RVO Health
Transforming health coaching in the US with human centric AI
Hope uses AI to deliver smoking cessation coaching that feels personal, builds trust, and helps people take control of their health — at a scale no human coaching team could match alone.
RVO Health is the largest health portfolio in the U.S. Its Prevention organization designs and delivers behavior change programs at population scale — spanning smoking cessation, vaping, and chronic disease.
Within Prevention, Quit For Life partners with organizations and state public health departments to provide evidence-based coaching, FDA-approved medications, and outreach through programs like Live Vape Free.
Hope is the SMS-based product at the center of that work — the daily touchpoint that keeps people engaged through their quit journey
The Impact
In September 2025, RVOH and ustwo launched the first AI-powered Hope pilot. The first results were immediate and profound:
1,500
users enrolled in first month, 3x the anticipated amount
22x
increase in message depth, with users writing full sentences and paragraphs instead of single-word replies
90
words average response length (grew from 4.9 words) as users began opening up about their habits, emotions, and challenges
Members weren't just responding — they were opening up. The depth of engagement mirrored human coaching conversations, but reached more people in a week than a coaching team could in a quarter. On the strength of those results, RVO Health and ustwo will be rolling Hope's AI-powered experience across all supported state quit programs by mid-2026 — expanding from one pilot to a national cessation platform.
ustwo's strategic, patient-centered process really helped push us to think through how to design our experience in a world class way for our members. I wholly trust their AI product and engineering talent to help guide us in the right direction.
The Challenge
When the team set out to evolve Hope – its long-running SMS-based cessation product – they faced a critical limitation: it relied on scripted, rule-based messages and human coach intervention for engagement. While effective, the model couldn’t scale fast enough to meet the demand across states and populations. Each message, update, or new program variant required significant internal effort to adapt, slowing progress and increasing costs.
The challenge: could AI make the experience more human, more responsive, and more scalable – without sacrificing trust or efficacy?
The Partnership
RVOH partnered with ustwo to reimagine Hope as an AI-driven digital coach – one that could understand, respond, and adapt like a human while operating at the scale of public health. The partnership focused on three foundational pillars:
- Making conversations feel real: We replaced the old “if/then” messaging engine with a dynamic AI layer that blends generative conversation models with deterministic rules for clinical compliance. The result: messages that read like they come from a person who knows your story, not a decision tree.
- Building a more unified platform: Rather than patching Hope’s existing infrastructure, we re-architected around a shared AI orchestration layer. This doesn’t just modernize Hope — it creates a foundation that RVO Health can extend to other cessation programs (like Live Vape Free) and future coaching products across Prevention.
- Creating a fuller view of the member: We unified content and data aggregation to build a single profile of each user — capturing intent, program progress, and sentiment. Human coaches now see where members are structurally and emotionally in their quit journey, so when they do step in, they’re informed from the start.
Our Approach
We embedded product management, product delivery, and engineering talent within RVOH’s Prevention team to define, build, and train the next generation of Hope.
Together, we:
- Re-architected the platform around an AI orchestration layer capable of blending deterministic rules (for compliance) with conversational AI leveraging generative models (for expressing dynamism, building empathy, and creating emotional / functional depth).
- Introduced a dynamic message engine, enabling contextual, human-like conversations that evolve based on user tone and progress.
- Unified content and data aggregation to create a single profile of user context including intent, program progress, and sentiment to help human coaches better understand where members are structurally and emotionally in their quit journey.
- Piloted non-deterministic AI messaging, enabling natural dialogue that feels conversational rather than scripted.
What we’ve built with Hope is genuinely significant. It shows how AI can support meaningful human connection at scale. Members are engaging, sharing full stories, opening up in ways they never did before, telling me we got something right. And it's only the beginning.
What's Next?
Following the success of the Florida pilot, Hope will expand into new states, with an emphasis on integrating voice and multimodal AI to create a seamless prevention experience that maximizes every interaction with a human coach and reduces operational burden so that coaches can be their best for members.
The underlying architecture also enables RVOH to explore how this hybrid program structure – meaningful human coach interactions with AI-powered support in-between – across other prevention programs.
Together, we’re shaping a future where AI amplifies the care and attention of coaches, without replacing the human connection at its core.
By bringing empathy, adaptability, and insight to scale, Hope is redefining what digital health support can feel like for delivering meaningful behavior change at scale.
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