Rule-Bottleneck RL: Learning to Decide and Explain for Sequential Resource Allocation via LLM Agents in Public Health
Proceedings of the Thirty-Fifth International Joint Conference on Artificial Intelligence. AI and Social Good. Pages 7512-7520.
https://doi.org/10.24963/ijcai.2026/835
Keywords
- Planning and Scheduling: Planning and Scheduling
- Agent-based and Multi-agent Systems: Agent-based and Multi-agent Systems
- Multidisciplinary Topics and Applications: Multidisciplinary Topics and Applications
Abstract
Reducing preventable maternal mortality remains a global health priority. Under Sustainable Development Goal (SDG) target 3.1, the WHO emphasizes timely and equitable allocation of limited maternal health resources. Motivated by Department of Obstetrics and Gynecology at several important hospitals in Uganda and Ghana, we study the problem of sequential allocation of wearable vital sign monitoring devices among maternal mothers. While deep reinforcement learning (RL) has shown promise for sequential resource allocation, its limited interpretability hinders adoption in such high-stakes settings. In contrast, large language model (LLM) agents provide human-readable reasoning but often struggle with effective long-term decision making. To bridge this gap, we introduce Rule-Bottleneck RL (RBRL), the first LLM agent framework for resource allocation problems that jointly optimizes language-based decision policy and explainability. At each step within RBRL, an LLM first generates candidate rules---language statements capturing decision priorities tailored to the current state. RL then optimizes rule selection to maximize environmental rewards and explainability, with the LLM acting as a judge. Finally, an LLM chooses the action (optimal allocation) based on the rule. We provide conditions for RBRL performance guarantees as well as the finite-horizon evaluation gap of the learned RBRL policy. Experiments in maternal health show that RBRL outperforms baseline LLM agents and approaches the performance of deep RL, while producing clearer, policy-relevant explanations. Human evaluations further confirm improved trust and usability, demonstrating RBRL as a practical AI approach aligned with SDG target 3.1.
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1 Introduction
Under the United Nations Sustainable Development Goal (SDG) 3 on Good Health and Well-Being, target 3.1 aims to reduce the global maternal mortality ratio to fewer than 70 deaths per 100,000 live births by 2030, yet progress toward this goal remains uneven and slow, particularly in resource-constrained settings[SDG, 2026]. Under SDG target 3.1, WHO emphasize the timely and equitable allocation of limited maternal health resources, balancing urgency, equity, and long-term outcomes. These decisions are inherently sequential and high-stakes, as early allocation choices can substantially influence downstream health trajectories and survival outcomes[Boehmer et al., 2024]. Deep reinforcement learning (RL) is an effective method to optimize decision-making in resource allocation offering scalable high-reward policies [Yu et al., 2021; Talaat, 2022], albeit generally providing action recommendations without human-readable reasoning and explanations. Such lack of interpretability poses a major challenge in maternal health where decisions must be transparent, justifiable, and in line with human decision-makers to ensure trust and compliance with ethical and regulatory standards.
For instance, doctors may need to decide whether to prioritize intervention for mother A or mother B based on their current vital signs [Boehmer et al., 2024]. An RL algorithm might suggest: "Intervene with mother A" with the implicit goal of maximizing the value function. However, the underlying reasoning may not be clear to the doctors, leaving them uncertain about the factors influencing the decision [Milani et al., 2024]. For doctors, a more effective suggestion could be risk-based with specific information, e.g., "mother A's vital signs are likely to deteriorate leading to higher potential risk compared to mother B, so intervention with mother A is prioritized" [Boatin et al., 2021].
LLM agents [Sumers et al., 2024], on the other hand, leverage large language models (LLMs) for multi-step decisionmaking using reasoning techniques like chain of thought (CoT) [Wei et al., 2022]. They enable natural language goal specification [Du et al., 2023] and enhance human understanding [Hu and Sadigh, 2023; Srivastava et al., 2024]. However, agents based solely on LLM reasoning often struggle with complex sequential decision-making out of the box [Furuta et al., 2024], making RL a crucial tool for grounding to specific tasks [Wen et al., 2024; Zhai et al., 2024].
Consequently, aiming to combine the strengths of both deep RL and LLM agents, we pose the following question:

Can we design an LLM agent framework that can simultaneously perform sequential resource allocation and provide human-readable explanations?
Similar to the celebrated index policy for prioritizing arms in resource allocation problems [Whittle, 1988], we explore the potential of using rules-based prioritization in resource allocation tasks. In the context of LLM agents, rules are defined as "structured statements" that capture prioritization among choices in a given state, aligning with the agent's goals [Srivastava et al., 2024]. Building on this, we propose a novel LLM agent framework called Rule-Bottleneck Reinforcement Learning (RBRL), which integrates the strengths of LLM and RL to bridge the gap between decision-making and interpretability. RBRL provides an agent framework (as shown in Figure 1) that simultaneously makes sequential resource allocation decisions and provides human-readable explanations, in contrast to prior work that generates posthoc explanations for a learned policy [Peng et al., 2022; Milani et al., 2024]. RBRL leverages LLMs to generate candidate rules and employs RL to optimize policy, allowing the creation of effective decision policies while simultaneously providing human-understandable explanations. RBRL aims to increase efficiency and avoid the computational cost of directly fine-tuning LLM agents, which can be highly challenging in interactive environments due to the heavy computational costs and the complexity of token-level optimization [Rashid et al., 2024].
Our contributions are summarized as follows. First, LLMs are leveraged to generate a diverse set of rules according to the environment state, where each rule serves as a prioritization strategy for individuals in resource allocation, enhancing interpretability in decision-making. Second, we extend the conventional environmental state-action space by integrating the rules into states generated by LLMs, creating a novel framework that enables RL to operate on a richer, more interpretable decision structure. Third, we introduce an attention-based training framework that maps states and rules to queries and keys of a cross-attention network. The rule selection process is optimized by a policy network trained using the Soft Actor-Critic (SAC) algorithm [Haarnoja et al., 2018], ensuring robust and efficient decision-making. In particular, the LLM also acts as a feedback mechanism, providing guidance during RL exploration to improve policy optimization and promote more effective learning. To the best of our knowledge, this is the first work to jointly optimize decision-making and explanation generation in constrained RL tasks.
We evaluate our method in environments from a real-world domain: WearableDeviceAssignment, for distributing monitoring devices to maternal mothers. Using cost-effective LLMs such as gpt-4o-mini [OpenAI, 2024] and Llama 3.1 8B [Meta AI, 2024], we first assess decision performance by comparing RBRL with pure RL methods and language agent baselines. We then evaluate explanation quality through a human survey conducted under IRB approval. The results demonstrate RBRL's effectiveness in both decision quality and interpretability.
2 RelatedWork
Our work is positioned at the intersection of RL for resource allocation, LLM agents, and Explainable RL (XRL). While traditional RL methods effectively optimize rewards for resource allocation [Boehmer et al., 2024], they often lack the interpretability required for high-stakes domains. Conversely, LLM agents that provide reasoning [Wei et al., 2022] can struggle with sequential optimization. Our framework is novel compared to hierarchical approaches that use LLMs for high-level planning [Carta et al., 2023; Szot et al., 2023], as RBRL is the first to treat the natural-language rule as a primary output, jointly optimizing for both decision-making performance and the rule's quality as an explanation. Furthermore, unlike post-hoc or attribution-based XRL methods that analyze decisions after the fact [Guo et al., 2021; Chen et al., 2024], RBRL provides intrinsic explanations, as the rule is a functional component within the decision-making loop.
3 Social Good Context and Real-World Relevance
Real-World Societal Problem Reducing preventable maternal mortality remains a critical global public health challenge, particularly in resource-constrained settings. Decision-makers must allocate limited maternal health resources over time under uncertainty, balancing urgency, fairness, and long-term outcomes. This problem is motivated by the Department of Obstetrics and Gynecology at several important hospitals in Uganda and Ghana. However, despite advances in data-driven decision support, limited interpretability continues to hinder adoption in high-stakes healthcare settings where accountability and trust are essential.
Stakeholders and Domain Experts The primary stakeholders in this problem include frontline healthcare providers (e.g., clinicians and nurses) from several hospitals in Uganda and Ghana, hospital administrators fromMassachusetts responsible for operational planning, and public health policymakers from Massachusetts concerned with equitable and effective resource distribution. In addition, domain expertise from public health and clinical decision-making informs the formulation of constraints, prioritization principles, and evaluation criteria considered in this work. These stakeholders represent the intended users and beneficiaries of AI-assisted decision-support systems in public health settings.
Roles and Modes of Engagement Healthcare providers from hospitals in Uganda and Ghana contribute by providing anonymized data, identifying practical decision-making challenges in maternal health workflows, and highlighting clinically relevant constraints faced in daily practice. Domain experts in public health and clinical decision-making from hospital in Massachusetts define the problem formulation and design interpretable prioritization rules that reflect established medical and ethical principles. Hospital administrators fromMassachusetts support the evaluation process by recruiting participants and coordinating surveys to assess the usability, clarity, and trustworthiness of the system's recommendations. The proposed framework is explicitly designed as a decision-support tool rather than an autonomous decisionmaker: human stakeholders retain final authority over resource allocation decisions, while the AI system provides structured recommendations and transparent explanations to support informed judgment.
Methodology Overview and Evaluation To address transparent sequential decision-making in maternal health, we propose RBRL, which integrates RL with language-based rule generation. At each step, the system generates human-readable prioritization rules, selects among them using reinforcement learning to optimize long-term outcomes, and outputs both an allocation decision and an explicit explanation for stakeholder review. By treating rules as a decision bottleneck, RBRL jointly optimizes decision quality and interpretability. We evaluate RBRL along dimensions relevant to real-world deployment, including decision quality, interpretability, and alignment with domain expectations. Decision quality is measured using task-specific reward and constraint satisfaction metrics, while interpretability and usability are assessed through human evaluations of rule clarity and actionability.
4 Preliminary, Key Concepts, and Problem Formulation
4.1 Preliminary: Resource-Constrained Allocation
Resource-constrained allocation tasks are usually formulated as a special type of constrained Markov Decision Process, which is defined by the tuple →S↪ A↪ P↪ R↪ C↪ h↪ ω↑, where S denotes a state space and A denotes a finite action space. The transition probability function, specifying the probability of transitioning to state s→ ↓ Rd1 after taking action a ↓ Rd2 in state s, is P(s→ ♣s↪ a) : S ↔ A ↔ S ↗ !(S), R(s↪ a) : S ↔ A ↗ R represents the reward function, defining the immediate reward received after taking action a in state s, and we let C(s↪ a) : S↔A↗Rd3 be the immediate cost incurred after taking action a in state s. Often, each dimension i ↓ [d2] in a is either 0 or 1 in resource-constrained allocation tasks. In addition, h is the time horizon and ω ↓ [0↪ 1] denotes the discount factor, which determines the present value of future rewards.
The goal is to find a policy ε : S ↗ !(A) that maximizes the expected cumulative discounted reward while satisfying the cost constraints with a budget function B : S ↗ Rd3 :
Due to space limitation, the detail of maternal health domain WearableDeviceAssignment is relegated to Appendix D.1. The general formulation in (1) can be fitted into many differeng domains as well.
4.2 Key Concepts for Rule-based LLMAgents
Our challenge is to design a rule-based LLM agent that jointly optimizes a language policy to both solve the optimization problem and improve explanation quality-a direction rarely explored. We next introduce the key concepts and terminologies underlying our main contribution.
LLM Agent For our LLM agent, the action space includes internal language actions ˜ A = A⇐L [Yao et al., 2023]. The LLM agent has two types of internal language actions: First, thoughts athought ↓ L, are reasoning traces from the current problem state used to inform environment action selection aenv ↓ A. Second, explanations ϑ expl , are generated from actions and thoughts to enhance human trust and interpretability [Zhang et al., 2023], a focus of this work.
Rules Thoughts are useful to highlight relevant aspects of a problem. However, they often lack detailed information to identify the next optimal action. In this work, we will consider "rules" arule ↓ L, which are structured language statements derived from thoughts that generally take the form "[if/when][do/prioritize] ". More formally, each rule arule consists of a triple (background↪ rule statement↪ state relevance). Figure 12 shows examples of generated rules from the domains used in the experiments.
Task and Constraints Description Language agents require: (1) a language description of the environment and the agent's goal, denoted task, containing the available actions for the task; (2) a function describing the state of the environment in natural language, denoted lang : S ↗ L. At each state st, these descriptors are used to construct a natural language prompt pt = f(task↪ lang(st)). Figure 11 exemplifies language wrapper generated for the environments in our experiments.
Rule-based Language Policy The objective is to jointly optimize the reward and explainability of the environment.
Hence, we have an LLM agent-driven policy εLLM for online interaction with the environment:
The rule acts as a "bottleneck" to the action and explanation. In the next section, we will introduce RBRL, which allows an RL-based learnable selection policy εε choosing among a set of dynamically generated candidate rules.
4.3 Problem Statement
We aim to increase the quality of ϑ expl while also optimizing decision-making by selecting rules that encourage both good quality explanations and high reward. To achieve this goal, we construct a surrogate explainabilty "rule reward" Rrule LLM(arule ) using an LLM as judge [Shen et al., 2024; Bhattacharjee et al., 2024; Gu et al., 2024], which will be detailed in Section 5. Then, we propose the following augmented optimization objective under the joint environment/rule reward as ˜R(st↪ aenv t ) = R(st↪ aenv t ) +Rrule LLM(arule t ):
where ˜ rt = ˜R(st↪ aenv t ). We emphasize that LLMs cannot fully replace the ultimate human assessment, but they they provide a scalable alternative during the optimization process.
5 Rule-Bottleneck Reinforcement Learning (RBRL)
In this section, we propose RBRL, a novel LLM agent based on the key concepts in Section 4.2, which leverages the strengths of LLMs and RL to achieve both interpretability and robust sequential decision-making for (3), thereby achieving our goal of jointly optimizing policies and explanations for resourceconstrained allocation in (1).
AlgorithmOverview The framework of RBRL shown in Algorithm 1 involves four steps: (1) RULE SET GENERATION (line 3), where the LLM processes the state-task pt to create candidate rules Rt for action selection; (2) RULE SELECTION (line 4), where an attention-based RL policy εε selects the best rule arule t ↓ R; (3) DECISION, RULE REWARD AND EXPLANATION (lines 5-8), where the LLM generates an environment action aenv t and based on the chosen rule arule t gives a humanreadable explanation ϑ expl t ; (4) REINFORCEMENT LEARNING (line 11), where it updates the policy εε based on collected data with standard RL algorithm [Haarnoja et al., 2018] and the combined environment and rule reward ˜ rt. Algorithm 1 details the entire process. Further sections elaborate on these steps.
5.1 Rule Set Generation
The rule generation process seeks to create interpretable and actionable guidelines for decision-making. Under this framework, a set of candidate rules Rt is generated according to Rt ⇒ εLLM(Rt♣pt↪ athought t ). To enhance interpretability, each
Algorithm 1 RBRL
Require: Rule-selection policy εε; and Replay buffer B.
- 1: Initialization: Initial state s0 and task-state prompt p0.
- 2: for t = 0↪ ▷ ▷ ▷ ↪ max iters⇑1 do
- 3: Generate rule candidates Rt using CoT from pt and athought t . // Section 5.1
- 4: Select rule arule t using the RL policy εε fromRt and st. // Section 5.2
- 5: Generate the environment action aenv t with the LLM from arule t , pt, and previous thoughts.
- 6: Apply the action in the environment and obtain new state st+1 and environment reward renv t .
- 7: Generate explanation with the LLM from aenv t , rrule t , pt, and previous thoughts.
- 8: Generate rule reward rrule t with the LLM as judge. // Section 5.3
- 9: Update the prompt pt+1 from st+1, and the constraints C and budget B.
- 10: Append transition to the replay buffer B ⇓ B ⇐ ¶(˜st↪ arule t ↪ ˜ rt↪ ˜st+1)♦.
- 11: Sample from the replay buffer and update the policy network εε(arule t ♣˜st). // Section 5.4
12: end for
rule is accompanied by a rationale explaining the reasoning behind the decision. The LLM is instructed to generate rules as a JSON format, which is common for integration of LLMs with downstream applications [Shen et al., 2024]. See Figure 11 in the Appendix for the prompt templates used rules generation.
5.2 Rule Selection
In this step, rules are converted from text to vector form, and a trainable attention-based policy network εε provides the probability distribution for sampling a rule. Figure 2 illustrates the process, with a detailed procedure in Algorithm 2 of the Appendix. Below are the major components of the architecture of εε. We propose to base the architecture on cross-attention layers [Bahdanau et al., 2015; Vaswani et al., 2017], with the state acting as the keys and values, and the rules as the queries. This allows to learn from the embedding representations of rules, and efficiently handle dynamically changing number of rules if needed.
State Representation The numeric state is projected by a linear layer: kt = Linear(st) ↓ R1↔dh , with dh being to denote the architecture hidden dimension.
Rule Candidate Embedding Each rule in the list of rule candidates Rt = ¶ϖt1 ↪ ϖt2 ↪ ▷ ▷ ▷ ↪ ϖtq ♦ is embedded into a numeric representation using a Sentence Embedding language model (m2-bert-80M-8k-retrieval,see Table 3, App. D.3.) and further processed by a projection layer similar to the state representation. This results in a query matrix Qt ↓ Rq↔dh .
Attention-based Policy Network εε εε εε The vector kt, serving as keys, engages with the rule embeddings Qt, acting as queries, via a cross-attention mechanism to derive a hidden state representation h(1) t = Attention(Qt↪ k↗t ↪ k↗t ) ↓ Rq↔dh , computed as Attention(Qt↪ k↗t ↪ k↗t ) = softmax ( Qtk→t ↘dh ) k↗t ↪ which facilitates the rule candidate vector embeddings in attending to the environment state. Subsequently, we sequentially apply self-attention layers to the hidden representation h(k+1) = Attention(h(k) t ↪ h(k) t ↪ h(k) t ), enabling the rule embeddings to attend to one another to rank an optimal candidate. Ultimately, following K ⇑ 1 self-attention layers, a final linear layer converts the rule representations into logit vectors ϱtε = Linear(h(k) t ) ↓ Rq used for the computation of the probability of selecting each rule.

Rule Selection The policy distribution over the rules is calculated as: εε↪i(Qt↪ kt) = exp(ϑtω↪i (Qt↪kt)) ∑qj=1 exp(ϑtω↪j (Qt↪kt)) ↪ i = 1↪ ▷ ▷ ▷ ↪ q▷ Therefore, a rule is selected at random from the distribution: arule t ⇒ Categorical(R; (εε↪i(Qt↪ kt))qi=1 ).
5.3 Decision, Rule Reward, and Explanation
Upon selection of rule arule t , the LLM determines the action to be applied within the environment aenv t ⇒ εLLM(aenv t ♣arule t ↪ athought t ↪ pt), ensuring concordance with the chosen strategy. Subsequently, the LLM formulates an explanation ϑ expl t ⇒ εLLM(ϑ expl t ♣aenv ↪ arule ↪ athought ↪ pt) contingent upon the rule. Figure 11 in the Appendix illustrates the prompt template employed to generate both the action and explanation.
This procedure concurrently produces the rule reward Rrule LLM(rrule t ), used for RL in the next step. This rewards is derived from using the LLM as a judge to answer the following three questions: ER1. Without providing aenv t , is arule t sufficient to predict the optimal action? ER2. Does arule t contain enough details about the applicability of the rule to current state? ER3. Given aenv t , is arule t compatible with this selection? Each question scores as 0 if negative or 1 if positive. The rule reward is calculated as rrule t = Rrule LLM(arule t ) ⇔ (1◁3) ∑i ERi. Refer to Figure 11 in the Appendix for the full prompt.
5.4 Policy Update through RL
Augmented state space Traditional RL frameworks fail to directly return a policy based on current environment state due to intermediate steps: generating the rule set Rt, mapping rules arule t to actions aenv t in an LLM-driven environment. RBRL addresses this issue by creating an augmented state
˜st := (st↪Rt) with transition dynamics P(˜st+1♣˜st↪ arule t ), integrating rules into the state space for reasoning over both the environment's dynamics and decision rules arule t . The following theorem explains the transition computation.
Theorem 5.1. The state transition of the RBRL MDP can be calculated as
where P(Rt+1♣st+1) = εLLM(Rt+1♣pt↪ ς t) is the probability of the LLM generating rule set Rt+1 provided the state st+1, P(st+1♣aenv ↪ st) is the original environment dynamics, and P (aenv ♣arule t ↪ st) = εLLM(aenv ♣pt↪ arule t ) is the probability of the LLM selecting the environment action aenv .
Policy update step The attention-based policy network in Section 5.2 is optimized using the standard SAC algorithm, which balances reward maximization with exploration. The policy network in SAC is updated by minimizing the KL divergence between the policy and the Boltzmann distribution induced by Q networks Qϖi ↪ ↘i = 1↪ 2, which is expressed as
where ↼ is a temperature parameter. The detailed implementation for SAC update procedure is detailed in Algorithm 3 in Appendix B.
6 Performance Guarantee
In this section, we derive and prove conditions under which RBRL can learn the optimal task policy, as well as characterize the potential trade-off between explainability and task performance when rewarding rules for higher explainability.
Proposition 6.1 (Rule Set Coverage). Let A be a finite action space and Q↑ (s↪ aenv ) the optimal state-action value function, with aenv↪↑ (s) := argmaxaenv≃AQ↑ (s↪ aenv ) denoting the optimal action at state s. Given state s, an LLM samples N rules independently from a conditional distribution εLLM(· ♣ s), and each rule ϖi maps s to an action aenv i ⇒ εLLM(aenv i ♣ϖi↪ s). Assume there exists ↽ > 0 and ⇀s ↓ (0↪ 1] such that: Pϱi⇐ωLLM(·♣s) [Q↑ (s↪ aenv i ) ↖ Q↑ (s↪ aenv↪↑ (s)) ⇑ ↽] ↖
⇀s▷ Define the ↽-optimal rule set as: Rς (s) := ¶ϖi : Q↑ (s↪ aenv i ) ↖ Q↑ (s↪ aenv↪↑ (s)) ⇑ ↽♦ ▷ Then with high probability over the sampled rules, there at least has a rule ϖi and the induced action aenv i ⇒ εLLM(aenv i ♣ϖi↪ s) that satisfies:
where ⇁worst := maxϱ◁≃Rε (s) (Q↑ (s↪ aenv↪↑ (s)) ⇑Q↑ (s↪ aenv i )) is the worst-case loss outside the ↽-optimal set.
Remark 6.2. Proposition 6.1 states the rule diversity property in the rule candidate set such that the best possible action (when ↽ ↗ 0) is included is guaranteed with high probability when number of rules N goes large. This is crucial in guaranteeing that RBRL can learn a near-optimal policy with high probability (with optimality when ↽ = 0 and ⇀s = 1). See Section C in Appendix for more detail. We also numerically evaluate rule-coverage in Figure 7 of Appendix E.5.
Define the T-step value function V ω↪T M↑ (s0) = [∑T ↓1 t=0 ω tRM↑ t (st↪ ε(st))♣s0], where RM↑ is the reward function in M→ . We will denote the original MDP as M and use ˜M to denote the MDP for the RBRL agent with transition function as in Theorem 5.1 and reward ˜R. We have the following theorem.
where λ is a constant depending on the magnitude of the rule reward, and, with a slight notational abuse, V ωRBRL↪T M is the value of the RBRL policy when seen as a policy in the original MDP mapping states to actions (i.e., by integrating out the rule generation and action selection via LLMs.)
Remark 6.4. This analysis focuses on the evaluation gap between the optimal policy ε↑ under the original MDP M and the policy εRBRL, captures the suboptimality of using εRBRL instead of the true optimal policy ε↑ , assuming RBRL is optimized under the extended MDP ˜M (with same transitions as M but additional rule-based reward). It can be decomposed into two interpretable terms. The first part captures the optimism of using εRBRL under the extended MDP ˆMrather than the original MDP, which is non-positive. The second part quantifies the accumulated reward difference induced by the additional explanation rewards when using the same RBRL policy in both MDPs.
7 Experiments &Human Survey
In this section, we evaluate RBRL and empirically show that it can achieve a joint improvement in both reward and explainability over comparable baselines. We briefly summarize these environments here, with additional details in Appendix D.1.
| Dataset (@steps) | RBRL | SAC | PPO | DDT | DDT w/rules |
|---|---|---|---|---|---|
| Uganda (@500) | ⇑0▷56◦0▷18 | ⇑0▷83◦0▷14 | ⇑0▷91◦0▷14 | ⇑1▷01◦ 0▷20 | ⇑1▷20◦0▷31 |
| Uganda (@2500) | ⇑0▷60◦0▷20 | ⇑0▷75◦0▷14 | ⇑0▷74◦0▷05 | ⇑1▷28◦ 0▷35 | ⇑1▷20◦0▷30 |
| MimicIII (@500) | ⇑0▷36◦0▷05 | ⇑0▷61◦0▷11 | ⇑0▷78◦0▷05 | ⇑0▷92◦ 0▷10 | ⇑1▷02◦0▷10 |
| MimicIII (@2500) | ⇑0▷39◦0▷07 | ⇑0▷43◦0▷10 | ⇑0▷64◦0▷10 | ⇑0▷97◦ 0▷11 | ⇑0▷99◦0▷13 |
| HeatAlerts (@500) | 0▷14◦0▷11 | ⇑0▷04◦ 0▷33 | 0▷00◦0▷01 | 0▷22◦0▷25 | 0▷15◦0▷29 |
| HeatAlerts (@2500) | 0▷13 ◦ 0▷14 | 0▷05◦0▷04 | 0▷00◦ 0▷01 | 0▷38◦0▷57 | 0▷38◦0▷56 |
| BinPacking (@500) | ⇑0▷03◦0▷00 | ⇑0▷03◦0▷00 | ⇑0▷03◦0▷00 | ⇑0▷19◦ 0▷03 | ⇑0▷19◦0▷04 |
| BinPacking (@2500) | ⇑0▷03◦0▷00 | ⇑0▷06◦0▷00 | ⇑0▷03◦0▷00 | ⇑0▷21◦ 0▷02 | ⇑0▷21◦0▷02 |
Domains We evaluate RBRL in three main distinct resourceconstrained allocation domains:
▷ WearableDeviceAssignment: We use two environments, Uganda and MimicIII, from the vital sign monitoring domain introduced by [Boehmer et al., 2024], modeling the allocation of limited wireless devices among postpartum mothers as an MDP setting. ▷ HeatAlerts: We use the weather2alert environment from [Considine et al., 2025] , which formulates issuing heat alerts as a constrained MDP to reduce hospitalization risk from the alert. ▷ BinPacking We adopt the online stochastic BinPacking: environment introduced by [Balaji et al., 2019], which Sequentially places arriving items into bins with fixed capacity to minimize total waste, following the online stochastic formulation. Detailed domain description can be found in Appendix D.1.
7.1 Environment Reward Optimization
We discuss the main results and refer to Appendix D for the detailed experiment setup and Appendix E for additional experiments. Unless otherwise specified, we use gpt-4o-mini as LLM due to its reasonable cost and high performance.
Did RBRL optimize the reward function? RBRL is compared to CoT [Wei et al., 2022] for language reasoning and PPO [Schulman et al., 2017] for numeric states. Figure 3 indicates RBRL outperforms CoT, showing RL-optimized rule selection improves decision-making. RBRL also exceeds PPO in all environments with equal environment steps, suggesting a better online learning performance. Notice that RBRL is compatible with a baseline LLM trained for advanced reasoning techniques (e..g, GRPO [Shao et al., 2024]). However, GRPO or similar cannot be used directly in MDPs. Nevertheless, our experiments with the comparable GPT o3 (see Appendix E) prove that RBRL can also help improve reasoning models in our tasks.
Additional comparison with XRL benchmarks We further compare RBRL against a representative XRL method that also targets joint optimization and intrinsic interpretability: Decision Diffusion Trees (DDTs) [Silva et al., 2020]. As shown in Table 1, RBRL is consistently competitive and often outperforms the tree-based baseline across most domains, particularly in the early stages of training, underscoring its sample efficiency. Although DDT achieves a higher average reward than RBRL in HeatAlerts, it exhibits substantially higher variance, highlighting the greater stability of RBRL.
7.2 Human Survey and Explainability
Did RBRL increase the explainability of explanations? A survey with 40 participants was conducted to assess explanation quality, detailed in Appendix H. Each prompt included the task, state, and action space as originally given to the LLM, followed by actions and explanations from the CoT agent and the RBRL agent, without disclosing agent types. Participants were asked to choose preference for explanation A, B, or none. Prompts were split between WearableDeviceAssignment and HeatAlerts domains. Figure 4 shows results, favoring RBRL's explanations in both domains, with a detailed breakdown in H. An additional experiment with an LLM judge using a large gpt-4o model showed strong agreement with humans, preferring RBRL's explanations in all cases.

Discussion on Explainability The trustworthiness of explanations is a core challenge in XAI. Following recent work [Kunz and Kuhlmann, 2024; Parcalabescu and Frank, 2023; Jacovi and Goldberg, 2020], we highlight three concepts: Plausibility: whether an explanation is convincing to humans (validated via our survey, Figure 4). Consistency: whether the stated reason logically entails the action (Appendix E.3). Faithfulness: whether the explanation reflects the true decision mechanism.
Our work is motivated by the gap between plausibility and faithfulness in post-hoc methods. By design, RBRL ensures consistency: explanations factually follow the State ↗ Rule ↗Action pipeline, where the rule is the verifiable cause of the action. As shown in Table 8 in Appendix E.3, including reasoning traces does not affect the decision, confirming that consistency stems from the state and rule rather than LLM self-explanation. While our experiments validate consistency, establishing faithfulness-verifying the LLM's internal reasoning for rule generation-remains an open challenge.

Acknowledgements
This work is supported by the Harvard Data Science Initative.
@inproceedings{ijcai2026p835,
title = {Rule-Bottleneck RL: Learning to Decide and Explain for Sequential Resource Allocation via LLM Agents in Public Health},
author = {Xiong, Guojun and Tec, Mauricio and Wang, Haichuan and Dominici, Francesca and Ngonzi, Joseph and Boatin, Adeline and Tambe, Milind},
booktitle = {Proceedings of the Thirty-Fifth International Joint Conference on
Artificial Intelligence, {IJCAI-26}},
publisher = {International Joint Conferences on Artificial Intelligence Organization},
editor = {Diego Calvanese},
pages = {7512--7520},
year = {2026},
month = {8},
note = {AI and Social Good},
doi = {10.24963/ijcai.2026/835},
url = {https://doi.org/10.24963/ijcai.2026/835},
}
TY - CPAPER TI - Rule-Bottleneck RL: Learning to Decide and Explain for Sequential Resource Allocation via LLM Agents in Public Health AU - Xiong, Guojun AU - Tec, Mauricio AU - Wang, Haichuan AU - Dominici, Francesca AU - Ngonzi, Joseph AU - Boatin, Adeline AU - Tambe, Milind T2 - Proceedings of the Thirty-Fifth International Joint Conference on Artificial Intelligence, IJCAI-26 PB - International Joint Conferences on Artificial Intelligence Organization PY - 2026 SP - 7512 EP - 7520 DO - 10.24963/ijcai.2026/835 UR - https://doi.org/10.24963/ijcai.2026/835 ER -Copied
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