As healthcare costs continue to climb and employer patience with fragmented benefit offerings wears thin, Included Health is making a decisive bet on consolidation.
The company's recent agreement to acquire Firefly Health pairs Included Health's AI-native care navigation platform with Firefly's clinically integrated health plan and network of more than 2,300 providers.
Owen Tripp, co-founder and CEO of Included Health, spoke with Insurance Business America about what the deal means for brokers, employers, and the future of benefits design.
“Employers and employees are feeling the weight of too many disconnected solutions,” Tripp said. “People think of healthcare as being one system, but their benefits often come from a collection of separate companies. The result is more handoffs, more data silos, and more confusion about where to start."
The ask from employers has shifted as a result, with clients wanting a partner that connects those pieces and takes responsibility for the result.
“They want a clear place to start, real clinical support behind it, and a path from virtual care to in-person and specialty care, with benefits and advocacy connected along the way. The member shouldn't have to start over at every handoff,” said Tripp.
Cost is driving a fundamental change in what benefits teams are being asked to deliver and while employers have absorbed much of the increase in recent years, Tripp says they have reached their limit.
"In the past, they may have added another benefit or shifted more of the bill. That's no longer a sustainable answer,” he said. “Employees are already facing higher premiums and out-of-pocket costs without necessarily seeing a better care experience in return. Benefits teams are being asked to improve affordability and the care experience at the same time."
That shift is pushing more employers toward value-based strategies and requirement for a partner that can actually improve care and bend the cost curve, without limiting access or asking employees to absorb more of the cost.
Included Health announced their agreement to acquire Firefly Health on July 28, 2026, and Tripp has a clear rationale for the deal.
"Navigation, primary care, and plan design work best as parts of the same model; not as separate products,” he said. “Navigation helps people find the right care. Primary care provides continuity. Plan design makes high-quality care easier to choose and afford."
While both companies started in different places, both are focused on putting care at the center of the health plan rather than bolting it on afterward.
“Over time, we see the opportunity to connect nationwide virtual and in-person care, high-quality local networks, specialty support, and a plan that understands both the member's clinical and financial context. The goal is better access and better outcomes without asking people to give up choice," said Tripp.
Firefly reported a 15% reduction in total cost of care across its Administrative Services Only (ASO) book in 2025, with member satisfaction exceeding 90%. The transaction is expected to close in the third quarter of 2026, subject to regulatory review.
When assessing platform performance, Tripp says employers often rely on utilization data, but he believes a better starting point is the Centers for Disease Control and Prevention’s (CDC) Healthy Days.
"It is a simple, clinically validated measure of the number of days in the past month when someone experienced good physical and mental health.” He said. “That is closer to what employers are trying to create than an app login or a completed visit. Did they have the energy for the activities they love? Were they able to show up fully to work and life? In our data, members who engage with our clinical services see an average of two additional Healthy Days each month."
But the Healthy Days measure should be paired with the measures that drive it, Tripp says. These include whether people get to the right care in time, follow through on recommended care, avoid unnecessary emergency and hospital care, and have a better experience. The final test is total cost of care.
“Together, those measures show whether a platform is actually improving health, versus simply generating activity that doesn't move the needle," Tripp said.
He also has a sharper challenge for brokers evaluating vendors.
"Benefits brokers should start by asking what changes for the member. What problem is the solution solving, and what should be different after someone uses it? If the answer focuses mainly on features or engagement, keep digging."
The follow-up questions matter just as much, Tripp says. Such as those to help brokers understand how the model works when care becomes more complex.
“How easily can the member reach a human expert? Does the context follow them, or do they have to start over? When another program or provider gets involved, who owns the next step?” he said. “Then ask to see the result. Are people receiving better care, having a better experience, and spending less overall? Clicks are easy to count, but the more meaningful measure is whether the solution changes what happens next."
Tripp says the integrated model addresses the single most expensive failure point in employer health spending; delayed intervention.
"The biggest opportunity is to help people before a manageable condition becomes a crisis,” he said. “When people can't get primary care, or afford a medication, they may end up in a more serious and costly episode. An integrated model helps people get to the right next step sooner, while giving primary care, behavioral health, pharmacy, and specialty care a shared view of what that person needs."
Specialty care, in particular, requires hands-on coordination, to help the employee get to the right care faster.
“That means finding the right provider, getting an expert opinion when the case is complex, and making sure someone stays with them before and after treatment,” said Tripp. “When you help people make the right decision the first time, you can improve the outcome and lower the cost of the entire journey, not just one visit or drug."
Looking at the next five years, Tripp expects the employer market to consolidate decisively with a move toward fewer, more accountable platforms.
“Employers will still need specialized solutions, but they will expect those solutions to work within a broader model that includes primary care, navigation, plan design, and a clear owner for the member experience," he said.
