How Sana Benefits Scaled Care Navigation with AI-Native Provider Intelligence
As Sana scaled its care navigation model, fragmented provider data slowed referrals and limited growth.
Executive Summary
Sana Benefits is a health plan and care delivery company serving small and mid-sized employers. In addition to offering level-funded employer-sponsored health plans, Sana operates Sana Care, an integrated model that combines primary care, care navigation, and a curated network of high-quality providers.
Accurate, reliable provider data is foundational to this model, enabling care navigators to confidently guide members to the right care. As Sana scaled, provider data fragmentation became a limiting factor, forcing care teams to verify information across disconnected systems and slowing referrals.
These challenges were not unique to Sana. Provider data accuracy is a well-documented industry-wide problem, with average accuracy rates hovering around 50–55% across the healthcare ecosystem due to fragmented data ownership, infrequent updates, and inconsistent standards across payers, vendors, and provider organizations.
By partnering with Candor Health, Sana replaced 13 disparate provider data sources with a single, AI-native provider intelligence platform. Candor continuously validates and enriches provider data in real time, giving Sana a trusted, unified view of its provider network and enabling faster, more reliable care navigation at scale.
Challenge: Fragmented Data Slowed Care
Before Candor, Sana tried multiple other methods for continuous data validation, including other vendors, but provider specialties, locations, affiliations, and network participation data were often inaccurate. As a result, the Care Navigation team depended on a patchwork of internal tools, spreadsheets, and external platforms to piece together usable information.
“There was no single source of truth,” said Dr. Courtney Scanlon, Senior Medical Director at Sana Benefits. “We were using up to 13 different platforms to try to find options for our members, and we really could not trust the data.”
Because Sana's care navigation model emphasizes concierge-level support, navigators manually verified provider details for nearly every referral. This meant multiple phone calls and cross-checks before presenting options to members. Completing a single referral routinely took around two hours, sometimes longer.
We could not provide the level of service members expected because we were always chasing data.
The impact extended beyond internal workflows. Sana's self-service provider directory relied on the same flawed data, leading members to encounter incorrect specialties or outdated practice locations. As care navigation became a more prominent member benefit, demand increased, and the cracks in the system widened.
“It wasn't sustainable or scalable,” Dr. Scanlon explained. “We knew we couldn't continue to grow volume while relying on manual workarounds and unreliable information.”
Solution: A Unified Source of Real-time Provider Data
Sana sought a partner with a fundamentally new approach to provider data. The team needed a single, accurate data source that could support care navigation, network operations, and member-facing tools. Given the importance of accurate provider data to the Sana member experience, Sana defined clear requirements and designed a rigorous, cross-functional evaluation process.
Care Navigation, Network Operations, Product, Engineering, and executive leadership all participated. Sana completed a two-week trial, conducted a thorough provider accuracy validation, reviewed mockups built from Sana's own data, and spoke directly with an existing Candor client.
Candor's approach differed from prior solutions in a critical way. Rather than relying primarily on historical claims data or static directories, Candor used AI to maintain a living provider intelligence graph. Provider data was continuously validated across thousands of sources, and claims were used to understand clinical expertise, not infer accuracy.
“What stood out was their consistency and their willingness to prove it. As we raised more complex challenges, they were transparent and confident in their answers.”
That approach helped Sana move past the assumption that provider data accuracy was an unsolved problem and embrace a system that could be trusted for day-to-day care navigation decisions. “A lot of people accept that this is just hard and no one really fixes it,” Dr. Scanlon noted. “Candor did not accept that.”
Implementation: Replacing 13 Systems with One Platform
Once Sana selected Candor, implementation started quickly. The teams met weekly and worked closely across product and engineering. Within a few months, Care Navigation fully transitioned to Candor, replacing all 13 previous provider data sources with a single platform used for daily workflows.
“Candor is now our source of truth. It is the one platform our team relies on.”
Candor also integrated directly into Sana's Provider Directory tool, replacing the prior API integration easily without disruption. Product and engineering teams described the integration as seamless, with immediate improvements in data reliability for members.
Network Operations benefited as well. Previously, the team spent hours standardizing provider rosters received in inconsistent formats. With Candor, rosters are automatically uploaded and standardized in less than five minutes, significantly reducing manual effort.
Results: Faster Care, Better Utilization, and Scalable Growth
Care Navigation Efficiency
With clean, validated provider data, improvements were immediate and measurable. Sana conducted a manual timing exercise before and after implementation. Average referral processing time dropped from roughly two hours to under one, representing a 50% efficiency gain. “That was actually more than we expected,” Dr. Scanlon said.
These gains allowed Sana to increase care navigation volume by more than 50% without adding staff, while continuing to meet service-level agreements. Navigators were able to spend more time supporting members instead of verifying data.
Candor has become an invaluable tool in our provider search process. A rheumatology referral in Orlando that would have taken hours with our previous system was scheduled in under an hour. In Seattle, Candor helped me identify multiple options within 15 miles, confirm participation, and complete the referral quickly. The process is fast, reliable, and lets us focus on the member experience.
Network Utilization and Member Experience
Provider recommendations improved significantly. With direct contracts and trusted partners clearly surfaced in one place, care navigators could consistently prioritize high-value options. Since implementing Candor, the share of recommendations pointing to directly contracted providers increased from 17% to 53%, driven by having a single, accurate search tool that reliably surfaces Sana's contracted network. At the same time, identification of high-value provider options increased from approximately 45% to over 75%, allowing care navigators to consistently prioritize quality, cost-effective care.
Since implementation, Sana has also seen a sharp reduction in member concerns related to inaccurate provider information in the self-service portal. More reliable data improved trust and reduced friction for members navigating care on their own.
As Dr. Scanlon summarized, “Having one accurate search tool changed everything. We can reliably surface our contracted providers and identify high-value options in a way we simply could not before.”
Scaling Without Added Headcount
As referral volume grew by more than 50%, Sana maintained service levels without expanding the Care Navigation team. They eliminated internal workarounds, and teams operated more efficiently across care navigation and network operations.
Foundation for the Future
Beyond operational gains, Candor has given Sana confidence to move toward more advanced, automated care navigation models. “AI is only as good as the underlying data,” Dr. Scanlon said. “Solving provider data accuracy was the essential first step.”
Accurate, continuously validated provider data enriched with clinical expertise and plan-specific network intelligence is a prerequisite for any agentic care navigation system, but Sana's leadership views this as more than just an operational requirement. By solving provider data accuracy at the foundation, Candor has provided a strategic lever for scaling care navigation across plans, networks, and member populations without expanding care coordination teams.
Members consistently rate the Sana Care experience highly, driven by strong relationships with providers and a care navigation team that functions as an extension of the clinical care team itself. Looking ahead, Sana will be offering Sana Care alongside care navigation even for individuals who are not enrolled in a Sana benefits plan. While delivering navigation across multiple plans and networks introduces significant complexity, Sana believes this is something that could be thoughtfully scaled over time, particularly with Candor's ability to address provider data accuracy and fragmentation at the foundation.
What began as a solution to a workflow bottleneck has become a strategic foundation. Sana's leadership now points to the Candor evaluation and rollout as a model for how to assess and adopt critical technology partners.
“If a peer asked me about Candor, I would say they have been an exceptional partner. They solved our provider data accuracy issue in a way I have never seen before, and they delivered consistently on every commitment.”