Included Health Launches a Health Plan Challenger — Bundling Primary Care, Specialty Carve-Outs and Navigation

Included Health is moving from healthcare navigation and care delivery into a much broader role: health plan alternative.

Following its acquisition of Firefly Health, the company has launched Included Health Plans for self-insured employers, with plan go-lives available for January 1, 2028.

The model combines advanced primary care, behavioral health, acute care, expert medical opinions, navigation, benefit design and network optimization with an in-house national clinical workforce and an ecosystem of in-person and specialty partners.

That makes this more than another point solution.

Included Health is attempting to assemble many of the pieces employers have historically purchased separately into an integrated alternative plan architecture.

Two paths for self-insured employers

Included Health is offering two configurations.

Complete

Complete is the more comprehensive model.

It includes a preferred third-party administrator, several national network options, integrated care guidance and benefit design intended to steer members toward higher-value providers.

Included Health currently markets the configuration at 12% to 15% net savings.

Flex

Flex is designed for employers that do not want to replace as much of their existing infrastructure.

It can work alongside existing carrier networks and supports multiple TPA options, while using tiered benefit design and navigation to guide members toward higher-quality, lower-cost care.

Included Health markets Flex at 6% to 8% net savings.

Those are company-stated savings expectations, not independent guarantees of what every employer will achieve.

Primary care becomes the coordination layer

The architecture is built around primary care rather than treating primary care as another disconnected benefit.

Included Health says members have access to more than 1,000 virtual care providers alongside more than 2,000 Firefly Nearby in-person care partners.

Primary care is then connected to navigation and specialty care.

The specialty ecosystem includes partners such as:

• Carrum Health;
• Oshi Health;
• Pomelo Care; and
• Hinge Health.

The result is an interesting inversion of the traditional employer health plan.

Instead of beginning with a broad carrier network and layering navigation and point solutions on top, Included Health is trying to begin with coordinated care and navigation, then build the network and benefit design around it.

Firefly supplies the health-plan architecture

The Firefly acquisition is central to this strategy.

Firefly had already built a clinically integrated employer health plan centered on advanced primary care, navigation, network design and member incentives.

Included Health says Firefly's existing health plan demonstrated more than 15% total-cost-of-care savings and approximately 90% member satisfaction.

In its July acquisition announcement, Included Health said Firefly delivered a 15% reduction in total cost of care across its 2025 ASO book compared with a risk-adjusted market benchmark.

Those are company-reported results and methodology, not independently verified savings across the new Included Health Plans product.

But they give Included Health an operating base rather than forcing it to build the health-plan component from scratch.

Why this matters for employer direct contracting

Employers have spent the past decade adding alternatives around the edges of traditional carrier plans:

DPC + navigation + COEs + specialty carve-outs + behavioral health + pharmacy alternatives + virtual care.

The challenge is fragmentation.

Each solution may improve one category, but the employer is still responsible for making the pieces work together.

Included Health is effectively asking whether those pieces can become the plan itself.

That is an important evolution for the direct-contracting market.

A self-insured employer no longer has to think only in terms of negotiating an individual direct contract with a hospital or adding a standalone center of excellence.

It can increasingly purchase an architecture that coordinates multiple alternative care channels and steers members toward them through plan design.

The specialty-carve-out ecosystem gets embedded

The inclusion of Carrum, Oshi, Pomelo and Hinge is particularly relevant.

These companies represent categories employers have often purchased separately:

• surgical and complex-care centers of excellence;
• gastrointestinal specialty care;
• maternity and women's health; and
• musculoskeletal care.

Embedding those services inside the plan experience changes their role.

They become components of the network architecture rather than optional point solutions sitting beside it.

That could be an important direction for the employer healthcare market.

The question may increasingly shift from "Which point solutions should we buy?" to "Which healthcare operating system should coordinate our plan?"

What to watch next

Included Health says the plans are available to self-insured employers for January 1, 2028 launches.

The next evidence DirectContract will be watching for is:

• named employer conversions;
• covered lives;
• employers choosing Complete versus Flex;
• incumbent carriers or TPAs being displaced;
• realized versus marketed savings;
• specialty-partner utilization;
• changes in member out-of-pocket costs; and
• whether other navigation and care-delivery companies launch similarly integrated plans.

The launch does not eliminate traditional carrier infrastructure overnight.

But it is another sign that employer healthcare alternatives are moving from isolated carve-outs toward integrated plan architecture.

Follow employer plan alternatives, specialty carve-outs and direct-provider arrangements in the Direct Contract Deal Tracker.

Sources

• Included Health — Included Health Plans launch
• Included Health — Included Health Plans
• Included Health — Firefly Health acquisition announcement