What You Should Know
- Included Health has launched Provider Connect, a healthcare experience that combines real-time member context with quality and cost data to guide members toward high-quality, in-network providers.
- The platform is embedded within Dot, Included Health’s AI assistant, allowing members to use natural language to find doctors, view out-of-pocket estimates, and book appointments.
- The system is powered by 45 billion clinical and cost data points from 140 million patients and over 300 specialty-specific quality measures.
- Provider Connect highlights clinical expertise alongside provider–member matches for preferences such as gender and race/ethnicity, factors linked to improved trust and treatment adherence.
- Historical data from the company’s provider match capabilities shows a 92% increase in connections to top-quartile clinicians and 9% total cost of care savings per referral.
Employers currently face significant pressure to manage rising healthcare trends, while members often struggle with choices that provide little information regarding clinical quality. Included Health is addressing this friction by launching Provider Connect—a “clinician-in-the-loop” model that turns static in-network lists into a dynamic, personalized match engine. The platform recognizes that two people in the same location may require different primary care doctors based on their unique risk factors and personal preferences.
Nupur Srivastava, chief operating officer at Included Health, noted that the integration of Provider Connect with the Dot AI assistant allows the company to connect members with doctors who are “extremely relevant” for their specific care needs.
Data-Driven Personalization and Transparency
Provider Connect sets a new bar for navigation by moving away from generic filters and focusing on longitudinal clinical history.
- AI-Native Experience: Members describe their needs in natural language to receive a curated set of best-fit providers with clear “why this doctor” rationales.
- Single Quality Score: An explainable quality score helps members understand recommendations and routes them toward higher-value choices.
- Contextual Matching: The proprietary engine continuously analyzes data points to recommend providers based on condition, coverage, and preferences.
All-in-One Integration and Financial Alignment
Provider Connect is not a standalone tool; it is embedded across Included Health’s entire platform, including virtual primary care, navigation, and care management. This ensures that members encounter quality guidance during routine interactions, such as asking coverage questions or chatting with Dot, rather than just when they are explicitly looking for a doctor.
The platform is also central to Included Health’s alternative health plan designs. These designs align member financial incentives with high-quality providers to amplify results and reduce avoidable spend driven by low-quality care.
