The Next (and Now) in Benefits Playbook

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 employers, 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 employee 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 in 2026 and beyond. Explore the first two parts of The Next (and Now) Benefits Playbook below—or unlock all five strategies by downloading the full guide.

Objective:

Think differently about how healthcare solutions can be priced and measured, with a shift towards strategic investments that maximize ROI and make a meaningful impact on rising healthcare trends.

Traditional pricing models, such as Per Employee Per Month (PEPM), remain a widely used approach. They offer predictability and simplicity for budgeting and forecasting, and, when paired with the right partners, can link costs and savings to demonstrated clinical outcomes. By focusing on clinical performance–such as reductions in unnecessary ER visits or improved chronic condition management–employers can validate that their dollars are driving meaningful improvements in employee health. 

For those looking to take this further, this may be the year to explore value-based care models that align financial incentives with health outcomes. These models deliver value that employees can feel and see, such as cost savings, better clinical outcomes, and more Healthy Days. They also offer employers tools to combat rising medical trends while ensuring long-term sustainability.

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.

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.