What You Should Know
- Integrated virtual care, navigation, and advocacy leader Included Health announced the official commercial launch of Included Health Plans, scheduled for a January 1, 2028 plan year go-live date across the self-insured employer market.
- Positions the new offering as a direct challenger and alternative to traditional legacy carrier-led administrative services only (ASO) and insurer models, engineered to reverse escalating employer healthcare costs without shifting out-of-pocket expenses to employees.
- The plan design delivers validated total cost of care (TCOC) savings between 6% and 15%, building upon operational data from Firefly Health (acquired by Included Health in mid-2026), whose comprehensive plan model demonstrated over 15% TCOC reductions and a 90% member satisfaction rating.
Total Cost of Care Impact and Financial Architecture
Included Health Plans are structured to break the cycle of employee cost-shifting while guaranteeing measurable savings for plan sponsors:
- Demonstrated Cost Reductions: Delivers total cost of care savings ranging from 6% to 15%, with sustained multi-year reductions without degrading clinical quality or shifting financial liability onto employees.
- Firefly Foundation Track Record: Scales the underlying Firefly Health plan model, which demonstrated over 15% total cost of care savings, a 90% member satisfaction score, and consistent clinical improvements across preventive health and complex chronic conditions.
- Two Flexible Plan Configurations:
- Comprehensive Configuration: A full-stack health plan replacement that combines preferred TPA functionality, national provider network access, and native clinical steerage to maximize total cost savings.
- Flexible Configuration: An overlay structure designed to sit alongside an employer’s existing health plan carrier networks, TPAs, and administrative infrastructure, utilizing tiered steerage to optimize network utilization.
Unified Delivery Network: In-House Primary Care Meets Specialty Ecosystem
Rather than acting merely as a passive navigation app or an outsourced claims administrator, Included Health Plans integrate direct care delivery directly into member coverage:
- In-House Longitudinal Virtual Care: Anchored by a dedicated, salaried nationwide clinical network of more than 1,000 virtual care clinicians delivering continuous primary care, behavioral health, urgent triage, and expert medical opinions.
- Firefly Nearby Hybrid Delivery: Direct integration with more than 2,000 “Firefly Nearby” in-person clinical partners across all 50 states, ensuring patients transition to physical clinics, imaging hubs, and labs when in-person care is required.
- Curated Digital Health Specialty Network: Integrates proven digital health specialty platforms into the core plan design to address high-cost clinical categories:
- Carrum Health: Bundled surgical care and oncology centers of excellence.
- Oshi Health: Virtual gastrointestinal and digestive specialty care.
- Pomelo Care: Maternity, neonatal, and women’s health.
- Hinge Health: Digital musculoskeletal (MSK) therapy.
- Dynamic Copay-Focused Benefit Designs: Replaces confusing deductibles with transparent, copay-first benefit structures that financially reward members for choosing high-value, cost-effective in-network clinicians and virtual-first care pathways.
For years, enterprise purchasers bought digital navigation platforms to guide members through confusing carrier networks. However, navigation without direct control over plan design, claims adjudication, or provider contracting cannot enforce steerage. By becoming the health plan and TPA, Included Health gains direct control over the financial levers that dictate where care is delivered.
“Healthcare costs have moved from being a tolerable burden to becoming a threat that will sink businesses. Incumbent models don’t work — not for employers, not for people,” said Owen Tripp, Co-founder and CEO of Included Health. “Included Health Plans are about forging the path companies need to overhaul the economics of healthcare without having to cost-shift to employees. Included Health Plans give employers a clear value proposition and flexibility: Supercharge your existing network, or build a supercharged network to make the highest-quality care the easiest choice. In either case, engagement, trust, and better health are the result — along with meaningful cost savings. We’ve seen the approach play out over the past two years with proven results.”
