Healthcare is at a tipping point. Traditional solutions are falling short—unable to keep up with rising costs, the complexities of navigating red tape, and the evolving needs of today’s workforce. Incremental fixes are no longer enough. For many organizations, now is the time to commit to transformative change, think boldly, and act strategically.
This playbook offers a fresh perspective for those ready to redefine healthcare benefits. By prioritizing member experience, investing in big-bet innovations like AI, and building agile benefits frameworks, you can position your organization for success and lay the groundwork for lasting impact. Explore the first two parts of The Next (and Now) Benefits Playbook below—or unlock all five strategies by downloading the full guide.
1. Consider a model that aligns incentives for win-win partnerships
Objective:
Thinking differently about healthcare pricing means shifting towards strategic investments focused on maximizing ROI and impacting rising healthcare trends. While traditional PEPM models are widely used for predictability, pairing them with clinical outcomes validation can ensure spending drives meaningful employee health improvements, like fewer ER visits. To go further, exploring value-based care models can align financial incentives with measurable health outcomes such as cost savings and increased "Healthy Days," helping employers combat medical trends sustainably.
Action steps:
- Start by assessing current costs across point solutions, and consider transitioning to partners that offer all-included support that addresses multiple employee needs and improves overall ROI.
- Evaluate your organization’s readiness for payment models that align incentives with improving care quality, enhancing employee experiences, and reducing overall costs.
- For those ready to take the next step, explore value-based contracts where partners share financial risk and reward based on clinical outcomes and employee engagement, ensuring your investments drive measurable value.
Tactical Win
Employers can cut costs, enhance employee health, and reduce vendor fatigue. By adopting a strategic approach, organizations unlock higher ROI and deliver sustainable, long-term value through comprehensive care partnerships.
Included Health supports this transformation with flexible pricing models tailored to meet each organization's unique needs and readiness. Whether through PEPM arrangements or innovative value-based approaches, we offer adaptable solutions designed to drive meaningful results at every stage of your benefits journey.
At a time when people are really feeling squeezed, it’s smart to rethink how we define value—moving beyond cost per solution to the big picture, where healthy outcomes and cost efficiency align."
—Mark Flakne, Chief Financial Officer, Included Health
2. Expect AI to set the standard and lead the way
Objective:
Understand how AI is leveraged by solution providers and demand that it delivers measurable value. At Included Health, we’ve pioneered AI tooling and leverage data science that drives real results, enhancing experiences, boosting engagement, and improving outcomes—without ever compromising member trust. Our industry-leading AI enables seamlessly integrated, instantly accessible support for your employees’ mind, body, and wallet. And with our care team-facing innovations, we continue to set the benchmark for a high-quality, trustworthy member experience.
Action steps:
- Invest in tools that leverage AI to personalize care, and proactively engage employees with the right care options, making healthcare feel more accessible.
- Demand accuracy and reliability from vendors: Insist on systems that prioritize precision and member safety, ensuring AI enhances–rather than diminishes–the member experience.
- Seamless integration is key: AI should enhance and unify existing care models, creating a frictionless employee experience across virtual and physical touchpoints.
Tactical Win
AI empowers employers to proactively address employee needs, enhance satisfaction, and deliver a personalized experience across the entire population—not just high-cost members. By enabling more targeted and effective interventions, AI also ensures access to high-quality care that supports better outcomes for all employees.
In other industries like shopping or entertainment, experiences just happen magically and the average person doesn't even think about how that's tailored very, very specifically for them. Bringing that kind of personalization to healthcare is a really interesting [exciting] opportunity."
—Jeff Birkeland, Senior Vice President of Product, Included Health
Get the Full Playbook for Bold Benefit Moves
Ready to redefine healthcare benefits? Fill out the form to access all five transformative strategies in the playbook.