Virtual care and health navigation company Included Health has launched a new artificial intelligence-powered tool aimed at helping members find care within its network.
Provider Connect uses a proprietary matching engine to recommend the best provider for each user, including quality score descriptions. The integrated platform built into its AI assistant is built on “tens of billions” of clinical and cost point data from millions of patients and uses more than 300 specialty-specific quality measures, the company said.
“With this release, we’re making it much easier to leverage the power of AI to highlight some of these features and make it more transparent for our members to understand what makes them high-quality,” Nupur Srivastava, chief operating officer at Included Health, told Fierce Healthcare.
Included Health works with health plans and employers, including 30% of Fortune 10 companies, Srivastava said. In addition to medical benefits and insurance navigation, the company offers virtual primary care, behavioral health, specialty care, expert medical opinions, and urgent care appointments. The company rolled out a personalized AI assistant and chatbot (called Dot) in December.
AI solutions can help answer member questions about specific health benefits and coverage and find in-network providers.
Srivastava said early feedback on Provider Connect has been “very positive.”
“(Clients) feel that we provide a level of transparency that is rare in the industry,” she said. “Even as a healthcare provider, you can see why if you focus on connecting someone to quality care, you can actually not only improve outcomes, but also reduce costs.”
Additionally, one of the most important elements of healthcare, according to Srivastava, is the interaction between patients and healthcare providers.
“If we can optimize that matching, it’s much more likely that downstream impacts will occur in a more controlled manner, leading to better outcomes and savings,” Srivastava said.
