Included Navigation

Healthcare navigation simplifies a member’s healthcare journey by providing them with the right support at every step. It guides them to high-quality care, helps them understand costs, and handles complex administrative issues, leading to a better experience and better health outcomes. Learn more.

Clinically-led navigation is a proactive, expert-driven approach to healthcare navigation. Unlike traditional solutions that simply point members to a provider, a clinically-led model uses a team of in-house clinicians to provide personalized guidance and support throughout a member’s entire healthcare journey. This ensures that members get the right level of care for their specific needs, from a simple question to a complex diagnosis.

Healthcare navigation saves your company money by ensuring your employees get the right care at the right time. Included Navigation uses a proprietary, data-driven matching engine to guide members to high-quality providers who deliver better outcomes at a lower cost, preventing unnecessary procedures and reducing costly emergency room visits. Our clinicians proactively engage with members to address needs early, which helps avoid more expensive health issues down the road.

We don’t just promise savings—we prove them.

Included Navigation will improve members’ experience and satisfaction by simplifying and personalizing their healthcare journey. It gives them a single, trusted source of support for all their needs, from a simple question to a complex medical issue. The result is a healthcare experience that is less confusing, more empathetic, and ultimately, more effective.

Unlike other solutions that rely on static directories or basic metrics, our provider quality vetting is a dynamic, clinically-driven, and data-backed process.

We have developed a first-of-its-kind matching engine that leverages:

• Hundreds of machine learning algorithms to go beyond simple metrics and predict provider performance.
• Novel quality measures created by our in-house clinicians and data scientists to capture key, often-overlooked aspects of provider quality.
• Dynamic scoring that matches a provider’s skill to the member’s specific clinical need, ensuring a personalized recommendation every time.

This powerful engine, which has been externally validated by leading healthcare experts, ensures that our members are not just finding a doctor, but finding the right doctor for them, leading to better outcomes and more efficient care.

Included Navigation integrates with your existing benefits and carrier relationships by acting as a single, centralized “front door” for all of a member’s healthcare needs. We work alongside existing benefits, making them easier for members to access and use.

This seamless integration is powered by a strategic approach to benefit navigation and routing, both through a dedicated Care Team and within the self-service Included Health app. Our Care Coordinators have deep knowledge of your benefits and can guide members to the most appropriate service for their needs. Meanwhile, the app makes other benefits discoverable through features like quicklinks and recommendation cards, ensuring members can find and engage with all the resources you offer.

AI is a powerful tool, but we believe it’s most effective when it augments human expertise, not replaces it. Other solutions may rely on AI to answer basic questions or provide static recommendations. We take a different approach, embedding AI into our processes to empower our clinicians and Care Team to deliver a truly personalized, high-quality experience. Learn more about our approach to AI+EQ.

We measure success through a combination of key metrics that prove both member engagement and financial value. Our unique, clinically-guided approach delivers tangible results, which we validate through data and third-party analysis.

We deliver measurable success by focusing on two key areas: member engagement and clinical and financial outcomes. Included Navigation achieves an 87% member satisfaction rate, driven by proactive outreach and an experience that members love and actually use. By guiding members to top-quality providers and increasing preventive screenings, we deliver a confirmed >2:1 ROI, providing a clear and significant return on your investment.