Owen Tripp, CEO and cofounder of Included Health, says the key to delivering lasting value in health care is AI + EQ.
Health care costs continue to rise at an unsustainable rate. Employers are projecting double-digit increases in health care spend this year, driven by an uptick in chronic conditions, higher hospital and physician fees, and expensive new drugs and treatments. Employers and households alike are paying more while getting less in return.
In response, the health care industry is racing to deploy AI as a cost-control tool. Payers are automating claims processing and prior authorization. Hospitals and physicians are streamlining administrative work and automating clinical documentation. Digital health startups are launching chatbots and “AI doctors” to triage patient requests and reduce call center volume.
Most AI solutions in health care today are designed to make the existing system more efficient and cost-effective for those delivering and managing care—not necessarily for the individuals and families on the receiving end. These fragmented efforts won’t be enough to bend the health care cost trend for employers or workers.
AI by itself isn’t the answer. The real opportunity is what I call AI + EQ: the combination of AI-powered technology, clinical expertise, and human empathy. The best clinicians have always had a rare mix of empathy, knowledge, and good judgment. Before AI, that mix was all but impossible to scale. Now, advances in generative AI and data science are enabling us to capture the collective wisdom of world-class care teams and put it to work to modernize the health care experience.
People want high-quality care that’s simple, personalized, fast, and affordable. Today’s health care experience is none of the above. The predictable result? Trust in the health care system has fallen to its lowest point in a generation. And that trust deficit leads people to give up, disengage, and delay or skip essential care, which is making us all sicker and sending health care costs through the roof.
AI + EQ can reverse this cycle. AI—with empathetic clinicians in the loop, shaping the experience behind the scenes—is making health care more responsive, proactive, integrated, and personalized.
Virtual AI assistants, for instance, are now available 24/7 to provide clinical guidance, answer coverage and benefits questions, surface tailored recommendations, and seamlessly connect people to a physician or care team member when needed. This combination of always-on AI support and human connection creates a consistent, longitudinal experience in which people feel seen, heard, remembered, and supported throughout their care journeys.
Delivering this experience at scale requires building EQ, not just AI, into every layer of the system. That includes platforms and partnerships that break down data silos to connect clinical insights, medical and pharmacy claims, info on social and financial context, and myriad other data points to create a three-dimensional picture of individuals and populations.
It also means making that data visible and available to the entire care team, including doctors and nurses as well as pharmacists, case managers, advocates, and support staff. When everyone—including AI assistants—is looking at the same 3D person, care teams and technology can work together in new ways to anticipate needs, close gaps in care, and intervene before small problems become costly ones.
Efficiency matters, but it isn’t transformative. If we use AI as a blunt instrument to optimize a flawed system, we’ll end up right back where we started.
Real transformation comes from harnessing AI + EQ to make people’s lives easier by helping them access care, understand their options, and feel confident about their next steps. That experience builds trust, and trust drives repeat engagement, one of the strongest predictors of better outcomes and lower costs.
Ultimately, it’s trust—not efficiency—that delivers lasting value for people and the employers and organizations funding their care.
Learn more about the AI + EQ approach here and download Included Health’s AI + EQ: The Formula for Lower Healthcare Costs and Lasting Value report here.
Note: This content was created by Included Health.