Included Health Launches AI-Powered Provider Matching Tool

Virtual care and health navigation company Included Health has launched a new artificial intelligence (AI) tool called Provider Connect. This solution is designed to help members find in-network healthcare providers by using a proprietary match engine that recommends the best-fit options, complete with quality score explanations.

Provider Connect is integrated into the company’s AI assistant, Dot, which was rolled out in December. The platform leverages tens of billions of clinical and cost data points from millions of patients, along with over 300 specialty-specific quality measures. This robust dataset ensures that recommendations are both accurate and personalized.

Nupur Srivastava, Included Health’s chief operating officer, emphasized the tool's transparency: “This release is bringing the power of AI to make it really easy to highlight these features and be more transparent about what makes someone high quality so that a member can understand it.”

Under the Hood

Provider Connect’s match engine operates by analyzing extensive datasets to identify providers who best meet the specific needs of each user. Here are some key technical details:

• Data Sources: The platform draws from tens of billions of clinical and cost data points, including patient outcomes, treatment effectiveness, and cost efficiency.
• Quality Measures: Over 300 specialty-specific quality measures are used to evaluate providers. These metrics cover a wide range of factors, such as patient satisfaction, adherence to best practices, and clinical outcomes.
• Match Engine: The AI algorithm uses machine learning models to match users with providers based on their unique healthcare needs, preferences, and location.
• Transparency: Users receive clear explanations of why certain providers are recommended, including detailed quality scores and specific metrics that contribute to those scores.

The integration with Dot, the company’s AI assistant, enhances user experience by providing real-time support. Members can ask questions about health benefits, coverage, and provider recommendations through a conversational interface. This seamless interaction aims to reduce confusion and improve overall satisfaction with healthcare navigation.

Key Takeaways

• Enhanced Transparency: Provider Connect offers detailed explanations of quality scores, helping users make informed decisions.
• Personalized Recommendations: The AI match engine uses extensive data to recommend the best-fit providers for each user.
• Seamless Integration: The tool is embedded within Dot, Included Health’s AI assistant, providing a cohesive and user-friendly experience.
• Positive Feedback: Early feedback on Provider Connect has been highly positive, with clients appreciating the level of transparency it provides.

Nupur Srivastava highlighted the broader impact of this technology: “Even our providers can understand why connecting someone to high-quality care will lead to better healthcare outcomes and lower costs.” This approach not only improves patient satisfaction but also contributes to more efficient and effective healthcare delivery.