A-Squared Ventures Managing Partner Nadav Shimoni

Welcome to DHW 461 – prime number, prime newsletter.

We’re diving into the adverse effects of pharmaceutical ads in LLMs, the questionable unit economics of AI agents, and the rise of fake citations in peer-reviewed research.

Happy Monday,
Jason

Artificial Intelligence

Ad-verse Effects in Consumer-Facing AI

As AI companies embed more ads in their user interfaces for clinicians and consumers, the BRIDGE GenAI Lab decided to take a look at whether these ads impact model performance.

Turns out, they do. BRIDGE ran four experiments across 12 leading LLMs from Anthropic, Google, and OpenAI. The models were far more recent than most studies we cover, an upside of not waiting around for peer-review before publishing a preprint.

• Each experiment paired a clinical scenario with a system prompt containing a pharmaceutical advertisement, then asked the model for a treatment recommendation.

Ads definitely moved the needle. Across 74,880 calls and 13 scenarios, advertising shifted the model’s choice toward the advertised drug from a baseline of 34% to 48%. 

• That’s a jump of +12.7 percentage points on average.

The LLMs had some nice range. Model bias varied widely by developer.

• Google’s advertising DNA was on full display when Gemini led the pack with an average shift of +29.8 percentage points toward the advertised drug. 

• Five models from OpenAI were swayed by an average of +10.9 pp.

• Anthropic’s models were the most resilient at +2.0 pp, and the ever-skeptical Opus 4.6 actually steered away from the promoted drug by -3.8 pp.

Three experiments contrasted three different conditions. That let BRIDGE triangulate the bias across a trio of distinct categories.

• Equipoise (+12.7 pp) – When two drugs were guideline-equivalent, the ad acted as a tiebreaker. The output was clinically correct, but biased.

• Suboptimal Drug (+0.6 pp) – When the advertised drug was clinically inferior, models resisted. Only 4.4% of responses chose the suboptimal advertised option.

• Wellness Supplements (-0.6 pp) – For supplements lacking evidence, endorsement decreased. Anthropic models actively pushed back at -2.4 pp.

The picture was consistent. Advertising didn’t override medical knowledge, but it did tip the scales when two or more options were medically defensible. 

• Another important note: When models were asked to justify their choices, they almost never disclosed the ad. If they chose the advertised drug, the justification echoed the ad in 52.7% of cases.

The Takeaway

BRIDGE just showed why the real harm with AI advertising might not be patients receiving dangerous drugs. It could be that they receive clinically sound recommendations that were shaped by commercial interests – without them knowing it, and without a mechanism to flag it.

The Virtual-First Difference at MetroHealth

When the MetroHealth System needed a comprehensive, scalable solution to help its patients access care, it turned to Ovatient’s virtual-first care model. Ovatient isn’t another point solution, it’s a virtual care partnership – integrated clinically, operationally, and technologically with your existing infrastructure. Discover how MetroHealth’s virtual-first approach is keeping patients connected to high-quality care whether they’re at home, at work, or on the go.

Best Practices for Value-Based Obesity Care

Healthcare executives focused on value-based obesity care need actionable guidance, and that’s exactly what they’ll find with Withings’ new best practices. By leveraging connected health data to measure outcomes and optimize resources, care teams can improve long-term patient engagement and success, while still being cost effective. Get the best practices today.

The Wire

• Doximity Prescribe: Doximity took the lid off Doximity Prescribe to help ensure that when visits are over, prescriptions are too. Prescribe is free, fully mobile, and integrates end-to-end prescribing directly into the platform that physicians are already using every day. The capability was co-developed alongside none other than Photon, the up-and-coming prescription infrastructure company that we highlighted last week, and rounds out the Doximity Clinical AI Suite that already handles the visit, the note, and the clinical question.

• The Agent Tax: A solid Substack post from A-Squared Ventures’ Nadav Shimoni was making the rounds last week after raising the question of whether agentic AI startups are actually building good unit economics? Shi argues that many AI-native software startups pitching themselves as obvious margin winners are quietly stacking up significant costs across inference, human oversight, QA, monitoring, and beyond. Shimoni believes that the next crop of success stories “may not be the companies using AI the most, but rather the companies using AI the most efficiently.”

• Health Plans Prefer Vendor-Built AI: Innovaccer released a new report examining how health plan executives at 63 major payors are evolving their AI strategies, and nearly 80% now plan to buy or co-develop AI capabilities with vendors rather than build in-house. This represents a sharp pivot from late 2024, when most (78%) were trying to develop internally. Three quarters of payors plan to invest more than $10M on AI-driven payment and care initiatives over the next 3 to 5 years, and 62% say personalized member navigation will be the AI use case most critical to success.  

• Glooko Heads to the Cloud: Glooko received FDA 510(k) clearance for EndoTool IV Cloud, the first FDA-cleared, cloud-based patient-specific insulin dosing platform. The platform is a cloud-native version of the on-prem EndoTool IV (which Glooko gained through its acquisition of Monarch Medical late last year), using the same underlying dosing algorithm to support inpatient IV insulin therapy with reduced hypoglycemia and faster time-to-target blood glucose. The cloud rebuild simplifies maintenance and lays the groundwork for future AI-driven updates, while also capping off a busy week for Glooko that also expanded its mylife Diabetes Care partnership.

• Fake Citations on the Rise: A new audit in the Lancet shows that fake citations are spreading like wildfire in peer-reviewed papers. Columbia researchers verified 97M references across 2.5M papers on PubMed and identified 4,046 fabricated citations in 2,810 articles. The sharpest spike unsurprisingly came in mid-2024 alongside the rise of LLM writing tools. Two former JAMA editors are calling for blanket retractions of any paper with fake citations, while others are making sound arguments in favor of a more case-by-case approach.

• Enzo Lands $20M: Enzo Health raised $20M of Series A funding to expand its AI home care coordination platform into skilled nursing and hospice. The core product trio (Intake for referral processing, Scribe for documentation, and QA for chart review) is reportedly fine-tuned specifically for home health’s documentation-heavy workflows. Enzo launched in 2024 before expanding to organizations serving 500k patients annually, and it’s now looking to become the Ferrari of remote care startups by expanding into skilled nursing and hospice before the “silver tsunami” arrives.

• HHS Launches Moms.gov: The wait is finally over for moms that wish the U.S. government could be more directly involved with their pregnancy after last week’s launch of Moms.gov. HHS debuted the new website as a resource for anyone who’s pregnant or looking to conceive, complete with maternity education, nutrition advice, and information on tax-advantaged children’s investment accounts. It also offers easy access to TrumpRx and a 24/7 pro-life helpline. 

• U.S. Gives Visa Relief to International Doctors: The U.S. Department of Homeland Security has resumed processing visa applications for international physicians. The move reverses a pause on visa extensions, work permits, and green cards that DHS implemented earlier this year and that threatened the ability of some international doctors – mostly from Africa, the Middle East, and Venezuela – to continue practicing in the U.S. The pause had complicated efforts to address the U.S. physician shortage with foreign-trained doctors. 

• Basata Series A: Basata scored $21M to simplify administrative workflows with specialty-specific AI agents. The platform tackles end-to-end referral workflows from fax extraction to chart creation and voice agent booking, reportedly achieving perfect same-day referral processing and dropping time-to-first-patient-contact from weeks to minutes. Basata has served 500K+ patients to date (100k of those in just the past month) across cardiology, urology, gastroenterology, and ophthalmology groups.

• Providence Brings on Watson: Providence is the latest system to deploy agentic HR at scale after integrating IBM’s watsonx with its existing HR platform. The initial rollout across the 52-hospital system saw watsonx help HR managers spend 90% less time on hiring steps, make job requests 70% more accurate, and accelerate internal caregiver transfers by 12 days on average. The partnership was unveiled at IBM Think 2026 to serve as a blueprint for other large systems looking to put a dent in HR admin burden.

Unlock Better Care With LOLA 

Whether you’re looking to augment your team’s capacity or capabilities, Tucuvi’s clinically validated LOLA voice agent is purpose-built to make it happen – and has the success stories to prove it. Hear first-hand from Tucuvi’s customers how LOLA is empowering clinical teams to care for patients while maximizing ROI.

State of Payer Enrollment and Credentialing

Over half of provider orgs are losing revenue due to credentialing delays – with many missing out on over $1M annually. Medallion’s new report unpacks the forces quietly undermining operational and financial performance, and how leaders across the industry are addressing them. Check out the full report to get insights tailored to your role and org type.

Start Practicing With a Partner

What began with notes now supports the work that surrounds them. From conversations to clinical questions and follow-ups, Heidi brings the full clinical day into one platform. See why clinicians across the country are making Heidi their trusted AI Care Partner.

The Resource Wire

• Same Tool, New Name, Better AI: DoxGPT is now called Ask, and it’s powered by a new agentic reasoning engine that delivers better, faster, and more reliable responses. Physicians can still find verified answers to complex clinical questions, integrated drug references, and full-text access to over 2,000 top journals – all in the Doximity workflows they’re already using every day. Don’t wait, Ask.

• Why Ambient Alone Isn’t Enough in Clinical Care: Clinicians were promised that AI would save them time, yet ambient scribes often leave them manually piecing together missing data after the visit. Navina’s new study found that combining ambient transcripts with the patient’s longitudinal history doubled documentation completeness, underscoring the limits of recording conversation alone. Explore the findings to learn why AI’s real value comes from uniting ambient notes with clinical context and connected workflows.

• Execution for Every Workflow: Health systems have no shortage of ideas for improving care and operations. Bunkerhill lets them bring those ideas to life – at scale, across service lines, and around the clock. Discover how the Carebricks platform is empowering clinical and operational teams to deploy AI agents that turn the data they have into the actions they need.

• Abridge Named #1 Best in KLAS – Again: KLAS just named Abridge #1 Best in KLAS for Ambient AI for the second year in a row. The recognition was based on direct customer feedback from the nation’s largest and most complex health systems, which gave Abridge the highest overall satisfaction score and A+ ratings across Culture, Loyalty, Relationship, and Value. Discover why Abridge is the market-leading AI platform for clinical conversations.

The Industry Wire

1. Supreme Court preserves access to abortion drug – for now.
2. Report: Millions of Americans canceling Obamacare coverage. 
3. RFK Jr. says he won’t run for president in 2028. 
4. HHS threatens $1.3B in Medicaid to California over fraud allegations.
5. STAT continues investigation into America’s alcohol epidemic.
6. U.S. overdose deaths drop for third straight year.   
7. High schooler presents spinal AI model at rural health fair. 
8. Hospitals report growing use of AI for business tasks. 
9. Texas hospital to create clinic to “detransition” gender-affirming surgeries.
10. Penile implant specialist leads federal briefing on hantavirus.

Healthcare Whisperer Andrew Tsang

Everybody loves a good market map (DHW included), so today we’re highlighting what might be the best RCM category breakdown we’ve ever seen.

Also on deck – nurses getting left out, and nurses getting included.

Let’s get into it.

Jason

Revenue Cycle

Mispricing the RCM Bundle

Recovering consultant Andrew Tsang is back with another top tier analysis exploring why healthcare’s revenue cycle management bundle is currently mispriced. 

Great bundles lead to great unbundling. The term “unbundling” was first coined in a 2010 Tumblr post that applied the concept to Craigslist, a patchwork homepage of loosely related categories waiting to be peeled off as specialized startups.

• AirBnB eventually took housing, Indeed took jobs, and dating apps took personals. Investors were standing by with checkbooks in hand every time. 

RCM is healthcare’s Craigslist. It’s a $300B monster of about a dozen different steps that exist to process the disagreement when payors and providers can’t agree on what care is worth.

• Tsang maps these steps out in what might be our favorite visual of the year. 

• RCM is practically begging to be broken into its component parts (prior auth, clinical documentation, denials), but the same investors funding the unbundling thesis are also the ones writing huge checks to fuse the wedges back together.

That’s because Craigslist isn’t linked like RCM. You don’t need a new love interest to get a new couch, and you don’t need a new couch to get a new love interest. Although it couldn’t hurt.

• With RCM, optimize coding and the patient’s bill goes up. Optimize collections and patients defer future care. Every optimization at one step ripples through the others.

Hospital execs know this. They’re not buying best-of-breed point solutions, they’re consolidating onto platforms that cover the full lifecycle, and vendors are behaving accordingly.

• Tsang argues that RCM vendors are rational actors that are being pushed to acquire nearby wedges rather than build them, and you don’t have to look much further than Waystar or Smarter Technologies to find evidence to support that.

• “The payor-provider fight is structurally dysfunctional, and that dysfunction rewards positioning over performance.”

RCM isn’t getting unbundled, it’s getting rolled up. When IT budgets get cut, CFOs pick the partner who covers enough of the arc to be worth keeping.

• The worse the market gets, the more valuable broad coverage becomes, and the RCM platform moat continues compounding. That’s the state of the RCM market.

The Takeaway

Tsang makes a compelling case that the RCM vendors that survive the next decade won’t be the ones that reduce the claims disagreement. They’ll be the ones that own the channel for it.

A Care Partner for the Full Clinical Day

Patient conversations are more than just a note. Heidi supports clinicians across the day from documentation to decisions and follow-ups, without adding any burden. See why clinicians around the globe are turning to Heidi for a true AI Care Partner.

State of Payor Enrollment and Credentialing

AI is changing the way that healthcare leaders tackle provider network management. Medallion’s latest report breaks down the biggest challenges, emerging trends, and how automation is transforming the landscape. Get the insights you need – read the full report today.

The Wire

• WHOOP Gets Clinical: WHOOP is diving deeper into healthcare with the unveiling of on-demand video consultations and a HealthEx partnership for EHR syncing. The clinical push was paired with two AI updates, a “My Memory” persistent context layer for personalized coaching and “Proactive Check-Ins” for timely recommendations based on biometric trends. The moves come less than two months after WHOOP closed a $575M round at a $10.1B valuation, and a few weeks after it announced its participation in CMS’ new ACCESS chronic care program.

• Nurses Feel Overlooked: Elsevier’s just-published Clinician of the Future report shows that nurses feel left out of both the AI boom and decision-making at their org. The survey of 2,757 clinicians showed that just 41% of nurses frequently use AI tools (compared with 57% of physicians), and only 55% believe AI will save them time within the next two to three years (significantly less than the 70% of doctors who said the same). One key driver was that 41% of nurses said their views are rarely or never reflected in AI decision-making, a massive gap considering only 18% of physicians felt nurses’ views aren’t reflected.

• Abridge for Nurses: The nurses feeling left out of all the AI innovation didn’t have to wait long for Abridge to lend a helping hand. Co-developed alongside Mayo Clinic, Abridge for Nurses translates bedside conversations into discrete documentation that’s deeply connected to the realities of nursing workflows and the care delivered throughout a shift. Early numbers leveraging GPT-5.4 look impressive, with Abridge able to draft 30-40% more flowsheet fields from the bedside conversation versus the previous generation for nurse review.

• Telemedicine vs Utilization: New research in JAMA Network Open suggests telemedicine might reduce overall visits and spending, key word: “might.” The difference-in-differences analyses of over 3M U.S. adults during 2019 to 2023 suggested that high-telemedicine-adopting areas had 2.4% fewer visits and 0.5% lower spending, but the 95% confidence intervals crossed the null across all populations (Medicare, MA, Medicaid, dual eligible, commercial). Although that means telemedicine wasn’t significantly associated with any major changes, the authors point out that it should also ease concerns about virtual care driving large spending increases. 

• Electronic Prior Auth Adopters: CMS announced the 29 healthcare organizations that have already signed on as early adopters in its new effort to advance electronic prior authorization. They include major players across providers (Cleveland Clinic and BSMH), EHRs (all the big names), and networks (b.well and CommonWell) – all of which will be joining the health plans that pledged to tackle the issue last June. Should the initiative work out as planned, we should have “API-enabled data exchange using FHIR-based standards, defined timeframes for PA decisions, and public transparency” ahead of the January 2027 deadline.

• Sanford + North Memorial: South Dakota-based Sanford Health is breaking into the Minneapolis market after announcing a merger with North Memorial Health. Sanford failed to break into the state by picking up Fairview three years ago and has since reached out to dozens of organizations as potential merger partners, none of which were very receptive to the idea. North Memorial wasn’t even included in that initial outreach, but after facing mounting financial pressures, it looks like it might finally give Sanford the foothold it’s been looking for with two hospitals and 22 clinics across the Twin Cities region.

• FDA Turmoil Continues: The turmoil at the FDA is dragging on this week with the departure of Commissioner Marty Makary, MD. The departure had been rumored for weeks as Makary was buffeted between the FDA’s traditional role in regulating the food and medical industries and demands for more rapid change by the Make America Healthy Again movement. Makary also presided over a year of personnel cuts that slashed the FDA’s workforce by about 21%, which wasn’t exactly great for the morale of remaining staffers. 

• AI Catches Cancer: A new AI model from Mayo Clinic could change how one of the deadliest cancers is detected. The REDMOD system can identify signs of pancreatic cancer on routine CT scans up to three years before a typical diagnosis, way before tumors are visible to the human eye, by analyzing subtle tissue patterns, texture, and structural signals that clinicians cannot see. In a study of ~2,000 scans that were originally read as normal, REDMOD flagged 73% of cases that were later diagnosed with cancer. Two years ahead of diagnosis, it identified roughly 3x more early cancers than experienced radiologists.

• Availity Extend: Availity introduced Availity Extend, a new activation layer that lets payors, providers, and technology partners build agentic workflows on top of the Availity network without stitching together point-to-point integrations. The pitch is that the constraint on healthcare AI isn’t intelligence, but execution across siloed systems, and Availity’s existing direct connectivity (4,000+ payors and 3.5M providers powering half of all U.S. healthcare activity) makes it uniquely positioned to be that backbone. The initial rollout is underway with select customers, and broader availability is slated for later this year.

• Disparity Despite Progress: The Commonwealth Fund’s 2026 State Health Disparities Report found that racial and ethnic health gaps persist in all 50 states despite some post-pandemic gains in coverage and affordability. The annual scorecard tracks 24 measures across access, quality, and outcomes for different demographics, with Native, Hispanic, and Black communities continuing to bear the worst outcomes in the majority of states. The data only runs through 2024, but authors warned that Medicaid cuts and ACA subsidy expirations are likely to widen the gaps from here.

DoxGPT Nabs a New Name – and Big Upgrades

The tool formerly known as DoxGPT is now called Ask, and it’s packing more upgrades than just the name. Ask’s new agentic reasoning model delivers better, faster answers to physician’s most complex clinical and workflow questions – with the same verified outputs, journal access, and drug dosing they already know and trust. Discover the difference and Ask today.

Privia Accelerates VBC Success With Navina

How do you give physicians new AI tools to accelerate VBC without slowing them down? Privia Health found its answer with Navina. They co-designed an under-one-hour training program that onboarded 800+ clinicians in the first year, driving 87% weekly active usage while providing clearer visibility into their patient panels. Read the full case study to see what it takes to make adoption stick and outcomes follow.

Abridge & Availity Redefine Payer-Provider Synergy

Abridge is teaming up with Availity to redefine payer-provider synergy at the point of conversation. The collaboration aligns Abridge’s evidence-aware intelligence with Availity’s real-time health information network to create a first-of-its-kind prior authorization experience, with a shared understanding between patients, providers, and payers. Find out how Abridge and Availity are extending conversational intelligence across the revenue cycle.

The Resource Wire

• Unlock Better Care With LOLA: Whether you’re looking to augment your team’s capacity or capabilities, Tucuvi’s clinically validated LOLA voice agent is purpose-built to make it happen – and has the success stories to prove it. Hear first-hand from Tucuvi’s customers how LOLA is empowering clinical teams to care for patients while maximizing ROI.

• Virtual-First, Local Always: The humans of healthcare can get lost in the background at conferences full of robo-docs and AI assistants, but deep personal connections are just as key as new technologies for driving better outcomes. Find out how Ovatient is keeping care “virtual-first, local always” in Digital Health Wire’s rapid-fire interview from the ViVE exhibit hall.

• Any Use Case, Any Specialty: Bunkerhill’s Carebricks platform doesn’t stop at surfacing insights. It translates them into real-world action. From automating prior auths to closing care gaps, Carebricks lets health systems design and deploy AI agents for any clinical or operational need – without adding to anyone’s manual workload. Learn how Carebricks can automate actions for your patients today.

• BPM Pro 2 Delivers Data When It’s Needed Most: BPM Pro 2’s built-in questionnaires capture patient context alongside each blood pressure reading, reducing manual outreach and follow-ups. See how BPM Pro 2 is equipping care teams with actionable information upfront, and helping streamline workflows and prioritize interventions where it’s needed most.

The Industry Wire

1. What is White House looking for in next FDA commissioner?
2. Pharma leverages AI for faster drug development. 
3. FDA clears AI tool for early sepsis detection. 
4. Alcohol’s staggering toll on U.S. healthcare.
5. Discovery of third bodily system links Eastern, Western medicine.
6. Doctors flood No Surprises arbitration system with 1.2M claims.
7. Can CIA’s “Ghost Murmur” really detect heartbeats 40 miles away?
8. Celebrity endorsements boost ivermectin prescriptions. 
9. OpenEvidence now used by two-thirds of U.S. doctors.
10. Health coverage industry “shows signs of life.”

CVS President of Health Care Delivery Sree Chaguturu

Hope everyone saved room after their Mother’s Day feast because today’s newsletter has another tasty buffet of stories ready to go.

We’re serving up Photon’s $16M Series A, Perplexity’s healthcare push, Google’s new Health app, and a whole lot more.

Thanks for coming in!

Jason

Startups

Photon Raises $16M to Power Up Prescriptions

Electronic prescribing was designed to move prescriptions from point A to point B, not to give patients the information needed to pick those points on the spot. Photon just raised $16M in Series A funding to fill that gap.

Photon got its start in 2021 building prescription infrastructure for direct-to-consumer telehealth companies, powering some of the fastest-growing brands of the pandemic and GLP-1 era.

That experience provided a solid foundation. Photon built deep integrations across pharmacy networks, real-time formulary data, and a patient-first prescribing experience.

• That foundation not only proved compelling to DTC startups, but also to health systems looking for better ways to engage patients at the point of care and drive visibility into their in-house pharmacies. 

• Fast forward to the Series A, and Photon is leaning in on the enterprise market where it can make the biggest impact.

Photon isn’t a pricing widget. It’s an end-to-end platform that includes:

• Modern prescribing and routing infrastructure
• A network of pharmacy partners across retail and home delivery
• A consumer-facing marketplace that surfaces real-time price and stock information
• A full suite of capabilities including prior auths and clinical decision support 

AI underpins everything. Photon’s AI ingests fragmented data across pharmacy networks, benefit structures, and formularies, then translates it into info that patients can actually use.

• That gives patients a sense of what’s convenient, what’s covered, what delivery options are available, and most importantly – price. 

• Put it all together, and patients can make informed choices before prescriptions ever get sent.

Health systems get something equally valuable. The prescription becomes a patient engagement touchpoint instead of a handoff.

• In-house pharmacy teams gain real-time visibility into fill activity, and having patients that are actually informed results in fewer abandoned scripts, less reroutes, and a meaningfully better experience for everyone involved.

The Takeaway

Right when healthcare services are getting disrupted by LLMs and agents, patients are hitting a boiling point with affordability and transparency. The pharmacy experience is a major intersection for both roads, and Photon just raised $16M to modernize all four corners.

Abridge & Availity Redefine Payer-Provider Synergy

Abridge is teaming up with Availity to redefine payer-provider synergy at the point of conversation. The collaboration aligns Abridge’s evidence-aware intelligence with Availity’s real-time health information network to create a first-of-its-kind prior authorization experience, with a shared understanding between patients, providers, and payers. Find out how Abridge and Availity are extending conversational intelligence across the revenue cycle.

DoxGPT Nabs a New Name – and Big Upgrades

The tool formerly known as DoxGPT is now called Ask, and it’s packing more upgrades than just the name. Ask’s new agentic reasoning model delivers better, faster answers to physician’s most complex clinical and workflow questions – with the same verified outputs, journal access, and drug dosing they already know and trust. Discover the difference and Ask today.

The Wire

• Perplexity Premium Health Sources: AI-powered search engine Perplexity took the lid off Premium Health Sources to help answer questions from consumers and clinicians alike. The new capability enables Perplexity to draw from medical journals and clinical guidelines, starting with a pair of big name partners: New England Journal of Medicine and BMJ Best Practice. Perplexity has some tough competition that’s spread less thin, but it sounds like it’s also planning to stake a bigger claim in the evidence landgrab with sources like Micromedex for medication information and Health Affairs for policy research.

• CMS Goes After Prior Auths: CMS is doubling down on its effort to modernize prior authorizations by adding electronic prior authorization to its Health Tech Ecosystem. The move arrives after last year’s “landmark pledge” to get payors to commit to easing the prior auth burden, and CMS designed the new initiative to “bring everyone else.” Health systems, hospitals, physician practices, EHR vendors, and digital health developers are now joining payors as “a unified coalition” to make electronic prior auths work end-to-end for every patient.

• Good News for Hospital-at-Home: A large study in JAMA Network Open provided the latest evidence that hospital-at-home can serve as a safe alternative to inpatient care. Among over 15k Medicare beneficiaries (4,174 HaH and 11,697 inpatient admissions), the analysis found that HaH admissions were associated with lower in-hospital mortality (0.4% vs. 3.6%) and lower ED use within 30 days of discharge (8.8% vs. 10.0%), with no significant difference in 30-day readmissions (11.7% vs. 11.0%). The authors concluded that HaH may maintain the same or better short term outcomes depending on “appropriately selected patients.”

• PitchBook’s Big AI Take: PitchBook put out a provocative report that stokes the flames of the AI-replacing-doctors discussion. “AI Will Deliver Care to Billions and Break the System That Built It” outlines a U.S. healthcare system reimagined by AI, with many of the generalist-specialist themes that other folks have been touching on, as well as how AI should be regulated and how care should get reimbursed. Pitchbook is in the camp that AI will increase costs in the short term by driving up demand for services, and that costs will only go down once new models tie reimbursement to outcomes.

• Unified Google Health App: Google unveiled its new Fitbit Air, and the announcement included the bigger news that the Fitbit app is getting overhauled into a Google Health app that serves as a centralized health platform that works across both Fitbits and Pixel Watches. Google said its Health app integrates with third-party apps and devices through Health Connect, Apple Health and Google Health APIs, allowing users to combine data from platforms like Peloton, MyFitnessPal, Dexcom and Abbott into a single dashboard.

• U.S. Menopause Differences: Withings published a great analysis of over 470k U.S. women that wrapped some interesting numbers around the menopause transition. The Menopause Transition 2026 Report leveraged data from Withings’ suite of connected devices to show that the prevalence of atrial fibrillation rises 3.8x in U.S. women, climbing from 1.86% in early reproductive years to 7.0% by late postmenopause. Heart rate variability during sleep – an increasingly popular marker of cardiovascular health – also declines just 17%, roughly half the 33% drop observed in women worldwide. 

• A Typology of GenAI: A helpful paper in NEJM AI provided a fantastic termsheet for the many types of AI sweeping across the industry. The authors clarify key distinctions among emerging AI paradigms and provide a lens for understanding their functional differences, risks, and potential applications in clinical and administrative contexts. It maps out LLMs and chatbots like Claude and ChatGPT, AI platforms for everything from call centers to ambient scribes, as well as the new frontier of agentic AI systems. Worth the skim whether you’re looking for an initial overview of the space or just need a quick refresher.

• LLMs Tackle Prior Auth Denials: Researchers tested the ability of four large language models to dispute prior authorization denials for medical imaging scans in the DENIED-AI study in Academic Radiology. Four interventional radiologists gave the AI-generated appeal letters decent scores on a five-point scale for content (3.9) and grammar (4.3), but the prevalence of hallucinations led the authors to conclude that human oversight is still a necessity. 

Execution for Every Workflow

Health systems have no shortage of ideas for improving care and operations. Bunkerhill lets them bring those ideas to life – at scale, across service lines, and around the clock. Discover how the Carebricks platform is empowering clinical and operational teams to deploy AI agents that turn the data they have into the actions they need.

The Virtual-First Difference at MetroHealth

When the MetroHealth System needed a comprehensive, scalable solution to help its patients access care, it turned to Ovatient’s virtual-first care model. Ovatient isn’t another point solution, it’s a virtual care partnership – integrated clinically, operationally, and technologically with your existing infrastructure. Discover how MetroHealth’s virtual-first approach is keeping patients connected to high-quality care whether they’re at home, at work, or on the go.

Unlock Better Care With LOLA 

Whether you’re looking to augment your team’s capacity or capabilities, Tucuvi’s clinically validated LOLA voice agent is purpose-built to make it happen – and has the success stories to prove it. Hear first-hand from Tucuvi’s customers how LOLA is empowering clinical teams to care for patients while maximizing ROI.

The Resource Wire

• BPM Pro 2 Delivers Data When It’s Needed Most: BPM Pro 2’s built-in questionnaires capture patient context alongside each blood pressure reading, reducing manual outreach and follow-ups. See how BPM Pro 2 is equipping care teams with actionable information upfront, and helping streamline workflows and prioritize interventions where it’s needed most.

• 8 Keys to Gain an AI Edge in VBC: As value-based care models evolve and competition intensifies, healthcare leaders are seeking practical strategies to improve performance across risk, quality, and financial outcomes. Head over to Navina’s roundup of eight key insights from VBC leaders to learn how aligning AI-powered tools with organizational priorities and clinician needs can help secure a measurable competitive edge in value-based care.

• State of Payor Enrollment and Credentialing: Over half of provider orgs are losing revenue due to credentialing delays – with many missing out on over $1M annually. Medallion’s new report unpacks the forces quietly undermining operational and financial performance, and how leaders across the industry are addressing them. Head over to the full report to get insights tailored to your role and org type.

• The AI Hardware Built for Clinical Work: Phones were never meant to be propped on a desk for a 12-hour clinical day. Heidi Remote transcribes patient sessions offline, stores them securely on-device, and syncs to Heidi whenever you’re in range. Just clip on and get to work with the Heidi Remote.

The Industry Wire

1. Trump reportedly plans to fire FDA Commissioner Makary.
2. Why hantavirus isn’t the next pandemic.
3. Atrium Health impacted by Oracle Health breach.
4. Trade court rules Trump’s 10% global tariff illegal.
5. OpenAI publishes AI health policy framework.
6. What Intermountain’s CEO didn’t anticipate about its EHR launch.
7. The biotechs wear Prada.
8. How PE is adjusting for healthcare now that it’s under the microscope.
9. Federation of American Hospitals taps new government relations head.
10. 8-hospital system adopts CommonSpirit name.

Alberta Health Services CEO Stephen Duckett

Providers

Study Questions Value of Management Consultants in Healthcare

If hospitals spend billions of dollars on management consultants, they will at least get:

• A) stronger finances
• B) better quality of care
• C) streamlined operations
• D) none of the above

The correct answer: D as in Deloitte! You guessed it, at least according to a new study in JAMA.

• Researchers analyzed 2,343 non-profit hospitals in the U.S. from 2009 to 2023, finding that they collectively spent over $7.8B on management consulting over that period.

• More than 20% of the hospitals brought on consultants, and the hefty total in the previous bullet means they spent an average of $15.7M for their services.

Here’s what that got them. Researchers compared 306 hospitals that enlisted management consultants for the first time during the study period to 513 matched hospitals that toughed it out on their own.

• Despite the substantial investment, the study found “little evidence of substantial, statistically significant, or systematic improvements” attributable to the consulting engagements.

Consultants couldn’t catch a break. The analysis showed that the hospitals that hired them saw no significant impact across any of the primary measures.

Not the financial measures. 

• Net patient revenue was down 2.22% (P = .14).
• Total margin was down 0.19 percentage points (P = .71).

Not the operational measures. 

• Inpatient length of stay was up 1.71% (P = .10).
• Total inpatient days were up 0.29% (P = .85).

Not the quality measures.

• All insignificant, besides 30-day stroke readmissions: up 1.37 percentage points (P = .03).

Big results, with limitations. An accompanying editorial applauded the analysis, but pointed out that struggling hospitals are also more likely to seek outside help. Future research should investigate this selection bias and “the factors that predict a hospital’s decision to hire a consulting firm.”

The Takeaway

High P-values don’t mean that management consultants aren’t making an impact. They just mean that the most notable study to investigate the impact couldn’t find one…

DoxGPT Nabs a New Name – and Big Upgrades

The tool formerly known as DoxGPT is now called Ask, and it’s packing more upgrades than just the name. Ask’s new agentic reasoning model delivers better, faster answers to physician’s most complex clinical and workflow questions – with the same verified outputs, journal access, and drug dosing they already know and trust. Discover the difference and Ask today.

Improving GLP-1 Treatment for the Long Term

Looking to make GLP-1 prescribing safer and more effective long term? Explore Withings’ suite of remote patient monitoring devices, designed to deliver the continuous, clinically relevant insights that care teams need to proactively monitor patients, identify risks early, and intervene with confidence.

The Wire

• UnitedHealth Cuts Prior Auths: UnitedHealth Group seems to be walking the talk after eliminating prior authorization requirements for 30% of services. The move was positioned as a way to build on UHG’s recent initiatives to invest in digital tools that support electronic submission or standardize submission requirements among payors, and at the very least it’s some decent PR spin on AI automation that would have happened anyways. UHG noted that only 2% of medical services require PA, and that 92% are approved in 24 hours.

• Docs Make Great Founders: New research in NEJM Catalyst challenged the industry trope that “physicians are famously bad at business.” The paper analyzed 105 healthcare startups that grew a unicorn horn by notching a valuation over $1B between 2015 and 2024, finding that more than 25% had at least one clinician founder. Physicians are particularly well positioned to identify pain points and “impassioned to solve them,” which is why the authors make the case for integrating more innovation and venture exposure into clinical training to help cultivate these skills.

• Same Tool, New Name, Better AI: DoxGPT just got an AI overhaul and a new name to go along with it: Ask. Doximity’s clinical AI assistant still provides answers that are grounded in the latest research, verified by PeerCheck, and built into the workflows physicians are already using – that’s just all getting powered by Ask’s new agentic reasoning model that delivers better responses even quicker than before. Ask slots in as the capstone of Doximity’s Clinical AI Suite next to its Scribe and Dialer, and we definitely recommend testing it out for yourself. 

• Cursor Dives Into Life Sciences: Cursor is expanding its popular AI coding platform into healthcare to help accelerate drug discovery, diagnosis, and research. SpaceX recently acquired the rights to acquire Cursor for $60B later this year in a potential push to help its flagship Grok model catch up to Claude’s coding prowess. Cursor also happened to jump into the life sciences arena the same week that Deloitte’s annual pharma report showed that the cost of developing a new drug topped $2.7B in 2025, up 20% in a single year.

• Assort Activate Launch: Assort Health is bolstering its voice AI platform with Assort Activate, a new outbound capability that proactively reaches out to patients to help fill care gaps. Activate delivers personalized outreach across use cases ranging from booking patients for their flu shots to rescheduling appointments when there’s a major snowstorm. In early deployments, Activate’s proactive outreach campaigns are already putting up some big numbers, including a 64% referral scheduling conversion at SENTA Partners.

• BCG’s 70-20-10 Rule for AI: Boston Consulting Group put out an analysis outlining why AI-driven productivity improvements will be a critical pressure release valve for health systems. BCG expects the demand for care to continue outpacing supply by 14% through 2036, with the current system already causing total healthcare spending to grow 3x faster than GDP. At the same time, AI’s potential to transform care delivery is being limited by the fact that nearly 80% of AI efforts fail to scale. BCG’s solution: Only focus 10% of effort on the AI models. Place 20% on building the scalable tech infrastructure to support them and 70% on the workflow redesign and role redefinition that actually makes transformation possible.

• Open Wearables, Open Platform: Open Wearables unveiled its open-source platform that unifies data across wearable devices and allows LLMs to easily reason over it. The platform ingests data from leading wearables like Apple Health, Whoop, and Oura – completely normalized and deduplicated – then provides a single API to access the information. Personalized health scores and coaching profiles also enable users to build custom programs and fine-tune open algorithms for their specific population (sleep, recovery, strain, stress, HRV, VO2 max).

• Fewer Doctors Plan to Quit: A promising sign for healthcare’s burnout crisis arrived in the form of a survey in JAMA Network Open that showed fewer physicians are planning to quit their current practice than during the pandemic. Researchers surveyed 37.1k U.S. physicians, finding that the percentage who intended to leave fell in 2024 compared to 2022 (15% vs. 20%), and the percentage who wanted to reduce their hours also dropped (23% vs. 26%).  

• Graybill Goes the Third Way: Graybill Medical Group released two-years of performance data after swapping its front office for Third Way Health’s AI-enabled service platform two years ago. The independent multi-specialty group, one of the largest in DHW hometown San Diego, saw Third Way’s hybrid AI and live-agent solution outperform industry benchmarks across the board, including a 20.2 second average call wait time (85% answered within 20 sec), 50% savings across call center and records staging ($3M total), and a 24% reduction in no-shows.

• Medical Liability Premiums Rise: Medical liability premiums unsurprisingly continued their upward trajectory in a new AMA survey on medical malpractice. The proportion of premiums that rose in 2025 was up sharply compared to 2018 (40% vs. 14%), and premiums rose for the past seven years, a trend not seen since the malpractice crisis of the early 2000s. Premiums tended to be lower in states that have caps on non-economic damages, and the report stated that further premium increases could limit patient access to care.

Unlock Better Care With LOLA 

Whether you’re looking to augment your team’s capacity or capabilities, Tucuvi’s clinically validated LOLA voice agent is purpose-built to make it happen – and has the success stories to prove it. Hear first-hand from Tucuvi’s customers how LOLA is empowering clinical teams to care for patients while maximizing ROI.

Any Use Case, Any Specialty

Bunkerhill’s Carebricks platform doesn’t stop at surfacing insights. It translates them into real-world action. From automating prior auths to closing care gaps, Carebricks lets health systems design and deploy AI agents for any clinical or operational need – without adding to anyone’s manual workload. Learn how Carebricks can automate actions for your patients today.

The Virtual-First Playbook: Rural Health

Rural healthcare is in crisis. More hospital closures, less access, and wider care deserts for essential services like primary care and behavioral health. Get Ovatient’s Virtual-First Playbook for Rural Health Transformation to see how your organization can leverage funding from new programs like the RHT to build enduring systems of care.

The Resource Wire

• Abridge & Availity Redefine Payer-Provider Synergy: Abridge is teaming up with Availity to redefine payer-provider synergy at the point of conversation. The collaboration aligns Abridge’s evidence-aware intelligence with Availity’s real-time health information network to create a first-of-its-kind prior authorization experience, with a shared understanding between patients, providers, and payers. Find out how Abridge and Availity are extending conversational intelligence across the revenue cycle.

• Making the Case for AI: Healthcare organizations have a lot to gain from implementing AI that can enhance coding accuracy and quality metrics, but securing buy-in from leadership is a crucial first step. Check out Navina’s new guide by Dr. Michael S. Barr to see exactly how to demonstrate clear financial benefits, ROI potential, and alignment with organizational priorities to help ensure AI projects are successful.

• State of Payor Enrollment and Credentialing: Over half of provider orgs are losing revenue due to credentialing delays – with many missing out on over $1M annually. Medallion’s new report unpacks the forces quietly undermining operational and financial performance, and how leaders across the industry are addressing them. Head over to the full report to get insights tailored to your role and org type.

• The AI Hardware Built for Clinical Work: Phones were never meant to be propped on a desk for a 12-hour clinical day. Heidi Remote transcribes patient sessions offline, stores them securely on-device, and syncs to Heidi whenever you’re in range. Just clip on and get to work with the Heidi Remote.

The Industry Wire

1. CMS to provide $50/mo GLP-1 access for Medicare beneficiaries.
2. HHS encourages doctors to consider lifestyle changes, not drugs, for depression. 
3. Pennsylvania sues AI company after chatbot posed as licensed doctor.
4. Hospitals face growing fallout from ACA coverage cliff.
5. Judy Faulkner shares keys to Epic’s success in Freakonomics interview.
6. Are blue zones real? Answering that question is harder than ever.
7. HCA VP of care transformation steps down.
8. Eko Health and Boehringer Ingelheim team up to help dogs live longer.
9. Atrium Health, WakeMed merger faces delay.
10. Trump’s immigration policies are fueling brain drain.

LeanTaaS CEO Mohan Giridharadas

May the 4th – big day for fans of Star Wars and digital health alike!

We’ve got an action packed issue to kick off the new month. LeanTaaS CEO Mohan Giridharadas joined us on the Digital Health Wire Show to unpack a new report on the State of Hospital Financial Health (or lack thereof) and share some pro pointers for creating healthcare companies that are built to last. You can catch the full ep here.

Also on deck: a landmark study in Science that saw AI outperform physicians in clinical reasoning tasks, Teladoc’s Q1 turnaround, and partnerships galore.

Let’s get into it.
Jason

Artificial Intelligence

OpenAI o1 Outperforms Physicians on Clinical Reasoning Tasks

A landmark study in Science found that OpenAI’s o1 series outperformed human physicians at multiple clinical reasoning tasks, but that doesn’t mean it’s time to hang up the scrubs just yet.

Researchers at Harvard and Beth Israel Deaconess Medical Center designed the study to evaluate whether LLMs are ready to do what physicians do on a daily basis: review messy patient charts and use that data to determine diagnosis and next steps.

• They evaluated o1 on clinical cases ranging from patient vignettes to second opinions on 76 real-world ED assessments, which included all the noise and incomplete information that clinicians routinely encounter in the EHR.

• The refreshingly well-designed study also incorporated a blinded evaluation with two attending physicians at BIDMC and GPT-4.

o1 came to play. On clinical vignettes evaluating management reasoning, o1-preview scored a median of 86%. Not too shabby.

• It outperformed GPT-4, humans with GPT-4, and humans with conventional resources like UpToDate – all of which scored below 45%.

The ED cases were even more impressive. o1 offered second opinions about the diagnosis at three points along the patient’s ED journey:

• At triage, o1 gave an exact or very close diagnosis in 67% of cases (when information in the record dump was most limited). The two physicians hit 55% and 50%. 

• o1 still outperformed the physicians when given all the data collected by the end of the ED encounter.

• It was only when the physicians were given the most information possible to inform their diagnosis – at the time the patient would have been admitted to the hospital – that the scores finally converged.

The cherry on top? Physician raters couldn’t tell whether the differentials came from o1 or a human. One rater couldn’t tell in 83.6% of cases, the other in 94.4%. 

• The authors were quick to mention that these results don’t mean AI is ready to replace human physicians. They mean it’s time for rigorous research into how AI can augment care teams, serve as a second opinion, and become a safety layer for clinicians.

The Takeaway

o1 outperforming a couple internists at triage isn’t quite Deep Blue beating Gary Kasparov at chess, but it’s a step in that direction – especially considering OpenAI’s performance jump in just the last week (let alone since o1 launched in 2024).

Any Use Case, Any Specialty

Bunkerhill’s Carebricks platform doesn’t stop at surfacing insights. It translates them into real-world action. From automating prior auths to closing care gaps, Carebricks lets health systems design and deploy AI agents for any clinical or operational need – without adding to anyone’s manual workload. Learn how Carebricks can automate actions for your patients today.

Unlock Better Care With LOLA 

Whether you’re looking to augment your team’s capacity or capabilities, Tucuvi’s clinically validated LOLA voice agent is purpose-built to make it happen – and has the success stories to prove it. Hear first-hand from Tucuvi’s customers how LOLA is empowering clinical teams to care for patients while maximizing ROI.

The Wire

• Teladoc Turnaround: Teladoc Health posted another down quarter after revenue slid 2% to $614M in Q1, but shares were still up nearly 15% due to some unexpectedly rosy forecasts on the investor call. The BetterHelp turnaround was definitely a bright spot, with the mental health segment now projecting full-year payor revenue between $90M and $105M as it continues to evolve from a strictly direct-to-consumer offering. That’s up from last quarter’s forecast of $75M to $90M, although BetterHelp’s total revenue slid 9% in Q1 so it seems like the extra help from payors hasn’t quite been able to fully offset the bleeding in the DTC business.

• Thin Margins Are Here to Stay: LeanTaaS’ new report on The State of Hospital Financial Health delivered the latest evidence that financial pressure is no longer cyclical, with the majority of healthcare organizations reporting consistently razor-thin margins. Nearly 3 in 4 of the health system CFOs surveyed report margins of 2% or lower, driven primarily by reimbursement or payor mix changes (45%) and reduced government funding (42%). The top financial priorities for this year include workforce scheduling (77%) and new tech investments for capacity/workforce utilization (65%). Look no further than our interview with LeanTaaS CEO Mohan Giridharadas for a deeper dive on the data.

• ThoroughCare + Withings: ThoroughCare is teaming up with Withings Health Solutions to equip providers with real-time visibility into patient progress via a new integration with Withings’ cellular scales. By eliminating the need for Wi-Fi and automatically transmitting data to care teams, Withings and ThoroughCare help hurdle the barriers to consistent readings that often prevent proactive treatment, particularly for patients in rural areas. The partnership is right on cue as CMS continues to push the industry toward better data sharing.

• DeepMind AI Co-Clinician: Google DeepMind shared an update on its new AI co-clinician that’s designed to entail “triadic care” where AI agents support patients under the clinical authority of their physician. The blog post describes the AI co-clinician as the next step in DeepMind’s journey from mastering exam-style tests with MedPaLM, matching physician performance in text-based simulated medical consultations with AMIE, and the culmination of a “long history” of studying how clinicians and AI systems can work together. This clip provides a good look at the tool in action.

• New Paradigm at the FDA: The FDA announced a key partnership with Paradigm Health to support its new model aimed at accelerating regulatory review. The new model is already operational in a Phase 2 and Phase 1b trial with Amgen and AstraZeneca, leveraging Paradigm’s Study Conduct platform to enable real-time review by the FDA by automating data collection and streamlining the reporting of safety and efficacy signals. The partnership was also touted as a key step toward broadening trial participation to more patients outside of academic medical centers and  by modernizing a fragmented, manual infrastructure into one that can be integrated directly into everyday provider workflows.

• 2026 Edelman Trust Barometer: Medical misinformation is spreading like wildfire according to the 2026 Edelman Trust Barometer. Over 70% of the 16k respondents in 16 countries believe at least one inaccurate health claim about food, vaccines, or medicine – a rate that’s consistent across education levels, demographic groups, and political lines. At the same time, fewer people are confident in their ability to make informed health decisions despite having new AI tools at their disposal (down 10 percentage points to 51% YoY). Standout stat from the report: 25% of people believe vaccines are used for population control.

• Koda Adds to Series A: Advanced care planning platform Koda Health bolted on an additional investment from UPMC to its recent $7M Series A. The platform helps health systems scale goals-of-care conversations and align treatment with patient preferences, enabling education and informed decision-making around serious illnesses that patients are often forced to face without adequate support. Nearly one in four healthcare dollars is spent in the last year of life, and a study with Houston Methodist showed that Koda reduced terminal hospitalizations by 79%, increased hospice use by 51%, and lowered costs by $9k per patient.

• Behavioral Nudges Improve Screening: A JAMA Network Open study suggests that behaviorally informed text messages can provide a low-cost strategy to promote colon cancer screening in underserved populations. Nearly 1,300 patients were randomized to receive either a single nurse-led telephone call reminder (usual care) or three automated text messages with various behavioral nudges like hard deadlines, social norms (your provider is waiting for your test kit) and gain-framing (screening may save your life). The end result was 58.9% of the text message group completing screening within 21 days, compared with 49.2% in the usual care group.

• Paws Off the Apple Watch: Data presented at the recent Heart Rhythm Society conference from the PAWS study revealed that the Apple Watch captured twice as many arrhythmia events as traditional patch monitors in children aged 6 to 28. Among the 107 children participating, 79% of the Apple Watch’s ECG tracings rated high quality while accurately identifying AFib and supraventricular tachycardia in 73% and 75% of cases, respectively. Check out Cardiac Wire’s stellar interview with Kenneth Civello, MD for a deeper dive on this topic. 

• UChicago Medicine + Artisight: University of Chicago Medicine is rolling out Artisight’s smart hospital platform system-wide, transforming over 1,800 rooms into entirely ambient care environments. The deployment spans patient care units, post-anesthesia care, and their new freestanding cancer care facility – all of which will be overhauled with computer vision, voice recognition, non-contact vitals, and virtual nursing. The platform is designed to provide a real-time “sixth sense” for care teams, enabling improved documentation and staff coordination with less operational burden. 

The Virtual-First Difference at MetroHealth

When the MetroHealth System needed a comprehensive, scalable solution to help its patients access care, it turned to Ovatient’s virtual-first care model. Ovatient isn’t another point solution, it’s a virtual care partnership – integrated clinically, operationally, and technologically with your existing infrastructure. Discover how MetroHealth’s virtual-first approach is keeping patients connected to high-quality care whether they’re at home, at work, or on the go.

Evidence, in the Flow of Care

Heidi brings trusted guidelines and peer-reviewed research directly into clinical workflows so decisions don’t stall care. Clinicians get clear, evidence-based answers without leaving the conversation. No ads, no limits, and no outside interests getting in the way of care. Find out how with Heidi Evidence.

The Resource Wire

• Abridge & Availity Redefine Payer-Provider Synergy: Abridge is teaming up with Availity to redefine payer-provider synergy at the point of conversation. The collaboration aligns Abridge’s evidence-aware intelligence with Availity’s real-time health information network to create a first-of-its-kind prior authorization experience, with a shared understanding between patients, providers, and payers. Find out how Abridge and Availity are extending conversational intelligence across the revenue cycle.

• 8 Keys to Gain an AI Edge in VBC: As value-based care models evolve and competition intensifies, healthcare leaders are seeking practical strategies to improve performance across risk, quality, and financial outcomes. Head over to Navina’s roundup of eight key insights from VBC leaders to learn how aligning AI-powered tools with organizational priorities and clinician needs can help secure a measurable competitive edge in value-based care.

• State of Payor Enrollment and Credentialing: Over half of provider orgs are losing revenue due to credentialing delays – with many missing out on over $1M annually. Medallion’s new report unpacks the forces quietly undermining operational and financial performance, and how leaders across the industry are addressing them. Head over to the full report to get insights tailored to your role and org type.

• Improving GLP-1 Treatment for the Long Term: Looking to make GLP-1 prescribing safer and more effective long term? Explore Withings’ suite of remote patient monitoring devices, designed to deliver the continuous, clinically relevant insights that care teams need to proactively monitor patients, identify risks early, and intervene with confidence.

The Industry Wire

Providence SVP Adar Palis

Artificial Intelligence

AI Moves From Proof-of-Concept to Proof-of-Return

Healthcare can cover a lot of ground when it’s moving at the speed of AI, and a new report from McKinsey found that the AI conversation is quickly shifting from proof-of-concept to proof-of-return.

The analysis was based on a survey of U.S. healthcare execs spanning payors, providers, and health services/technology groups.

AI adoption is skyrocketing at all of them. For the first time since McKinsey began tracking the metric in 2023, the orgs that have already implemented GenAI outnumbered those that haven’t.

• Half of respondents have deployed at least one GenAI use case at their organization, up from just 25% two years ago. Here’s a nice graphic on AI adoption by org type.

• McKinsey found that leadership teams are no longer questioning whether and where GenAI is relevant, they’re focusing on how it can be used responsibly at scale.

Agents are also building momentum. Despite being the new kid on the AI block, 19% of orgs reported that they’ve deployed agentic AI capabilities.

• That’s not a huge percentage considering all the new agents we’ve been covering, but another 51% of orgs are actively pursuing agentic AI proofs-of-concept.

Administrative efficiency is the priority. This chart breaks down the areas that respondents see the most potential for GenAI and multiagent systems.

• 87% ranked administrative efficiency as their leading GenAI use case.
• 76% said it was also their top priority for multiagent systems.
• Software infrastructure and engagement trailed as distant contenders for both categories.

Adoption varies by org type. Here’s the overview.

• Providers are leaning in on clinical productivity (54% are using GenAI to help).
• Payers are prioritizing administrative efficiency (34%).
• Health services and tech firms are using GenAI as software infrastructure (52%).

Adoption barriers had more overlap. Across all org types, the chief concerns with GenAI were difficulty integrating with existing workflows, risk/liability, and inaccuracies/bias.

The other shared belief? Nobody implements AI for fun. Everyone expects an ROI.

The Takeaway

AI has arrived in a big way, and McKinsey’s report confirmed that ROI is now the name of the game in every corner of the industry.

Evidence, in the Flow of Care

Heidi brings trusted guidelines and peer-reviewed research directly into clinical workflows so decisions don’t stall care. Clinicians get clear, evidence-based answers without leaving the conversation. No ads, no limits, and no outside interests getting in the way of care. Find out how with Heidi Evidence.

Shape Health AI at DHAI 2026

Mark your calendars. The Digital Health & AI Innovation Summit is bringing together AI leaders from across the industry for a live event in Boston on June 8-9th. This year’s agenda is packed with 150+ speakers and content curated specifically for the pioneers shaping health AI. Reserve your spot for DHAI 2026 today.

The Wire

• OpenEvidence Exits Europe: Physicians across Europe had a harder time finding medical evidence than they were expecting this week after OpenEvidence abruptly pulled its app from the E.U. and U.K. The apology message that took over OE’s entire home page cited “mounting regulatory uncertainty” as the primary driver behind the exit, particularly concerns around the E.U. Artificial Intelligence Act that’s set to take full effect later this year. The scope and duration of the withdrawal aren’t exactly clear, but this could end up being the first domino to fall if other clinical AI startups decide to follow OE’s lead.

• Heidi + BILH: Beth Israel Lahey Health is rolling out Heidi enterprise-wide to ensure none of its clinicians have to work in their PJs. During a six-month pilot where a majority of the 1k providers adopted Heidi, 90% said they felt more present with patients and 3 in 4 reported a reduction in time spent outside of work hours. Those results inspired BILH to bring the same ambient AI capabilities to all 6,000 of its clinicians across 14 hospitals and 175 primary care practices.

• Employers Consider Switching Vendors: A report from the Purchaser Business Group on Health shows that rising healthcare costs are pushing employers to the switching point with their vendors. PGHB represents 40 of the largest employers in the U.S. and over $350B in combined annual spend on health services for their workers. This year, 37% of those employers have issued an RFP for medical benefits (up from 12% in 2024), and 23% have put one out for pharmacy benefits (up from 20%). The cost of health benefits is expected to climb another 6-8% this year, and the numbers aren’t adding up for a growing slice of PBGH members.

• Gravity Rail Rolls Onto the Tracks: Gravity Rail emerged from stealth with $2.75M in seed funding from Redesign Health to build a “model-agnostic operating system” for patient engagement. The platform lets healthcare orgs turn their protocols into live, AI-driven workflows across phone, SMS, email, and web channels – without writing code or relying on implementation vendors. Gravity Rail is positioning the platform as an ideal fit for any organization that manages patient or member engagement at scale, from payors and providers to digital health startups and contact centers. 

• Availity Abrasion Index: Availity’s inaugural Abrasion Index revealed where payor-provider friction is hitting healthcare the hardest: denials, prior authorization, and payment integrity. Denials ranked as the most abrasive process for both payors and providers, with Availity finding that ~70% of denials are ultimately overturned, resulting in unnecessary headaches for both parties and avoidable costs to the tune of $18B per year. The report also showed that physicians are now spending 13 hours a week on prior auths, and 80% say long response times and denials are delaying care.

• Tom Finds His Voice: Lumeris equipped its AI-powered Primary Care as a Service platform, better known as Tom, with Native Audio to unlock more natural interactions with patients. The enhancements leverage Google Cloud and Gemini to give Tom real-time speech-to-speech capabilities, including lower latency, better conversational flow, and stronger noise handling. Native Audio builds on Lumeris’ mission to have Tom create meaningful dialogue that ensures patients feel heard and supported throughout their care journey.

• Providence Project Pixel: Providence flipped on 12 AI use cases in Epic as part of its cross-functional AI implementation program dubbed Project Pixel. The 51-hospital system deployed new AI tools across inpatient, ambulatory, and revenue cycle workflows, with guardrails and governance already baked in. Highlights include AI Text Assistant (rewriting communications in patient-friendly language), Inpatient Insights (auto-generating admission overviews), and Draft Hospital Course (drafting discharge summaries).

• Virtual Visits Hold Up in Neurology: New research in Neurology found that virtual visits are on par with in-person appointments for new neurology patients. Researchers analyzed over 16k matched visits during the pandemic and found that only a quarter of neurology patients had a follow-up appointment within 90 days, regardless of visit type. ED visits and hospitalizations were also the same between both groups, although in-person first visits were associated with more follow-ups for dementia and virtual visits led to more follow-ups for Parkinson’s disease.

• New Approach to AI Regulation: A thought-provoking essay in JAMA makes the case that it will take an entirely new regulatory approach to oversee autonomous AI that makes clinical decisions without physician oversight. The authors lay out a six-point approach to autonomous AI regulation, centered around licensure similar to human physicians and time-limited certifications. They also suggest the creation of an Office of Clinical AI Oversight within HHS to implement the new framework.

• Spotlight on Community Health Workers: The New York Times published a well-deserved spotlight on the community health workers that have been quietly closing care gaps for seniors. Despite being notoriously underfunded and inconsistently integrated into patient care, the article describes why CHWs are being increasingly relied on as a cost-effective way to improve outcomes by supporting areas like home visits, screenings, and transportation. The piece also does a good job tying in studies that demonstrate how CHWs are making an outsized impact for patients with serious illness.

Abridge Named #1 Best in KLAS – Again

KLAS just named Abridge #1 Best in KLAS for Ambient AI for the second year in a row. The recognition was based on direct customer feedback from the nation’s largest and most complex health systems, which gave Abridge the highest overall satisfaction score and A+ ratings across Culture, Loyalty, Relationship, and Value. Discover why Abridge is the market-leading AI platform for clinical conversations.

Privia Accelerates VBC Success With Navina

How do you give physicians new AI tools to accelerate VBC without slowing them down? Privia Health found its answer with Navina. They co-designed an under-one-hour training program that onboarded 800+ clinicians in the first year, driving 87% weekly active usage while providing clearer visibility into their patient panels. Read the full case study to see what it takes to make adoption stick and outcomes follow.

The Resource Wire

• State of Payor Enrollment and Credentialing: Over half of provider orgs are losing revenue due to credentialing delays – with many missing out on over $1M annually. Medallion’s new report unpacks the forces quietly undermining operational and financial performance, and how leaders across the industry are addressing them. Head over to the full report to get insights tailored to your role and org type.

• Improving GLP-1 Treatment for the Long Term: Looking to make GLP-1 prescribing safer and more effective long term? Explore Withings’ suite of remote patient monitoring devices, designed to deliver the continuous, clinically relevant insights that care teams need to proactively monitor patients, identify risks early, and intervene with confidence.

• Better Health Through Virtual-First Primary Care: For patients, positive health outcomes are driven by strong relationships built on trust with health systems and providers. Hear how Ovatient’s fully EHR-integrated, virtual-first care approach is helping primary care patients like Tito Santiago reach their care goals and build a stronger relationship with The MetroHealth System. 

• Evidence, in the Flow of Care: Heidi brings trusted guidelines and peer-reviewed research directly into clinical workflows so decisions don’t stall care. Clinicians get clear, evidence-based answers without leaving the conversation. No ads, no limits, and no outside interests getting in the way of care. Find out how with Heidi Evidence.

The Industry Wire

• FDA launches “real-time clinical trials” for faster drug review.
• GLP-1s improve motivation in trial with depressed patients.
• Survey tracks rise in health system CEO compensation. 
• Congressional hearing criticizes CEOs for high healthcare costs.
• OxyContin maker Purdue to dissolve as criminal trial concludes.
• Nebraska first to implement Medicaid work mandates next month,
• Health companies jockey for share of $50B rural health fund.
• FDA testing confirms safety of infant formula. 
• CDC says backyard poultry may raise salmonella risk.
• Baystate to acquire Trinity Health hospital.

Congressman Greg Landsman

Digital Health

Medicare’s None the WISeR

Washington state just delivered an unfortunate crash course on U.S. health policy after the model aimed at “Wasteful and Inappropriate Service Reduction” led straight to higher costs and fewer treatments for seniors.

Does Medicare need prior authorizations? CMS designed WISeR to find an answer by testing whether bringing AI-driven prior auths (which are already widespread among private payors in Medicare Advantage) to traditional Medicare could cut down on wasteful spending.

• The six-year pilot kicked off in six states on January 1st (AZ, NJ, OK, OH, TX, WA), targeting a list of 13 “low value” services with a high potential for fraud or waste – most notably orthopedic pain management procedures and skin substitutes.

Washington is already tapping out. Less than five months in, Senator Maria Cantwell (D-Wash.) had enough data to publish her new report on the “clear risks of AI in Medicare.”

• Drawing on a Washington State Hospital Association survey of 16 hospitals, the report found that procedures previously approved within days are now taking 4 to 8 weeks. 

• CMS’ own WISeR standards call for responses to providers within 1 day for urgent care and 3 days for routine care, both of which are now clocking in at 15 to 20 days.

You get what you pay for. WISeR compensates third-party administrators for each claim they deny, under the assumption that these denials account for the reduction in wasteful spending.

• That obviously creates some adverse incentives, which the report eloquently framed up by saying the model “incentivizes WISeR contractors to weaponize AI-driven medical determinations not for the sake of efficiency… but to maximize profitability.”

• As a result, Washington hospitals have had to add staff and increase hours to manage the surge in prior auths – not a great formula for lowering the cost of care.

The report went straight to the top. At a Senate hearing last week, Senator Cantwell made her case directly to HHS Secretary RFK Jr., who said “that kind of delay is unacceptable.”

• He went on to say that prior auths are there to prevent the government from being “ripped off” by unethical providers and only applies to 5% of services in Medicare.

• That might be accurate, but it doesn’t mean they aren’t high-volume services. A separate KFF analysis found that 86% of the 1.1M Medicare beneficiaries that used at least one of the services on WISeR’s list in 2024 received a pain management service.

The Takeaway

Reducing waste in Medicare is a worthy goal, but so far it looks like the best way to make it happen probably isn’t by adding prior auths to the program that many seniors specifically chose to avoid them.

Shape Health AI at DHAI 2026

Mark your calendars. The Digital Health & AI Innovation Summit is bringing together AI leaders from across the industry for a live event in Boston on June 8-9th. This year’s agenda is packed with 150+ speakers and content curated specifically for the pioneers shaping health AI. Reserve your spot for DHAI 2026 today.

Unlock Accurate Transcription With Medical Mode

Unlocking accurate transcription of even the most complex medical terminology is now as easy as adding a single line of code. AssemblyAI’s new Medical Mode eliminates errors on the words that matter most – medicine names, dosages, and clinical diagnoses – so that you can ship solutions that perform when accuracy isn’t optional. Start building with Medical Mode today.

The Wire

• Almanac Lands $10M: Almanac Health closed a $10M seed round to advance its unified AI platform for clinical decision support. The startup was founded by physician-researcher Cyril Zakka, MD, whose work at Stanford introduced the first retrieval-augmented generation system for clinical medicine through one of the most-cited papers in NEJM AI. Almanac is initially focused on giving every clinician specialist reach, with decision support grounded in peer-reviewed evidence and built directly into their current workflows – without pharma ads.

• Utah Pushes Back on AI Doctors: Doctronic’s AI-powered prescription pilot was fun while it lasted. The Utah Medical Licensing Board called for an immediate suspension of the program after revealing that they only found out about it once it was already live. Doctronic apparently circumvented the Medical Board’s approval by going through Utah’s broader Office of AI Policy to secure permission for its AI to be able to renew 200+ medications. Doctronic’s co-founders shared their side of the story in a new blog post called “The Status Quo Is the Biggest Risk,” but if we had to guess the Medical Board probably thinks healthcare pilots that it’s never heard of are a bigger risk than the status quo.

• IKS Acquires TruBridge: IKS Health’s rumored acquisition of TruBridge proved yet again that where there’s smoke, there’s usually fire. IKS got the acquisition across the finish line by offering $26.25 per share for TruBridge, just above its previous close of $25 – although the stock has also nearly doubled in the last month. The press release was light on details, but TruBridge’s EHR and RCM services will reportedly strengthen IKS’ AI care enablement capabilities in the rural healthcare market, and the combined company will now support over 4k orgs and 150k clinicians.

• Commure Heads Back to Court: Commure just got served with a(nother) lawsuit alleging it engaged in “a brazen scheme to steal valuable trade secrets” from EHR developer Adaptamed in order to create a competing product. The suit also claims former Adaptamed customer WellCare Health provided unauthorized access to its EHRYourWay platform after Adaptamed denied Commure’s request to get a look at how the sausage was made “under the guise of potentially forming a partnership to shore up its own nascent Athelas Air EHR product.” General Catalyst’s digital health bellcow might be developing a pattern of IP theft litigation considering Canopy also recently accused it of exploiting a similar partnership.

• Zocalo Recibe Una Inversión: Zócalo Health closed $15M in Series A funding to scale its community care model for Hispanic populations. The fresh funds will help Zócalo grow its community-based workforce across the country and deepen its payor partnerships after already expanding from two regional health plans in 2024 to more than a dozen in 2025. The announcement touts 4x revenue growth on the back of high member retention and frequent monthly engagement thanks to having “promotoras de salud” embedded near the patients they serve.

• EndoTool IV Eliminates Severe Hypoglycemia: Data presented at the AACE Annual Meeting showed that Glooko’s EndoTool IV achieved an impressive 98% reduction in severe hypoglycemia across a 19-hospital system compared to its historical paper protocols. The evidence stemmed from a three-year retrospective analysis (Jan 2023 to Dec 2025) that included nearly 18k patients and over 362k blood glucose values. Severe hypoglycemia (blood glucose less than 40 mg/dl) incidence dropped to 0.005% using EndoTool’s patient-specific dosing to help standardize care, compared with 0.23% under paper protocols.

• Highgate + Brook: NY-based primary care provider Highgate Medical Group is teaming up with Brook Health to scale sustainable chronic care management to its patients’ daily lives. By combining AI-driven intelligence with dedicated clinical teams, Brook enables ongoing monitoring, personalized engagement, and earlier interventions that will support Highgate’s value-based care delivery without adding to its providers’ plates. Highgate is leveraging Brook’s infrastructure across remote patient monitoring, chronic care management, and advanced primary care management.

• RAPID Response: A new regulatory pathway could help bridge the gap between breakthrough device approvals and Medicare reimbursement. CMS joined forces with the FDA to launch the Regulatory Alignment for Predictable and Immediate Device program, which enables the agencies to work together so evidence generated for breakthrough FDA submissions can also be used to determine Medicare coverage. The RAPID program is expected to slash the delay between FDA market authorization and Medicare national coverage decisions.

• Picking the Right Antidepressant: A JAMA study showed that web-based clinical decision support can meaningfully improve antidepressant treatment. The trial randomized 520 adults with major depressive disorder across 47 sites (in Brazil, Canada, and the U.K.) to receive either an antidepressant selected using the PETRUSHKA tool (combines clinical and demographic predictors with patient preferences to personalize treatment) or usual care. Patients in the PETRUSHKA group were not only less likely to discontinue their medication at 8 weeks (17% vs. 27% under usual care), they also showed significantly greater improvement in PHQ-9 and GAD-7 scores at 24 weeks.

• ModMed Picks Up Bonsai: ModMed scooped up Bonsai Health to bolster its specialty-focused EHR with AI-driven patient engagement. Bonsai’s AI agents proactively scan patient histories for care gaps, match their needs against open schedule slots, and reach out via SMS and email to re-engage patients. That functionality will now be integrated with ModMed’s Klara patient engagement platform to complement its existing staff-led communication workflows and help automate practice growth across its network of nearly 50k providers.

Abridge & Availity Redefine Payer-Provider Synergy

Abridge is teaming up with Availity to redefine payer-provider synergy at the point of conversation. The collaboration aligns Abridge’s evidence-aware intelligence with Availity’s real-time health information network to create a first-of-its-kind prior authorization experience, with a shared understanding between patients, providers, and payers. Find out how Abridge and Availity are extending conversational intelligence across the revenue cycle.

Making the Case for AI

Healthcare organizations have a lot to gain from implementing AI that can enhance coding accuracy and quality metrics, but securing buy-in from leadership is a crucial first step. Check out Navina’s new guide by Dr. Michael S. Barr to see exactly how to demonstrate clear financial benefits, ROI potential, and alignment with organizational priorities to help ensure AI projects are successful.

The Resource Wire

• State of Payor Enrollment and Credentialing: Over half of provider orgs are losing revenue due to credentialing delays – with many missing out on over $1M annually. Medallion’s new report unpacks the forces quietly undermining operational and financial performance, and how leaders across the industry are addressing them. Head over to the full report to get insights tailored to your role and org type.

• The Perfect Moment for Digital Health: With expanded support for remote care, digital health is positioned to play a central role in value-based models. Check out Withings’ latest overview to learn how connected technologies can help reduce preventable events while improving care quality and efficiency.

• Better Health Through Virtual-First Primary Care: For patients, positive health outcomes are driven by strong relationships built on trust with health systems and providers. Hear how Ovatient’s fully EHR-integrated, virtual-first care approach is helping primary care patients like Tito Santiago reach their care goals and build a stronger relationship with The MetroHealth System. 

• Evidence, in the Flow of Care: Heidi brings trusted guidelines and peer-reviewed research directly into clinical workflows so decisions don’t stall care. Clinicians get clear, evidence-based answers without leaving the conversation. No ads, no limits, and no outside interests getting in the way of care. Find out how with Heidi Evidence.

The Industry Wire

1. Medical lobbying groups spending record sums in Washington.
2. Payors launch effort to standardize prior authorizations.
3. Trump closes last of 17 drug cost agreements. 
4. Healthcare providers warily watch for pharma shortages. 
5. ER patients waiting days for inpatient hospital beds. 
6. Guest issues raise questions about academic publishing. 
7. Should the Main Residency Match be reformed?
8. FTC reaches pact to finally settle anesthesia roll-up complaint.
9. White House downgrades marijuana classification.
10. OpenAI’s growing healthcare footprint.

OpenAI CEO Sam Altman

Providers

OpenAI Launches ChatGPT for Clinicians

OpenAI is doubling down on providers, and this time around it’s going direct-to-docs with ChatGPT for Clinicians.

ChatGPT-5.4, but for clinicians. OpenAI’s medically-tuned version of ChatGPT uses the same engine as GPT-5.4, with specialized training to optimize it for clinical workflows and administrative tasks.

• Better yet, it’s free for any verified physician, NP, PA, or pharmacist in the U.S.

ChatGPT for Clinicians includes:

• Access to GPT-5.4 and OpenAI’s other models (increased limits for clinical tasks).
• Skills for repeatable workflows (like drafting referral letters and patient instructions).
• Clinical search based on “millions of peer-reviewed sources” (details were sparse).
• Optional support for HIPAA compliance (through a BAA for eligible accounts).

ChatGPT for Clinicians doesn’t include:

• Connectors to the CMS Coverage Database, NPI Registry, or ICD-10. Not impossible.
• Broader platform advantages like integrated drug information or telehealth.
• Evidence from big name partners that’s contextualized to the encounter.
• HIPAA compliance out-of-the-box.

All that said, the performance talks. ChatGPT for Clinicians was launched alongside HealthBench Professional, OpenAI’s new benchmark built from real clinical conversations.

• It grades models on chat tasks across three use cases (care consults, documentation, and medical research), with physician-authored scenarios and rubrics, as well as scoring designed to reflect real-world performance.

• As you might expect, OpenAI’s new tool did great on OpenAI’s new benchmark. ChatGPT for Clinicians outperformed Claude Opus 4.7, Gemini 3.1 Pro, and even specialty-matched physicians with unlimited time and web access.

What happened to ChatGPT for Healthcare? OpenAI launched ChatGPT for Healthcare just a few short months ago to help health systems with enterprise-wide deployments, but now it’s taking “the next step” by bringing ChatGPT straight to individual clinicians so that “AGI benefits all of humanity.”

The Takeaway

Whether OpenAI is pursuing an altruistic mission or hedging slow progress in the enterprise arena, millions of clinicians already use ChatGPT to support their care, and now they have a fine-tuned version that won’t break the bank.

Unlock Accurate Transcription With Medical Mode

Unlocking accurate transcription of even the most complex medical terminology is now as easy as adding a single line of code. AssemblyAI’s new Medical Mode eliminates errors on the words that matter most – medicine names, dosages, and clinical diagnoses – so that you can ship solutions that perform when accuracy isn’t optional. Start building with Medical Mode today.

Abridge & Availity Redefine Payer-Provider Synergy

Abridge is teaming up with Availity to redefine payer-provider synergy at the point of conversation. The collaboration aligns Abridge’s evidence-aware intelligence with Availity’s real-time health information network to create a first-of-its-kind prior authorization experience, with a shared understanding between patients, providers, and payers. Find out how Abridge and Availity are extending conversational intelligence across the revenue cycle.

The Wire

• Big Week for Peptides: The peptide market didn’t waste any time kicking off its big boom following last week’s news that the FDA is considering easing up restrictions. Established players like Hims & Hers saw shares skyrocket 50% after announcing that they’re expanding the product line, and new players like Protocole emerged from stealth with $6M to build physician-supervised peptide protocols. Noom also scooped up Tailor Made Compounding to push into the category, and Superpower debuted its own peptide platform to capitalize on the moment.

• Denial Reversals On the Rise: A study in JAMA Internal Medicine showed that patients and clinicians have been getting better at overturning claim denials. Researchers analyzed 51k cases in New York between 2019 and 2025, finding that the percentage of payor decisions overturned by external reviews climbed from 38% to 52.5% over the period. The rates varied widely by treatment category, with the most successful appeals in home healthcare (80%) and substance use services (61%). The most common reasons for denials included evergreen favorites like human error and ambiguous coverage rules.

• Amperos Series A: The denial stats might start looking even better after Amperos Health landed $16M of Series A funding to help providers resolve denials five times faster and cut denial rates by 70%. Amperos is reportedly the first revenue recovery partner capable of working denials end-to-end entirely with AI, although it also supports its agents with a team of subject matter experts to help with complex and difficult-to-recover claims.

• Hidden Side Effects of GLP-1s: A study in Nature Health combed through over 400k Reddit posts to uncover GLP-1 side effects that clinical trials might be missing. Just over 43% of Reddit users who self-reported that they’re taking a GLP-1 also mentioned a side effect, most commonly nausea (36.9%), fatigue (16.7%), and vomiting (16.3%). Reproductive symptoms like menstrual irregularities emerged as an unrecognized potential effect, as well as temperature-related complaints such as chills and hot flushes. The research lands just as the White House reverses course on Medicare coverage for weight loss drugs

• Coral Raises $12M: AI automation platform Coral hauled in $12.5M to automate healthcare’s back office “by working with, not against, the fax machine.” Instead of asking its customers to rebuild their infrastructure, Coral connects to existing EHRs, fax lines, and payor portals, then helps automate every workflow that touches them. The focus so far has been supporting areas like specialized intake and fax processing for DME suppliers, infusion centers, and radiology practices.

• Ambience Roadmap: Ambience Healthcare shared a glimpse of its product roadmap as it continues growing beyond its roots in ambient documentation. The roadmap emphasizes “redesign over optimization” across five domains: clinical workflows, revenue integrity, patient experience, care orchestration, and clinical research. Health system partners joined Ambience on stage at its inaugural Apex Summit to showcase how they’re bringing the roadmap to life through collaborations like Project Orchestra (a care orchestration initiative with Cleveland Clinic) and Project Archimedes (a research-focused effort with Mayo Clinic).

• LLMs for Health Queries: A new study in Nature wrapped some numbers around how people are using general-purpose LLMs to guide their health. The analysis of 500k conversations with Microsoft Copilot revealed that 40% of health-related conversations were seeking general health information as opposed to medical advice, while just one in five health conversations involved personal symptom assessments or condition discussions. The authors also pointed out that AI is increasingly relied on as a caregiving tool, with one in seven health queries involving someone other than the user.

• Hippocratic Voice Agents: Hippocratic AI rolled out a pair of new voice AI agents for intake and inpatient nursing. AI Front Door is an “omni-topic” agent that lets patients schedule an appointment, ask about lab results, or address a billing issue in a single conversation. Nurse Co-Pilot allows nurses to select a patient and workflow (e.g. education or medication adherence) then have a voice agent call them directly, with a structured clinical summary and full transcript written back to the EHR automatically.

• CB State of Digital Health: CB Insights’ State of Digital Health Q1’26 confirmed the funding momentum in Rock Health’s overview, while also adding some color to the M&A picture. Funding rose to $7.4B in Q1, hitting the highest total seen since 2022. CB highlighted DeepHealth’s $269M acquisition of Gleamer to show what drives premium valuations: broad adoption (700+ hospital contracts across 44 countries) and meaningful revenue ($30M projected for 2026). By contrast, Oxipit achieved the world’s first CE Class IIb certification for fully autonomous chest X-ray interpretation, and generated just $27.6K in revenue in 2024.

• Patients Struggle With Finances: Cedar’s 2026 Trends In Patient Payments report found that 40% of collections now come from patients without health coverage, up 54% in the past three years. A major contributing factor is the 65% increase in high-deductible health plan enrollment over the last decade, and the forecast doesn’t look much brighter. Cedar notes that 20M people are experiencing premium hikes following the end of ACA subsidies, while another 10M are expected to lose Medicaid coverage due to new work requirements.

Privia Accelerates VBC Success With Navina

How do you give physicians new AI tools to accelerate VBC without slowing them down? Privia Health found its answer with Navina. They co-designed an under-one-hour training program that onboarded 800+ clinicians in the first year, driving 87% weekly active usage while providing clearer visibility into their patient panels. Read the full case study to see what it takes to make adoption stick and outcomes follow.

State of Payor Enrollment and Credentialing

AI is changing the way that healthcare leaders tackle provider network management. Medallion’s latest report breaks down the biggest challenges, emerging trends, and how automation is transforming the landscape. Get the insights you need – read the full report today.

The Resource Wire

• The Perfect Moment for Digital Health: With expanded support for remote care, digital health is positioned to play a central role in value-based models. Check out Withings’ latest overview to learn how connected technologies can help reduce preventable events while improving care quality and efficiency.

• Virtual-First, Local Always: The humans of healthcare can get lost in the background at conferences full of robo-docs and AI assistants, but deep personal connections are just as key as new technologies for driving better outcomes. Find out how Ovatient is keeping care “virtual-first, local always” in Digital Health Wire’s rapid-fire interview from the ViVE exhibit hall.

• The AI Hardware Built for Clinical Work: Phones were never meant to be propped on a desk for a 12-hour clinical day. Heidi Remote transcribes patient sessions offline, stores them securely on-device, and syncs to Heidi whenever you’re in range. Just clip on and get to work with the Heidi Remote.

• Shape Health AI at DHAI 2026: Mark your calendars. The Digital Health & AI Innovation Summit is bringing together AI leaders from across the industry for a live event in Boston on June 8-9th. This year’s agenda is packed with 150+ speakers and content curated specifically for the pioneers shaping health AI. Reserve your spot for DHAI 2026 today.

The Industry Wire

1. RFK Jr. faces questions in Senate healthcare budget hearing. 
2. CDC blocks report on COVID vaccine’s effectiveness. 
3. CMS may kill NTAP program for breakthrough devices.
4. Cancer survivors face soaring medical bills. 
5. Pace of NIH research funding slows even more. 
6. Amazon’s One Medical launches program for GLP-1 weight-loss drugs. 
7. Becker’s updates list of top 100 health systems by revenue.
8. FDA recalls anxiety medication after failed QC test. 
9. Psychedelic wellness retreats mushroom into big business. 
10. California residents warned on spread of rat lungworm disease.

athenahealth VP of Government and Regulatory Affairs Joe Ganley

Digital Health

PHTI: AI Reality Opposite of Expectations

AI promised less friction and lower administrative costs, but a new report from the Peterson Health Technology Institute suggests that it might actually be delivering the exact opposite.

The report stems from a stakeholder workshop that PHTI held to uncover AI’s impact on two of healthcare’s most hotly debated administrative processes: prior authorization and medical coding.

The main finding highlights an obvious predicament. Speeding up flawed processes doesn’t make them any less expensive. PHTI didn’t pin the blame on either side of the AI arms race.

• It found that payors are (mostly) using AI responsibly. They’re accelerating PA reviews and auto-approving more clean cases, while simultaneously improving code validation and risk adjustment – although the DOJ would probably disagree.

• Providers are also using their AI superpowers for good. They’re automating the PA workflows driving burnout and streamlining the coding processes that take clinician time away from patients.

That almost sounds like it should create some efficiency. The problem is that it’s the system that’s broken, and AI doesn’t fix the underlying issues.

• The report pointed out how AI tools for providers caused an uptick in billing intensity, which payors naturally responded to with across-the-board downcoding and other reimbursement reductions.

• AI might also reduce the cost for individual orgs to execute or appeal prior auths, but it won’t impact costs for the overall system if nothing gets passed on to patients.

• PHTI believes this makes reimbursement policy the strongest lever that can realistically be pulled to slash system-level spending.

Follow the incentives. Or in this case, the lack thereof. 

• On paper, payors and providers should be competing for a finite pool of patients in an arena that rewards better products with smaller price tags. If AI cuts costs, providers would be able to bill less and payors could lower premiums.

• In reality, most patients go wherever the ambulance takes them, and there’s little incentive to sacrifice profits in order to get more people in the door.

Efficiency doesn’t translate to deflation. Payors or providers are rational market actors, and if AI can streamline a process that lets them hold onto more of their revenue, then that’s exactly what they’ll do.

The Takeaway

Bots arguing with bots might be faster than humans arguing with humans, but PHTI doesn’t see that eliminating friction from the overall system if nobody has any incentivize to make it happen. 

Abridge Named #1 Best in KLAS – Again

KLAS just named Abridge #1 Best in KLAS for Ambient AI for the second year in a row. The recognition was based on direct customer feedback from the nation’s largest and most complex health systems, which gave Abridge the highest overall satisfaction score and A+ ratings across Culture, Loyalty, Relationship, and Value. Discover why Abridge is the market-leading AI platform for clinical conversations.

Privia Accelerates VBC Success With Navina

How do you give physicians new AI tools to accelerate VBC without slowing them down? Privia Health found its answer with Navina. They co-designed an under-one-hour training program that onboarded 800+ clinicians in the first year, driving 87% weekly active usage while providing clearer visibility into their patient panels. Read the full case study to see what it takes to make adoption stick and outcomes follow.

The Wire

• Death by a Thousand Vendors: Over 40% of employers now manage eight or more digital health vendors, and 60% are spending upwards of $2.5M per year to do it. That’s the big takeaway from a Solera survey of 106 HR leaders at orgs with 1k+ employees, which found that 80% need over five hours every week to manage their health vendors, while over a quarter need 11 hrs/wk for reporting, employee comms, and troubleshooting the programs. That’s prompted 70% of orgs to engage outside consultants to support their health benefit ecosystem, and three-quarters invest $100k annually in third-party assistance.

• Abridge Adds NEJM & JAMA: Abridge locked in multi-year content partnerships with NEJM Group (of NEJM fame) and the American Medical Association, which is spinning a lot of plates including JAMA and 11 specialty journals. The partnerships will deepen Abridge’s clinical decision support capabilities, which let clinicians ask questions and receive information grounded in both peer-reviewed research and patient context – during the clinical conversation when it’s most valuable. The CDS solution is already available with insights from Wolters Kluwer’s UpToDate, and it sounds like the new content will be up and running in the coming months.

• Behavioral Health Gap Widens: Trilliant Health’s just-released 2026 Behavioral Health Report showed that the patient volume for behavioral health-related medications surged 20% from 2018 to 2024, yet the treatment gap has only gotten wider. Prescriptions for stimulants (53%) and antipsychotics (45%) led the pack, and it was interesting to see that the share of scripts written by NPs and PAs jumped from 20.7% to 34.3% during the same period. Over a fifth of patients with anxiety or depression (22.4%) didn’t receive treatment in 2024 (up from 19.0% in 2018), and Trilliant expects patient demand to exceed clinical supply by nearly 37k psychiatrists in 2038.

• Assort Moves Into Dermatology: Assort Health is bringing its AI agents to dermatology, one of “the most operationally demanding specialties” in healthcare. Dermatology appointments run the gamut from Botox to melanoma, and schedulers frequently have to interpret symptom descriptions that aren’t much better than “a weird spot” or “a bump” to determine whether a patient needs a cosmetic consult or same-day biopsy. Assort’s specialty-trained voice AI agents are ready to help manage that at scale after helping early partners like MDCS Dermatology increase appointment volume by over 29% in two years.

• LLMs Aren’t Doctors: A new study in JAMA Network Open provided the latest confirmation that AI is improving at the science of medicine, but it still can’t replicate the art of seeing a new patient. MGB researchers introduced a new PrIME-LLM framework to score the clinical reasoning of 21 leading LLMs models on their full diagnostic process instead of just the final answer. While every model nailed the final diagnosis over 60% of the time, none managed to produce the right differential diagnosis in more than 6 of the 29 test cases.

• Omada Muscle Math: Omada released results from a 12-week study that added to the growing body of evidence showing wraparound support is more than a “nice to have” for GLP-1s. Members in Omada’s GLP-1 Care Track, which supports the meds with tailored programming that emphasizes activity and strength, lost nearly double the total body weight (6.0% vs. 3.3% of starting weight) and 2.1x more body fat than those not on the specialized track. This is one of the first studies in the space that analyzes body composition instead of just weight, and Omada’s members that preserved (or even improved) muscle mass will be the first to tell you that not all weight loss is created equal.

• Walmart Expands Better Care Services: In other GLP-1 news, Walmart is expanding its Better Care Services platform with new offerings for patients on the weight loss meds. Better Care Services brings together virtual care, nutrition services, and pharmacy access in a single experience enabled by its growing partner roster. The latest additions include Aaptive (fitness app), Berry Street (nutrition therapy), Curai Health (AI-driven self-guided care), MyCare by Twin Health (insights into how food, sleep, and activity affect the body), and Wheel (full-service virtual weight management care).

• Patients Reject Doc Grading Criteria: Clinicians shouldn’t be graded on how many of their patients attend screening exams like mammography. That’s according to 1.9k patients surveyed in a JAMA Health Forum study that assessed whether screening should be a performance metric for grading physicians. Just over half (51%) said doctors shouldn’t be scored on how many of their patients got screened, while 21% said that they should be. Screening rates have been proposed as a metric to encourage guideline-concordant care, and it seems like most patients would oppose the proposal.

• Direct-to-Patient Guardrails: With more pharma companies launching direct-to-patient platforms on what seems like a weekly basis, the Digital Medicine Society kicked off a new initiative to help establish a foundation to ensure they can operate safely. Optimizing Direct-to-Patient Strategies for Pharma is a cross-sector effort that brings together pharma companies, digital pharmacies, and virtual-first providers like Wheel and Welldoc to build a shared blueprint for scaling DTP models responsibly. Welldoc’s chief AI officer told Fierce that the initiative has concrete objectives to “tame the Wild West before it becomes the Wild West.”

State of Payor Enrollment and Credentialing

AI is changing the way that healthcare leaders tackle provider network management. Medallion’s latest report breaks down the biggest challenges, emerging trends, and how automation is transforming the landscape. Get the insights you need – read the full report today.

Improving GLP-1 Treatment for the Long Term

Looking to make GLP-1 prescribing safer and more effective long term? Explore Withings’ suite of remote patient monitoring devices, designed to deliver the continuous, clinically relevant insights that care teams need to proactively monitor patients, identify risks early, and intervene with confidence.

The Resource Wire

• Virtual-First, Local Always: The humans of healthcare can get lost in the background at conferences full of robo-docs and AI assistants, but deep personal connections are just as key as new technologies for driving better outcomes. Find out how Ovatient is keeping care “virtual-first, local always” in Digital Health Wire’s rapid-fire interview from the ViVE exhibit hall.

• The AI Hardware Built for Clinical Work: Phones were never meant to be propped on a desk for a 12-hour clinical day. Heidi Remote transcribes patient sessions offline, stores them securely on-device, and syncs to Heidi whenever you’re in range. Just clip on and get to work with the Heidi Remote.

• Shape Health AI at DHAI 2026: Mark your calendars. The Digital Health & AI Innovation Summit is bringing together AI leaders from across the industry for a live event in Boston on June 8-9th. This year’s agenda is packed with 150+ speakers and content curated specifically for the pioneers shaping health AI. Reserve your spot for DHAI 2026 today.

• Unlock Accurate Transcription With Medical Mode: Unlocking accurate transcription of even the most complex medical terminology is now as easy as adding a single line of code. AssemblyAI’s new Medical Mode eliminates errors on the words that matter most – medicine names, dosages, and clinical diagnoses – so that you can ship solutions that perform when accuracy isn’t optional. Start building with Medical Mode today.

The Industry Wire

1. FDA reclassifies peptides and sends telehealth stocks soaring.
2. Trump taps former public health leader Erica Schwartz to run CDC.
3. CMS proposes repeal of breakthrough device pathway.
4. HHS brings on first affordability czar.
5. Inside Epic’s confidential vendor services agreement.
6. 37 leading health systems ranked by operating margin.
7. Amazon to stock Lilly’s new weight-loss pill at U.S. kiosks.
8. Premier Health names new chief digital information officer.
9. 83 health systems ranked by annual revenue.
10. Beyond March Madness: athletics boost academic health system marketing.

Venrock Partner Bob Kocher

Digital Health

The Rise of the Generalist-Specialist

Healthcare’s tidy hierarchy of specialties was formed by cognitive necessity. The corpus of medical knowledge is too massive for a single person to master and the clinical workforce was organized around it, but a new article in Health Affairs says it might be time for a redesign if AI removes that constraint.

AI is scaling specialist-level knowledge. Leading models are coasting through Board exams and polishing their clinical capabilities, which the authors argue will quickly scale specialist-level knowledge to the point where most specialty care can be delivered by PCPs.

• They coined the term “generalist-specialists” for a new category of doctors that transcends narrow specialty definitions.

Clinical expertise is increasingly democratized. The authors see a future where AI-augmented clinicians can manage the full constellation of patients’ chronic conditions within disease-based domains rather than organ-specific specialties. They give a few examples:

• Cardiometabolic Diseases – combines cardiology, endocrinology, and nephrology
• Infectious & Inflammatory – rheumatology, infectious disease, & gastroenterology
• Primary Care: spans OB/GYN, internal medicine, and pediatrics.

That could have some major benefits. Instead of shuffling a diabetic patient between an endocrinologist, cardiologist, and nephrologist, a generalist-specialist could manage the full cardiometabolic picture.

• That means fewer handoffs, faster diagnoses, and lower co-pays. It would also unlock a ton of specialty capacity for the patients that need it most.

• Consolidating care under fewer clinicians would also be a tailwind for value-based care, although it would likely increase utilization in a fee-for-service world by converting deferred, fragmented, or incomplete care into a cohesive billable treatment.

AI isn’t the only barrier to making that happen. Everything from med schools and malpractice standards to credentialing and referral systems would need to be completely overhauled.

• The generalist-specialist vision also assumes that specialists will be on board with either becoming quasi-PCPs or upskilling to ultra-complex care. Definitely not a given.

• Patient safety concerns also go without saying, but the AI will probably be pretty decent by the time we have cardio-endocrin-nephrologists putting together the care plans.

The Takeaway

AI could easily bring specialist knowledge to generalist fingertips, but if overworked PCPs are going to start also being OB/GYNs it will take more than a fancy LLM to get there.

Privia Accelerates VBC Success With Navina

How do you give physicians new AI tools to accelerate VBC without slowing them down? Privia Health found its answer with Navina. They co-designed an under-one-hour training program that onboarded 800+ clinicians in the first year, driving 87% weekly active usage while providing clearer visibility into their patient panels. Read the full case study to see what it takes to make adoption stick and outcomes follow.

State of Payor Enrollment and Credentialing

AI is changing the way that healthcare leaders tackle provider network management. Medallion’s latest report breaks down the biggest challenges, emerging trends, and how automation is transforming the landscape. Get the insights you need – read the full report today.

The Wire

• Delve Into Fraud: AI compliance platform Delve wound up in the hot seat last week after a former client published an anonymous report accusing the startup of widespread fraudulent activity. The report alleges that Delve has been fabricating compliance documents, using dubious auditors, and misleading its customers about regulatory adherence. Delve’s two 21-year-old cofounders dropped out of MIT to start the company in 2023, then quickly got accepted into Y Combinator and hit a $300M valuation. They’re denying the claims, but that hasn’t stopped millions of people from seeing the report on socials.

• Vida + Oura: Vida Health is teaming up with Oura to integrate the smart ring’s real-time biometric data into Vida’s virtual cardiometabolic care programs. Vida’s care teams will gain access to sleep, heart rate variability, and resting heart rate data, giving them a continuous view of patient health between appointments, lab tests, and coaching sessions. Makes sense on paper. Vida brings the clinical muscle (nutrition guidance, GLP-1 prescribing, lifestyle coaching) and Oura brings passive data collection that’s already on over 2.5M fingers.

• Hospitals Find New Normal: Kaufman Hall’s latest National Hospital Flash Report confirms what most hospitals have been saying for a while: finances are stable, but not comfortable. Operating margins closed out 2025 at 1.3%, and the report noted a persistent gap between gross and net operating revenue that was attributed to an eroding payer mix with more government reimbursement and uninsured patients weighing things down. Outpatient revenue per day rose 13% year-over-year, but expenses climbed across the board along with bad debt.

• ACCESS First 150: CMS announced the first 150 organizations accepted into the ACCESS model, and extended the application deadline to May 15th for anyone who wants to hop on late. The lineup includes some familiar faces – Verily, Aledade, Story Health – and it seems like many of the companies are wading into the Medicare waters for the first time. ACCESS uses outcome-aligned payments tied to measurable health improvements in chronic conditions (diabetes, hypertension, behaviorial health), and could end up becoming a major on-ramp for companies entering the Medicare space.

• Keebler Raises $16M: Risk adjustment startup Keebler Health locked in $16M of Series A funding to scale its AI-native platform for mining unstructured clinical data. Keebler uses LLMs to analyze full patient charts – handwritten notes, faxes, scans, PDFs – to surface HCC codes and risk adjustment opportunities with source-linked evidence for audit readiness. The LLM-first approach can reportedly cut risk adjustment costs by up to 70% compared to traditional methods.

• Prior Auth Progress Report: AHIP and BCBSA released an update on payors’ voluntary prior authorization commitments, which apparently saw participating health plans eliminate 11% of prior auths across medical services. That adds up to 6.5M fewer prior auths for patients – not too shabby – with Medicare Advantage seeing reductions upwards of 15%. Payors also rolled out a 90-day transition period that lets patients keep existing prior auth approvals when switching health plans. The next milestone hits in 2027, when at least 80% of electronic prior auth approvals will need to be answered in real-time.

• Yuzu Health Raises $35M: Yuzu Health pulled in $35M of Series A funding to lay the infrastructure for alternative plan designs. Yuzu started out trying to build its own health plan before pivoting to the infrastructure gap it discovered along the way – claims processing, payments, and administrative workflows cobbled together with fragmented tech and vendor partnerships behind-the-scenes. The platform already operates across all 50 states and has facilitated over $1B in claims transactions since 2022. 

• The Battle for MAHA Voters: A Politico poll surfaced some cracks in the MAHA movement heading into the upcoming midterms, with most voters viewing Democrats as better positioned to handle key health priorities. About half of U.S. voters (47%) say they support the MAHA movement, including roughly a third of voters who backed former VP Kamala Harris in 2024 and about a third of Americans who plan to vote for Democrats this November. By comparison, 70% of Trump 2024 voters say they support the MAHA movement. Overall, only 19% of voters rank healthcare access as their top issue.

• Gemini Adds Mental Health Guardrails: Google is adding new mental health safeguards to Gemini after a wrongful death lawsuit that alleged the chatbot contributed to a user’s suicide. The updates include a one-click crisis hotline interface that stays visible for the rest of any conversation where signs of self-harm are detected, plus a redesigned “help is available” module for broader mental health discussions. Google also pledged $30M over three years to scale global crisis hotlines. 

• Where Americans Get Health Info: A survey from Pew Research found that 85% of Americans still turn to providers as their first source for health information. Other top sources included friends or family members going through similar health experiences (66%), social media (36%), and AI chatbots (22%). Social media and chatbot users were also far more likely to call those sources convenient than accurate, with only 7% rating social media health info as highly accurate.

Improving GLP-1 Treatment for the Long Term

Looking to make GLP-1 prescribing safer and more effective long term? Explore Withings’ suite of remote patient monitoring devices, designed to deliver the continuous, clinically relevant insights that care teams need to proactively monitor patients, identify risks early, and intervene with confidence.

The Virtual-First Difference at MetroHealth

When the MetroHealth System needed a comprehensive, scalable solution to help its patients access care, it turned to Ovatient’s virtual-first care model. Ovatient isn’t another point solution, it’s a virtual care partnership – integrated clinically, operationally, and technologically with your existing infrastructure. Discover how MetroHealth’s virtual-first approach is keeping patients connected to high-quality care whether they’re at home, at work, or on the go.

The Resource Wire

• The AI Hardware Built for Clinical Work: Phones were never meant to be propped on a desk for a 12-hour clinical day. Heidi Remote transcribes patient sessions offline, stores them securely on-device, and syncs to Heidi whenever you’re in range. Just clip on and get to work with the Heidi Remote.

• Shape Health AI at DHAI 2026: Mark your calendars. The Digital Health & AI Innovation Summit is bringing together AI leaders from across the industry for a live event in Boston on June 8-9th. This year’s agenda is packed with 150+ speakers and content curated specifically for the pioneers shaping health AI. Reserve your spot for DHAI 2026 today.

• Unlock Accurate Transcription With Medical Mode: Unlocking accurate transcription of even the most complex medical terminology is now as easy as adding a single line of code. AssemblyAI’s new Medical Mode eliminates errors on the words that matter most – medicine names, dosages, and clinical diagnoses – so that you can ship solutions that perform when accuracy isn’t optional. Start building with Medical Mode today.

• Abridge Named #1 Best in KLAS – Again: KLAS just named Abridge #1 Best in KLAS for Ambient AI for the second year in a row. The recognition was based on direct customer feedback from the nation’s largest and most complex health systems, which gave Abridge the highest overall satisfaction score and A+ ratings across Culture, Loyalty, Relationship, and Value. Discover why Abridge is the market-leading AI platform for clinical conversations.

The Industry Wire

1. VA goes live with Oracle Health EHR.
2. Amazon launches AI drug discovery platform.
3. Hims & Hers data leaked through social engineering attack.
4. Patients using LLMs to fight medical bills with mixed results.
5. Epic launches Health Alerts for monitoring conditions at the county level.
6. Jefferson Health sues Aetna over Medicare Advantage downcoding.
7. ChristianaCare CEO announces retirement and successor.
8. Florida doctor indicted for removing liver instead of spleen in fatal surgery.
9. Henry Ford hospital strike enters seventh month.
10. Gambling legalization is outpacing the public health response to addiction.