Month: July 2025

Fortuna Closes Series A to Modernize Medicaid Access

Posted on by Jason Barry

It never hurts to be at the right place at the right time, and Medicaid navigation platform Fortuna Health just landed $18M of Series A funding in the wake of one of the biggest shakeups the safety net coverage program has ever seen.

Medicaid is complicated. Each of the 56 Medicaid programs in the U.S. has its own evolving eligibility rules, documentation standards, and renewal timelines – none of which are easy for anyone to keep track of.

  • Fortuna consolidates these programs into a single interface for patients and members, allowing them to manage their eligibility and applications while getting guided through the obstacle course.
  • For anyone with some time to spare for an exhaustive overview of Fortuna and the broader Medicaid market, look no further than HTN’s stellar interview with CEO Nikita Singareddy.

“TurboTax for Medicaid.” That’s the basic pitch to Fortuna’s payor and provider customers. 

  • Managed care plans and payors get a way to offload backend compliance work and “become invaluable to their members” by putting a Medicaid navigator in their pocket.
  • Health systems and other provider orgs get a way to maximize revenue / retention by helping more patients get (and stay) enrolled in Medicaid or navigate their way to financial support from partners like Cedar.

Over 71M people are currently covered by Medicaid, and One Big Beautiful Bill just reshuffled the rulebook for all of them.

  • OBBB includes roughly $1T in cuts to safety net coverage, as well as new proof-of-work restrictions, documentation requirements, and more frequent eligibility checks.
  • The CBO expects 10M people to lose coverage by 2034 as a result, and Fortuna plans to use its Series A to scale nationwide (it’s currently in 10 states) and invest in AI features that will help respond to the policy shifts.

The Takeaway

As long as Medicaid exists, there’s a place for software that makes enrolling easier. Medicaid infrastructure is long overdue for a healthy dose of AI modernization, and an extra $18M certainly won’t hurt Fortuna’s chances of being the company that makes it happen.

OpenAI Delivers Largest-Ever Study of Clinical AI

Posted on by Jason Barry

Hot on the heels of launching its HealthBench medical AI benchmark, OpenAI just delivered results from the largest-ever study of clinical AI in actual practice – and let’s just say the future’s looking bright.

40,000 visits, 106 clinicians, 15 clinics. OpenAI went big to get real-world data, equipping Kenya-based primary and urgent care provider Penda Health with AI Consult (GPT4o) clinical decision support within its EHR.

  • The study split 106 Penda clinicians into two even groups (half with AI Consult, half without), then tracked outcomes over a three month period. 

When AI Consult detected a potential error in history, diagnosis, or treatment, it triggered a simple Traffic Light alert.

  • Green – No concerns, no action needed
  • Yellow – Moderate concerns, optional clinician review 
  • Red – Safety-critical concerns, mandatory clinician review

The results were definitely promising. Clinicians using AI Consult saw a:

  • 16% reduction in diagnostic errors
  • 13% reduction in treatment errors
  • 32% reduction history-taking errors

The “training effect” is real. The AI Consult group got significantly better at avoiding common mistakes over time, triggering fewer alerts as the study progressed.

  • Part of that is because Penda took several steps to help along the way, including one-on-one training, peer champions, and performance feedback.
  • It’s also worth noting that there was no recorded harm as a result of AI Consult suggestions, and 100% of the clinicians using it said that it improved their quality of care.

What’s the catch? While AI Consult led to a clear reduction in clinical errors, there was no statistically significant difference in patient-reported outcomes, and clinicians using the copilot saw slightly longer visit times.

The Takeaway

Clinical AI continues to prove itself outside of multiple choice licensing exams / clinical vignettes, and OpenAI just gave us our best evidence yet that general-purpose models can reduce errors in actual patient care.

FDA Sparks Wellness Feature Debate With Warning Letter to Whoop

Posted on by Jason Barry

The FDA fired off a warning letter to wearable company Whoop for promoting its blood pressure feature without getting clearance, which quickly reignited the debate on whether wellness claims should be regulated as medical devices.

Whoop’s wristbands pack a punch. The just-released WHOOP MG tracks everything from sleep and heart strain to AFib and Blood Pressure Insights (BPI) – the new feature that landed them in the hot seat.

  • BPI delivers daily systolic and diastolic blood pressure estimates by measuring heart rate variability during sleep, allowing users to capture “medical-grade insights” related to their recovery and stress levels.
  • The FDA believes that makes the WHOOP MG a medical device subject to regulatory review, because it provides “a measurement or estimation of a user’s blood pressure, which is inherently associated with the diagnosis of hypo- and hypertension.” 

Whoop respectfully disagrees. CEO Will Ahmed took to social media to argue that BPI is strictly a wellness feature because it doesn’t diagnose a condition and is clearly labeled not for medical use. 

  • The 21st Century Cures Act states that “functions intended to promote a healthy lifestyle – and unrelated to the diagnosis, cure, mitigation, prevention, or treatment of a disease – are excluded from the definition of a medical device.”
  • Ahmed makes the case that BPI fits that definition, and said that Whoop won’t be backing down from “misguided” overreach that undermines innovation. 

Where should regulators draw the line? The carve-out for wellness features is explicitly based on intended use, and most people seem to agree that BPI meets that standard.

  • Law firm Hyman, Phelps & McNamara shared that the warning letter breaks the FDA’s precedent for intended use, and that the agency already has separate product codes for “general wellness” and “medical” versions of pulse oximeters and heart rate monitors.
  • The FDA’s stance is that blood pressure estimates are high-risk because an error could have major consequences for the user, placing them firmly outside the “general wellness” bucket. 

The Takeaway

The regulation versus innovation debate is the gift that keeps on giving, and Whoop’s response will make it obvious how far they’re willing to go to “not let regulatory overreach dictate how people access their own health data.”

OpenEvidence Locks in $210M Series B in Second Raise of the Year

Posted on by Jason Barry

OpenEvidence might just be the hottest startup in healthcare after locking in another $210M of Series B funding and tripling its valuation to a whopping $3.5B.

Déjà vu. If that sounds familiar, it’s probably because OpenEvidence first joined the unicorn club just five short months ago when it notched a $1B valuation through its $75M Series A.

  • Since then, the LLM-powered medical search engine inked a multi-year content agreement with JAMA to bring full-text articles directly to its platform, and continued to add new doctors at the breakneck pace of 65k per month.
  • It turns out that getting doctors to use a sleek new AI tool isn’t the hardest thing in the world when you make it available at no cost, and over 40% of doctors in the U.S. apparently don’t mind a few pharma ads if you can make their job easier.

Does that justify the valuation? Depends what physician trust is worth. OpenEvidence has added over 430k verified physicians since launching in 2023, and they’re now supporting over 8.5M clinical consultations every month.

  • The volume of medical research published annually is doubling every five years, and physicians are flocking to OpenEvidence so that they can search once, skip the scavenger hunt, and surface the science in seconds.
  • That type of growth is nearly unprecedented in healthcare, and investors are looking to capitalize by dogpiling into startups like OpenEvidence and Abridge, which also raised back-to-back megarounds in the first half of the year.

OpenEvidence is only ramping up from here. CEO Daniel Nadler told Forbes that he views the commoditization of AI copilots similar to TV streaming services, which have to differentiate around content and partnerships.

  • The Series B funds will help OpenEvidence add more strategic content to its medical knowledge library, and fuel new products that can take advantage of it – including its new DeepConsult research assistant.
  • DeepConsult helps physicians get up to speed on a topic by cross-referencing hundreds of studies to deliver comprehensive Ph.D.-level research reports in a matter of hours.

The Takeaway

OpenEvidence is off to the races, and “the fastest-growing platform for doctors in history” still hasn’t even started charging doctors to use it.

Samsung Leans In On Healthcare With Xealth Acquisition

Posted on by Jason Barry

It was already shaping up to be a great year for digital health exits, and Samsung just kicked things up another notch by acquiring tech integration platform Xealth.

Xealth was the first spin out from Providence’s Digital Innovation Group back in 2017. The platform integrates 70+ partner solutions for everything from RPM to patient engagement into a single user interface that allows providers to manage them within their existing workflows.

  • That not only allows clinicians to avoid juggling separate apps, but it also gives health systems an orchestration layer for controlling the data and painting a complete picture of their patients.
  • Over 500 hospitals are already in Xealth’s network, and they’ll now be gaining access to Samsung’s connected care ecosystem when the acquisition gets finalized.

Samsung’s no newcomer to healthcare. It’s fresh off another acquisition with prenatal ultrasound startup Sonio, and has been loading up its wearables with FDA-cleared features like sleep apnea detection and irregular heart rhythm monitoring.

  • It’s also developing a new health hub to let users share Galaxy Watch and Galaxy Ring data with their providers between visits, which would be a solid step toward making the data clinically useful – assuming they can get docs to use it.
  • A standalone Samsung health hub sounded like a tough pitch without a way to plug into provider workflows, which happens to be exactly what Xealth brings to the table.

Samsung isn’t just acquiring an integration platform, it’s acquiring a bridge between its consumer ecosystem and actual healthcare delivery.

  • Xealth CEO Mike McSherry said the move will enable “health data from wearables to fill in context that is missing to hospitals and bring more data analysis possibilities that were not available just with clinical records.”
  • Decent enough reason for an acquisition, but then again so is hitting a growth ceiling and needing a Korean tech giant with deep pockets to help you keep scaling, which is the logic that McSherry gave to MedCityNews.

The Takeaway

Samsung and Xealth are keeping the M&A momentum rolling, and we’re already on pace to double 2024’s deal volume. So far this year we’ve seen an end to the IPO drought thanks to Hinge and Omada, Arcadia just got scooped up by a PE firm, and now Big Tech is coming in hot with platform plays. Who said there’s no exit in digital health? 

Microsoft MAI-DxO and the Path to Medical Superintelligence

Posted on by Jason Barry

In an action-packed week to kick off the second half of the year, no story grabbed more headlines than Microsoft’s MAI-DxO proving four times more successful than human doctors at diagnosing complex diseases.

Microsoft is on the path to medical superintelligence… at least according to their excellent blog post outlining its new MAI Diagnostic Orchestrator, better known as MAI‑DxO.

  • MAI-DxO acts like a “virtual panel of physicians” collaborating on a case, orchestrating multiple AI agents with specific roles like forming diagnostic hypotheses, selecting tests, and interpreting results. 
  • It then applies a “debate chain” to arrive at an explainable diagnosis, all while avoiding over-testing to keep costs under control.. 

New breakthroughs require new benchmarks. As AI gets to the point where it’s breezing through multiple choice benchmarks like medical licensing exams, Microsoft decided to introduce SDBench to better simulate routine clinical practice.

  • SDBench deconstructs 304 of the most diagnostically complex NEJM cases, requiring LLMs (and physicians) to begin with an initial presentation, ask follow-up questions, order tests (each with assigned costs), and agree on a diagnosis.

Here’s how MAI-DxO stacked up:

  • MAI-DxO: 85% diagnostic accuracy / $7,200 estimated cost per patient
  • OpenAI o3: 79% / $7,850
  • Gemini 2.5 Pro: 69% / $4,800
  • Claude 4 Opus: 68% / $7,000
  • Llama 4: 55% / $4,000
  • Human Physicians: 20% / $2,950

What’s the catch? The human physicians weren’t allowed to use the internet or any outside help, which probably simulates a deserted island workflow more than routine clinical practice. Each of the participants also happened to be generalists as opposed to specialists, giving another edge to the LLMs. 

The Takeaway

MAI-DxO might have the potential to deliver superhuman diagnostics in constrained settings, but that doesn’t mean it’s ready to replace doctors. As Microsoft pointed out in its own blog post, “clinical roles are much broader than simply making a diagnosis. They need to navigate ambiguity and build trust with patients and their families in a way that AI isn’t set up to do.”

Current Health Starts Next Act After Best Buy

Posted on by Jason Barry

Sometimes the best M&A strategy is re-acquiring what you already built, and Current Health is once again an independent company after co-founder Chris McGhee decided to take back the reins from Best Buy.

Best Buy picked up Current in 2021. The pandemic boom in home health inspired the retailer to move into the space before the ink was done drying on hospital-at-home-waivers.

  • The thesis was that Best Buy could leverage its logistics and consumer-tech expertise to supercharge Current’s services, giving it a way to diversify revenue as TV prices plummeted and people held onto their smartphones for longer.
  • McGhee steered the ship as CEO before stepping away last year. By then Current had expanded to the point where it was managing about a third of all hospital-at-home volume in the U.S.

Hospital-at-home is a tough business. Best Buy sprinkled plenty of foreshadowing into its recent earnings call, revealing that it’s racked up $109M in restructuring costs as it scales back its healthcare business.

  • It sounded like a lot of HaH partnerships have taken longer to develop than initially thought due to health system financial challenges and uncertainty around waivers.
  • Medically Home sang a similar tune to investors when structuring its merger with Dispatch Health, then proceeded to leak all the details in a company-wide email.  

Current is starting its next act. McGhee announced that he’s returning “to build Current Health into the world’s largest healthcare organization” by honing its focus on high-acuity services where payment models are crystal clear.

  • Unlike the murky reimbursement pathways of RPM, high-cost / high-need areas like oncology-at-home (including cell and gene therapies) are where Current is finding its sweet spot of delivering meaningful outcomes through a scalable model.
  • While Current will continue to operate HaH and RPM programs, it views leaning in on the highest impact areas possible as the best way to serve its customer base – and move the needle for patients – going forward.

The Takeaway

Current Health is looking to build a healthcare system centered on homes and communities rather than hospital hallways, and it turns out the fastest way to get there isn’t by waiting around for GeekSquad.

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