Primary Care, AI, and Employer Activism: The Future of Care Delivery

In today’s healthcare environment, patients are often confused and frustrated, encountering unclear benefits, lack of trust, poor access, and high costs. But structural changes driven by employers, new technology, and rising patient expectations may be the key to reshaping the future of healthcare access.

The Evolving Role of Primary Care

This is not a great moment for traditional primary care. Fewer Americans have ongoing relationships with a primary care clinician, and many don’t fully understand what primary care means. This is despite strong evidence for the value that primary care provides patients and their long-term health goals. Primary care is currently a great product with insufficient access and a bad marketing strategy.

In my opinion, the future of primary care won’t be defined by physical location or title but by trust, access, and continuity. Patients increasingly want a relationship with a care team that knows them, understands their history, and can respond quickly in whichever channel the patient needs in the moment.

Care might happen through a call, a virtual visit, or an in-person appointment. What matters is seamless availability and coordinated information, not necessarily a single doctor’s office. Patients want care that fits in their pocket.

Virtual care, once viewed as a temporary supplement, has proven to be a durable and effective access point. Included Health’s data show that virtual primary care is particularly valued by rural populations, patients with multiple chronic conditions, and those with combined behavioral and physical health needs—groups often underserved by traditional systems.

However, virtual-only primary care isn’t sufficient. The most effective models combine digital convenience with in-person partnerships to ensure continuity and physical examination when needed.

Employer Activism Will Be a Catalyst for Change

One of the most significant and underappreciated forces in healthcare today is employer-driven reform. Employers are becoming healthcare activists, because as the largest purchasers of private health coverage—responsible for insuring roughly 165 million Americans and spending an estimated $800 billion annually—they are no longer content to accept rising costs and uneven outcomes as an inevitability.

Healthcare now ranks as the second-largest expense for most U.S. companies after payroll. Historically, managing benefits was the responsibility of HR departments, but escalating costs—which are rising 8 to 12 percent annually in some markets—have drawn the attention of CFOs and CEOs. The conversation is shifting from benefit design to strategic investment.

These companies are asking why healthcare remains so inefficient when everything else in their business (supply chains, logistics, operations) runs on precision and data. That frustration will likely accelerate experimentation with alternative models of care, narrow networks, and value-based contracting.

Many large employers, including technology leaders and major retailers, are already partnering with companies like Included Health to integrate care navigation, longitudinal virtual care, and expert medical opinions into employee benefit packages. The incentive alignment is clear: Both employers and employees want better health outcomes, improved access, and lower total cost of care.

Technology, AI, and the Next Phase of Integration

A defining feature of the new care landscape is the fusion of technology and human expertise. AI and data-driven tools must support—not replace—clinical relationships.

Included Health has built AI tools that streamline administrative and educational tasks, allowing clinicians to focus on complex, relational care. For example, “Dot,” an intelligent AI member assistant, handles coverage and billing questions, while integrated AI tools for clinicians provide scribing support and surface real-time information, such as a member’s deductible or recent test results.

AI is also being applied to quality monitoring through sentiment analysis, which evaluates tone and engagement in patient interactions. These tools help measure experience at scale, offering insights into both member satisfaction and clinician communication style.

But the most important skills for future clinicians are not technological. It no longer matters how much information you can keep in your head. What matters is listening, empathy, and the ability to handle complexity. Those are the skills that will keep us in business.

Policy Changes to Enable Better Care

In order to drive adoption of technology-enabled care and increase access for patients, policy could play a large role. As an example, state-by-state licensing approaches create administrative burden for telehealth organizations and limit national scalability. While interstate compacts have expanded reciprocity for nurses and advanced practice clinicians, physician licensing remains fragmented.

And I don’t expect a national medical license anytime soon. There’s a lot of protectionism at the state level. States rely on licensing fees, and local providers don’t necessarily want national systems competing for their patients.

However, there may be potential for progress through automation. Included Health is exploring AI-assisted licensing workflows to make the process more efficient. Technology can simplify, but not erase, regulatory friction.

A Cautious Optimism for the Next Decade

You have to be optimistic in this job. It’s too hard to do if you don’t believe it can get better.

The key is to stay flexible: The companies that succeed in healthcare will be the ones that welcome change.