge care) and explained tradeoffs between scope and cost.
Why it matters: SFHSS is considering how to integrate navigation and care‑management services with benefit design to improve access, reduce waste and steer members to higher-value providers. The board and staff said the SFHSS all-claims database and the system’s membership size could help prioritize use cases and evaluate vendors.
Key board actions and RFI: The board narrowed the RFI scope to three focus areas—navigation/coordination, musculoskeletal services and expert-opinion/second-opinion capabilities—so staff can learn about the market before issuing an RFP. Presenters warned vendor claims vary widely and urged rigorous evaluation criteria and measurement of clinical evidence.
Public comment and next steps: Public commenters urged accessible advocacy for members and straightforward materials explaining rights and emergency procedures. Staff said they will coordinate with health plans, continue the RFI process, and return with one-page summaries and recommended priorities for pilot testing.
Ending: The item was discussed at length and the board directed staff to use the RFI to narrow procurement options; no contract award or procurement decision was made at the meeting.
