How Castlight supports clinical advocacy in healthcare

“Advocacy” is a term that gets thrown around a lot in healthcare—and depending on who you ask, it might involve helping patients navigate complex systems, speaking up for underserved populations, or pushing for policy change. It’s a word with many interpretations and many players, which is why we think defining it is all the more important

We’ve asked ourselves: If advocacy can mean different things to different people, how do we clearly define advocacy and serve as advocates for our members?

Redefining advocacy in clinical healthcare

At Castlight Health, we’re redefining what advocacy looks like—and making it clear how Castlight’s navigation and advocacy solutions support both members and benefits leaders with impactful, personalized, and evidence-based care.

When we talk about “advocacy” services, we’re really talking about our Castlight Care Guides—real people who become trusted partners in our members’ healthcare navigation journeys. While Castlight provides industry-leading digital healthcare navigation, members have the option of engaging with a real human for extra guidance when self-service isn’t enough. Think of Care Guides as a key human component in the care loop—someone to help members close the gap between understanding their benefits, making complex care decisions, and taking meaningful action in their healthcare journey.

Castlight Care Guides come from a wide range of backgrounds: billing specialists, social workers, transcriptionists, and even clinicians. They provide personalized support based on each member’s needs—whether that’s understanding an Explanation of Benefits (EOB) or  finding care for a new or ongoing condition.—so members aren’t stuck trying to figure things out or advocate for themselves alone.

Two levels of advocacy support

Castlight offers two levels of advocacy support in our base offering:

1: Navigation and Advocacy 

A key part of Castlight’s core solution, Care Guides advocate for members. This isn’t just about providing information—it’s about removing confusion and friction throughout a member’s healthcare journey, addressing social determinants of health (SDoH), and helping people take the next right step for their health.

This level of support provides:

• Benefits education: Helping members understand coverage, costs, and what’s in-network.
• Billing and claims support: Resolving disputes and decoding statements.
• Primary care physician connection: If a member doesn’t have a PCP, we’ll not only recommend one based on their needs and preferences—we’ll book the appointment for them.
• Gap closure: When addressing a member’s immediate questions, Care Guides actively look for the next best actions—such as ensuring the member is up to date on preventive screenings or managing a chronic condition.
• Community support: Care Guides go the extra mile to connect members to vital community services like food banks, transportation services, and other social resources for maintaining a healthy lifestyle.

2: Navigation and Clinical Advocacy

In our enhanced core solution, members have access to both Care Guides and Clinical Care Guides. Clinical Care Guides are licensed RNs in all 50 states who can step in when medical guidance is needed. With this clinical safety net, members who need more than just navigation can seamlessly access immediate, compassionate, and qualified support.

This level of support provides:

• RN triage: For issues ranging from sore throats to mental health crises, our RNs provide timely clinical services in a compliant manner.
• Follow-up care: Every clinical escalation gets a 48-hour follow-up to make sure the member is improving once they receive care.
• Chronic care management: Members get clinical support managing chronic conditions like diabetes, hypertension, asthma, and more—with specialist referrals and medication remediation.
• Post-discharge outreach: Care Guides clarify discharge plans, coordinate referrals, and help prevent unnecessary ER visits.
• Behavioral health support: When mental health concerns surface, our RNs dig deeper and ensure members are connected to the right care at the right time.

Why should benefits leaders care about clinical advocacy in healthcare?

The right advocacy model doesn’t just support members—it delivers measurable value for organizations:

Reduced avoidable ER visits: By connecting members to the right care at the right time, we help reduce overuse of costly emergency services. 

Smarter referrals: When a member needs imaging or specialty care, we guide them toward high-quality, lower-cost providers. For example, choosing a community imaging center over a hospital MRI can save thousands per scan.

Improved experience and engagement: With Castlight, members feel cared for and confident in their decisions—which boosts satisfaction and, ultimately, retention.

System navigation with real follow-through: Unlike solutions that give members a list of providers and leave the rest up to them, Castlight closes the loop—whether that means booking the appointment or following up post-triage.

What to look for in an advocacy solution

If you’re evaluating vendors or upgrading your approach, prioritize these features and benefits:

• Full-scope service: From digital navigation to live RN support, members should be met with the level of help they need, exactly when they need it.
• Seamless partner and service integration: One platform, one sign-on, one experience—Castlight ties together ecosystem partners and services so members don’t get lost in the shuffle.
• True follow-through: It’s not enough to give a phone number or list of care providers. Your members need a solution that actually helps them take timely action for the best health outcomes.
• Genuine care: No time limits. No shortcuts. Just thoughtful, human-centered support from people who genuinely want to make a difference.

Clinical advocacy that means something

At Castlight, advocacy isn’t a buzzword—it’s a promise. It’s our commitment to guiding members with empathy, helping them take smart next steps, and delivering outcomes that matter to individuals and organizations alike.

As the healthcare landscape continues to evolve, one thing stays the same: our people are the difference. And we believe that when healthcare guidance is grounded in compassion, the results speak for themselves.

An internal study found:

• $33.83 decrease in monthly spending over six months following members’ first interaction with a Care Guide
• 55.67% reduction in avoidable ER visits per month when receiving support from a Care Guide*

Want to see what advocacy should look like?

Request a demo today to find out how Castlight’s advocacy solutions support members with compassion, clarity, and follow-through.

*Source: Castlight Health internal study, 2024