Category: Digital Health

Dr. Oz Sheds Light on Potential Priorities at CMS

Posted on by Jason Barry

Dr. Mehmet Oz appears to have passed his Senate testimony with flying colors, and the surgeon-turned-TV-personality’s confirmation as CMS administrator seems all but locked in.

The nearly three hour testimony wandered through a range of topics with a direct impact on digital health, giving us a first look at what might change – or get axed – in the years ahead.

  • Prior auth topped the hit list. The most concrete policy idea that Oz offered was limiting the number of procedures subject to prior auth in Medicare Advantage to 1,000, a steep reduction from ~15,000 today. Oz said the “pre-approval process is expensive and wastes time,” especially when we have AI that can “pretty quickly adjudicate whether you should have to wait even a day to have the medication that will get you out of pain.”
  • AI was a major theme throughout the testimony. Oz plans to use AI to help doctors “optimize care” and focus on their patients, making several references to its ability to augment treatments and cut down on paperwork. He also said “we should be using AI within the agency to identify [fraud] early enough so that we can prevent it.”
  • Medicare Advantage was another big focal point. Oz cited MedPAC research showing that MA is more expensive than traditional Medicare, but attributed much of the cost to upcoding from payors. He promised to hit the problem head-on with an AI hammer.
  • Medicaid was a mixed bag. While Oz said he fully supports the program, he also agreed that spending has gone off the rails since the ACA, and was in favor of implementing work requirements. Oz sidestepped questions about potential cuts by saying “the way you protect Medicaid is by making sure that it’s viable at every level,” which includes having enough practitioners, compensating them fairly, and improving patient access.

The Takeaway

It’s hard to take the other side when a charismatic doctor vows to fix a broken healthcare system, but it’s also tough to tell the difference between empty promises and real reform until action backs it up. Part of that will have to wait until the actual confirmation, but as Oz put it, “part of this is just recognizing there is a new sheriff in town.”

HIMSS 2025 Recap, Launches, and Major Announcements

Posted on by Jason Barry

It’s the final day of HIMSS 2025 in Las Vegas, and although the exhibitors are still diligently manning their stations, most of the announcement cards have already been dealt and it’s time to round up the biggest stories from the show.

HIMSS centered around the familiar themes of digital transformation, cybersecurity, artificial intelligence, and workforce development, but the single biggest trend landed at the intersection of all four: agentic AI.

The industry is embracing AI agents everywhere from the bedside to the contact center, and it was amazing to see how quickly last year’s hallucination worries gave way to what feels like a pedal-to-the-metal approach to new AI rollouts. 

You would have been hard pressed to find a dozen booths in the exhibit hall that didn’t mention AI, and the same could be said about the announcements from the show.

HIMSS 2025 major announcements, launches, and partnerships:

  • 1upHealth debuted the latest release of its 1up Platform, which introduces a modern lakehouse architecture designed to scale with healthcare’s growing data needs and improve control over real-time management and analytics. Check out our interview with CEO Andrew Boyd for the full overview.
  • Arcadia is bringing its longitudinal patient data to League’s CX platform to let healthcare orgs deliver individualized health recommendations and activate consumer engagement through AI and behavioral science. CEO Michael Meucci shares all the details.
  • eClinicalWorks can now connect and exchange data with PointClickCare applications in long-term and post-acute care settings to support remote and bedside physician encounters.
  • Elsevier expanded its flagship ClinicalKey AI clinical decision support solution through new workflow integrations with Epic and DrFirst’s iPrescribe platform, not to mention the launch of a dedicated mobile app.
  • Google Cloud rolled out new GenAI capabilities in Vertex AI Search for healthcare, including a multimodal search feature called Visual Q&A that ingests tables, charts, and diagrams to build a more comprehensive view of patient health.
  • InterSystems debuted its IntelliCare AI-powered EHR that includes an AI assistant to enable natural language commands, automatic patient history summarization, real-time note generation, and prepopulated billing codes.
  • Kontakt.io bolstered its Responsive Care Operations platform with Kio Agents, which help prioritize day-to-day management of patient flow, assets, and nurse staff while forecasting potential bottlenecks and dynamically redistributing resources in real-time.
  • Medallion enhanced its automated credentialing and compliance capabilities to support Joint Commission standards with electronic privileging workflow management and automated submission of privileging applications to partner hospitals.
  • Microsoft took the lid off Dragon Copilot, an AI assistant that combines the natural language voice dictation of Dragon Medical One with the ambient listening capabilities of DAX Copilot to support everything from documentation and after-visit summaries to referral letters and clinical evidence summarization.
  • Notable released the next generation of its Flow Builder, which rounds out the solution with a new Builder Assistant for AI-powered workflow creation, intuitive visualizations of data flowing through the automations, and granular role-based access controls.
  • Rush University System for Health expanded its partnership with Suki and will be deploying the AI clinical documentation assistant system-wide, allowing clinicians across 28 specialties to generate patient summaries and simplify coding.
  • RevSpring unveiled SeatMate, an AI assistant that guides customer service reps with intelligent scripting, infuses every conversation with patient insights, and enhances self-service through conversational chat capabilities.
  • Salesforce debuted Agentforce for Health, a library of pre-built agent skills to streamline tasks like benefits verification, clinical trial recruitment, provider search & scheduling, care coordination, and customer service.
  • Surescripts released its 2024 Annual Impact Report, highlighting its Touchless Prior Authorization capabilities that helped patients get medications faster by reducing the average time to approve a prior auth from over an hour to just 34 seconds.
  • symplr launched the first of many AI solutions coming to its symplr Operations Platform, a symplrAI Evidence Analysis chatbot designed to accelerate clinical research and streamline the medical device and technology decision-making process for health plans.
  • Talkdesk revealed its AI Agents for Healthcare, which not only automate common patient and member inquiries, but can also schedule appointments, verify benefits or prior auths, and manage prescription refills in any language.
  • TigerConnect announced the general availability of its TigerConnect Pre-Hospital solution that streamlines a wide range of EMS, ED, and transfer workflows to improve patient throughput and outcomes (think better prep for patient arrival and digitized transfer coordination).
  • Withings published an analysis of 3.4M smart scale users, finding that 38% of people classified as “overweight” and 2% classified as “normal” on the BMI scale actually have an unhealthy amount of fat – based on their body composition analysis – and should seek further screenings (6% of those with an “obese” BMI actually had a healthy body composition and should be considered “healthy”).
  • Wolters Kluwer Health is integrating UpToDate with Microsoft Copilot Studio to deliver patient-specific, evidence-based medical content through Microsoft Dragon Copilot ambient listening and other point of care workflows.
  • Zoom announced the public beta of Zoom Workplace for Clinicians, building on its partnership with Suki to automatically generate visit notes for both virtual and in-person appointments by simply clicking on the ‘Clinical Notes’ icon in the Zoom Workplace app.

We hope that everyone had an awesome time if you made it to Vegas, and welcome all of our new readers that we met at the show. Stay tuned for a deeper dive into some of these announcements next week.

ViVE 2025 Recap and Major Announcements

Posted on by Jason Barry

Hot chicken, cold weather, and artificial intelligence – ViVE Nashville had it all.

Over 10,000 attendees made the trip to Music City, making the event roughly a third larger than the last time it was in town in 2023. About a hundred of those attendees even stuck around for the last day, risking the snow (and flight delays) to bask in more innovation.

Many of the themes on the show floor were familiar (AI, point solution fatigue, ROI is king), but there were also plenty of new issues that were clearly top of mind, particularly Medicare & Medicaid reform, cybersecurity, and the mounting pressures facing payors.

True to form, ViVE kept the spotlight on the vendors, so we’ll follow their lead and dive right into some of the biggest announcements from the show.

  • Abridge crossed the 100 health system milestone and locked a $250M Series D in the process, but the even bigger story was its debut of a new Contextual Reasoning Engine that produces billable notes at the point of care. More to come on this one next week.
  • Ambience Healthcare notched a massive partnership with Cleveland Clinic after coming out on top of “a rigorous pilot program” throughout 2024. The AI platform for documentation, CDI, and coding will be rolling out enterprise-wide this year.
  • Arcadia launched new solutions to help payers and providers drive high-performing networks, simplify VBC contract creation, and enhance provider management efforts. A new AI Factory development platform is also slated to be showcased at HIMSS.
  • AvaSure showcased its new virtual care assistant Vicky, which uses AI to collect and prioritize in-room requests to help care teams be everywhere they need to be. The beautiful hardware demos were a nice bonus.
  • Clearsense unveiled its new Nashville HQ and the strategic rebrand of its active archiving solution (which now supports accounts receivable workdown requirements) and RevealCS data lakehouse offering. CEO Jason Rose is also a great interview.
  • IKS Health expanded its Scribble suite with Scribble Now, a generative AI ambient scribe that rounds out the five-product lineup with real-time clinical documentation.
  • Innovaccer made a big splash with the launch of its Agents of Care, AI agents designed to slash administrative burdens for everyone from clinicians, care managers, risk coders, patient navigators, and call center agents. 
  • Kontakt.io bolstered its Patient Flow offering with Rapid Room Turnover, an RLTS-powered solution that detects discharges in real-time to help hospitals drive greater bed utilization and cut down on costly extended lengths of stay.
  • Lumeris introduced its Tom AI-powered team member for primary care. Tom produces personalized, next-best actions at both the patient and population levels embedded within clinical workflows.
  • Memorial Sloan Kettering Cancer Center joined forces with AWS to build a novel longitudinal data resource for cancer research, which will serve as a way to accelerate AI-driven clinical studies and personalized treatment development.
  • Nabla took the lid off Nabla Dictation, a voice-to-text solution fine-tuned for 55 specialties that streamlines clinical workflows by transcribing speech wherever the cursor is placed (AKA anywhere in the EHR).
  • symplr debuted a first-of-its-kind symplr Operations Platform built on AWS that consolidates fragmented systems and standardizes non-clinical / administrative operations. This was definitely a major announcement so we’ll be circling back on it at HIMSS.
  • Talkdesk agent tools and persistent call controls can now be embedded directly in Epic for the first time, creating a seamless contact center integration with the EHR. 

Special thanks to all of our readers who were at the show and caught us up on the latest and greatest. For those of you holding onto more announcements for HIMSS, we’d love to connect in Vegas. Hit reply and let’s set something up!

Health Tech’s Defining Decade

Posted on by Jason Barry

We’re using today’s top story to circle back on Define Venture’s report on “Health Tech’s Defining Decade,” which included too many highlights to squeeze into last week’s update.

The analysis dives into the performance of venture-backed health tech startups that went on to go public, with a sprinkle of survivorship bias given that it doesn’t include companies that have been delisted.

Although still an emerging sector, 18 health tech companies have exited for over $1 billion since 2020, including 13 via the public markets and 7 through M&A.

Here’s a look at those “Wave 1” companies and how Define Ventures segments the market. 

These Wave 1 companies aren’t exactly known for their stock performance, but it was still surprising to see that only two have managed to increase their market caps since their IPO:

  • Hims & Hers, which went public at a $1.6B valuation via a 2021 SPAC, and has grown its market cap to $10.1B after shrugging off recent Super Bowl ad drama.
  • Doximity, which had a strong 2021 IPO at a ~$4B valuation, and is now valued at $14B after its latest financial results sent shares skyrocketing 25% on strong engagement from its new AI tools.

Define Ventures took these successes as a sign that SaaS and Hybrid models will drive future healthcare innovation, but UNC Professor Spencer Dorn shared a more sobering view of the mixed performances.

  • “Like Netflix, advertising is far more lucrative for digital health companies than other business models. Doximity – ‘basically an advertising platform for pharma’ – is the only one that is decently profitable.”

What will Wave 2 look like? Define Ventures tallied up ~20 companies that are growing quickly and “could seek liquidity events” even bigger than their Wave 1 predecessors.

  • While Wave 1 companies had to build each component of their offerings from scratch, Wave 2 companies had the perks of a more mature industry to weave throughout their offerings (ex. better data integration, AI, plug-and-play capabilities).
  • This could result in Wave 2 companies having 2-3X the revenue at exit, and it’s hard to argue with the shortlist of IPO predictions.

The Takeaway

These reports catch a lot of flack for overweighting the successes of the firms that put them together, and while Define Ventures didn’t shy away from patting itself on the back for some good investments, it also delivered a great analysis of past (and possibly future) publicly traded health tech companies.

HIPAA Gets First Major Update in Over a Decade

Posted on by Jason Barry

It might have taken the biggest data breach in healthcare history to make it happen, but HHS finally announced the first major changes to HIPAA in over a decade.

Big changes need big titles, and the HIPAA Security Rule Notice of Proposed Rulemaking to Strengthen Cybersecurity for Electronic Protected Health Information packs 393 pages of them.

We admittedly only skimmed that for about two minutes before turning to our usual sources for a summary, so here’s an even shorter summary of those summaries.

The proposed HIPAA changes would require provider organizations to:

  • Enhance data security measures, including multi-factor authentication, network segmentation, and encrypting electronic protected health information (ePHI) 
  • Maintain a technology asset inventory and network map illustrating the movement of all ePHI within their information systems 
  • Maintain a detailed risk analysis of each component in the inventory and network map
  • Establish written procedures to restore EHR systems within 72 hours of a cyberattack
  • Conduct HIPAA compliance audits at least once per year

Another key change is the elimination of the distinction between “required” security rules that must be followed and “addressable” rules that providers can choose not to obey.

  • By eliminating that line, HIPAA would make all of the above changes mandatory for all organizations, whether they’re ready to implement them or not.

Even tech savvy providers are still in the business of care delivery, not cybersecurity, and many of them will have to partner with outside companies to ensure compliance.

  • Larger organizations with strong IT teams might already be preparing for these changes, but smaller hospitals with already-slim margins are probably in for a tough transition.

Health data needs to be protected, and our current safety measures obviously aren’t getting it done. On the other hand, there’s also a growing divide between “the best” and “the rest” of U.S. hospitals, so an unfunded mandate with heavy compliance costs runs the risk of making it wider.

The Takeaway

Healthcare has its fair share of acronyms, but HIPAA might just be the most common one in the alphabet soup. It’s important to get these changes right, and that means finding a balance between protecting patients and not overburdening providers. HHS is seeking comments on the rule until March 7.

Rock Health 2024 Overview: David vs Goliath

Posted on by Jason Barry

If last year’s digital health market felt like David vs. Goliath, Rock Health’s full-year funding recap has you covered with the reason why.

Here’s 2024 by the numbers:

  • U.S. digital health funding totaled $10.1B across 497 rounds 
  • Continued downtrend in investment (2023 was $10.8B total, 503 rounds)
  • Shift to early-stage companies drove the dropoff

There’s a tale of two trends unfolding between the early-stage startups and late-stage incumbents battling for market share, and neither side is helping out the funding total.

  • Investors began focusing on early-stage startups throughout 2024, and a whopping 86% of labeled rounds went to Seed, Series A, and Series B startups.
  • Larger companies also started to see smaller checks, with the median Series C and D raise clocking in at $50M and $55M, respectively (down ~10% from 2023). 

The shift to earlier-stage investments was driven by an appetite for startups that can show traction with small/medium sized organizations, especially among increasingly influential mega-VCs like General Catalyst and Andreessen Horowitz.

  • These smaller orgs want gen AI capabilities, aren’t a top target for massive IT players, and can be a goldmine for the startups that can fill that gap.  
  • The mega-VC influence in digital health follows a broader trend, with PitchBook data showing that 50% of all venture capital raised in the U.S. last year went to just nine firms… out of 391 total VCs. GC and a16z happened to rank #1 and #2.

Since it wouldn’t be a 2024 recap without the magic two letters: AI investment reached a fever pitch, and AI-first startups took home 37% of the overall funding.

  • Goliaths in this space include incumbents like Epic, the healthcare divisions of Big Tech players like Microsoft, and younger startups with the warchest to compete like Commure.
  • Rock Health sees a future where the AI Davids can continue thriving by addressing specialized use cases or smaller customer segments, as long as they keep an eye on the roadmaps of their bigger competition to avoid getting stepped on.

The Takeaway

If the healthcare industry wants to keep innovating, it needs companies of all shapes and sizes to make it happen. Rock Health’s 2024 recap is a good reminder that not every startup needs to be a Goliath, and that the Davids are still finding success by right-sizing their operation to the customers they serve.

Crystal Ball Compilation: Digital Health in 2025

Posted on by Jason Barry

Welcome back to the first Digital Health Wire of 2025! The healthcare news cycle might never sleep, but we hope our readers are heading into the new year well rested and ready for big things to come.

The past few weeks have had plenty of fortune tellers predicting what those big things will be, so we’re kicking the year off with a compilation of the clearest crystal balls.

Let’s get right into it.

Second Opinion – There’s about to be a lot of AI capital incineration, Chrissy Farr

  • Favorite Forecast: AI startups will struggle if they don’t acknowledge that to sell into healthcare, you can’t ignore services. Until AI training is ubiquitous, startups will need their own teams to make it happen. Public healthcare “tech” companies have a service-heavy revenue mix for a reason.
  • Big Idea: “We are overdoing it on AI and missing out on opportunities to invest in solid, services businesses that are truly helping patients… These businesses have extremely low valuations and are struggling to raise, relative to their peers in AI that have made zero traction.”

The Surgeon’s Record – 2025 The Year of the Wood Snake, Dr. Ben Schwartz

  • Favorite Forecast: Care delivery innovation pivots from primary care to specialty care. Specialty care is extremely complex, with huge room for improvement from shifting sites of service, building new condition-specific treatment pathways, and aggregating high-quality networks.
  • Big Idea: “The specialty care innovation movement is well underway… Maven Clinic… Oshi Health… Thyme Care… Commons Clinic… The common thread here? Embracing a hybrid specialty care model.”

Out-of-Pocket – Out-Of-Pocket’s 2025 Predictions, Nikhil Krishnan

  • Favorite Forecast: Marketing becomes a mess. Meta is making some major healthcare advertising changes that make it difficult to actually target patients, and Google and LinkedIn could soon follow suit.
  • Big Idea: “AI generated slop is starting to mess up search engine optimization rankings. 50% of people are little content piggies that are fine with the slop though.”

Hospitalogy – 8 Predictions for Healthcare 2025, Blake Madden

  • Favorite Forecast: LLM advancements made back-office AI the talk of 2024, but this year could bring a surge in funding for clinical AI solutions.
  • Big Idea: “The cost and complexity of processing unstructured clinical data, combined with low risk tolerance, have historically limited the adoption of clinical AI products. Fortunately, LLMs excel at more accurately interpreting unstructured / multi-modal data, and the cost of compute is decreasing. This sets the stage for AI to create more value in clinical workflows.”

Forbes – Anti-Predictions For Healthcare In 2025, Seth Joseph

  • Favorite Forecast: Progress on data interoperability will continue, but painfully slowly. Everyone wants interoperability, but regulatory uncertainty and the rapid emergence of new data sources complicates the situation.
  • Big Idea: “The politics of access to healthcare data will continue as if it’s a 6th grade student council election.” – Zus Health CEO Jonathan Bush

NeuroFlow – 2025 Healthcare Forecast, Ellen Harvey

  • Favorite Forecast: Behavioral health will shift from access to impact. By collecting behavioral health data and merging it with physical health data, we’ll start to see which interventions truly reduce unnecessary utilization and improve outcomes. 
  • Big Idea: “The industry is finally shifting from asking ‘Do we have enough providers?’ to ‘Are our programs actually working?’ As healthcare costs continue to skyrocket, both public and private payers will demand proof that their behavioral health investments are paying off.” – NeuroFlow COO Robert Capobianco

The Takeaway

The healthcare industry has plenty of challenges, but it also has some strong tailwinds pushing it toward new solutions. Cheers to everyone making those solutions a reality in the new year.

Rock Health’s Innovation Maturity Curve Heading Into 2025

Posted on by Jason Barry

Rock Health is wrapping up the year in style by updating its Innovation Maturity Curve with the hottest trends of 2024, and sharing its predictions for what lies ahead.

The curve uses three major data categories to plot digital health innovations:

  • Research volume – gauges the potential of a topic through PubMed publications
  • Venture funding – tracks investment as a leading indicator of commercial interest 
  • Partnership activity – uses industry partnerships as a proxy for commercial traction

Here’s how 2023’s biggest trends progressed over the course of the year:

AI in Healthcare (Maturity Score: Developing) – Digital Health Wire readers know the AI hype cycle is still in full swing, with AI-first digital health startups landing $3.3B in venture capital through the end of Q3. AI partnerships also surged (Rock Health counted 80+, an undercount if anything), but 2024’s plateau in research activity gave another sign that we’re transitioning to practical applications and commercialization. 

  • Keep an eye on: We’re entering a phase of AI consolidation, with cutthroat competition for major accounts in segments like ambient documentation. As Big Tech inks their own partnerships and juggernauts like Epic double down on new features, “AI enablement will become table stakes across solutions rather than a core differentiator.”

Digital Obesity Care (Maturity Score: Developing) – Moving up from “Nascent” on last year’s curve, the conversation around obesity care has been transformed by GLP-1s and contributed to a rise in digital platforms to help patients access treatment and support.

  • Keep an eye on: Increased competition necessitates differentiation. With GLP-1 access still in flux, players need to build momentum with more than just prescribing (precision treatment planning, biometric tracking, support for co-occurring conditions like PCOS).

Food as Medicine (Maturity Score: Emerging) – FaM moved from a niche term to a buzzword (props to Rock Health for helping it happen), with category funding doubling on-year after big raises from players like Foodsmart ($200M). Payors, providers, and grocers contributed to over 30 new FaM partnerships this year.

  • Keep an eye on: FaM innovation is closely tied to reimbursement models for food delivery and nutrition consultations, so continued success hinges on sustained policy support. Assuming that happens – seems likely given the Make America Healthy Again chatter – 2025 could be another huge year.

The Takeaway

With the digital health recalibration now (mostly) behind us, Rock Health expects 2025 to give innovators a chance to demonstrate a measurable impact on outcomes and continue their trek along the maturity curve. The whole report is well worth checking out for details on smaller up-and-coming categories like new wearable form factors, digital twins, and climate tech.

CB Insights 2024 Digital Health 50

Posted on by Jason Barry

CB Insights unveiled its annual Digital Health 50 rankings of the most promising private digital health startups, and this year’s list certainly included many of the industry’s brightest stars.

Here’s the methodology / our disclaimer: The final cut was selected from a pool of 10k+ applicants based on “proprietary metrics” – Commercial Maturity and Mosaic Scores – along with data on partnerships, growth stats, and market adoption. (CB Insights is of course happy to share this data with its customers, but promises that being one of them doesn’t land you a spot on the list.)

With that out of the way, here’s a look at the Digital Health 50 (high-res version):

CB Digital Health 50

It’s tough to compare this list to last year’s given the ever-evolving categories and methodology, but CB Insights called out four key themes for the latest cohort:

  • AI is becoming foundational infrastructure: 36 of the 50 companies are building AI products, ranging from operational automation high-flyers like Laguna to specialized healthcare LLMs like Hippocratic AI. No surprises here.
  • Workflow efficiency is a key priority: 19 of the companies are streamlining administrative or clinical tasks, spanning document processing startups (Tennr) to ambient AI heavyweights (Abridge). These players seem like an obvious inclusion, but the same could be said last year when ambient AI was nowhere to be found.
  • Diagnostic innovations dominate: 11 companies comprised this year’s largest category, developing next-gen diagnostics across imaging (Airs Medical), pathology (Proscia), and non-invasive diagnostics (Alimetry). Diagnostics was in a three-way tie with Clinical Intelligence and Virtual Care, although the categories have some hazy boundaries. 
  • More specialized platforms: Virtual and hybrid care representation doubled in this year’s cohort, reflecting the shift from general telemedicine toward condition-specific virtual models in areas like mental health (Talkiatry) and cancer care (Resilience).

The Takeaway

Lists like these never fail to get pushback because of the methodology or glaring exclusions, but this year’s cohort feels pretty well aligned with the high momentum names that keep popping up in our own coverage. Major congrats to the companies that were included.

PHTI Delivers Mixed Review on Digital Hypertension Tools

Posted on by Jason Barry

Digital hypertension management solutions received a mixed report card from the Peterson Health Technology Institute’s latest evaluation, which found significant differences in performance depending on the treatment approach.

The 71-page report assessed clinical and economic evidence across three solution types:

  • Blood Pressure Monitoring – extend hypertension care beyond in-person visits using home monitoring devices that stream data back to providers. Ex. AMC Health, Health Recovery Solutions, VitalSight (Omron)
  • Medication Management – employ dedicated virtual care teams to coordinate medication adjustments as a supplement to the patients’ main primary care team. Ex. Cadence, Ochsner Digital Medicine, Story Health
  • Behavior Change – deliver educational content, alerts, reminders, and virtual interactions with coaches or care teams to improve hypertension self-management. Ex. Dario, Hello Heart, Lark, Omada, Teladoc (Livongo).

PHTI’s signature chart delivers a great summary of the findings:

The analysis found that all approaches across all payor types increase total healthcare spending over a three-year time horizon, because the cost of the solutions exceeds the savings from improved clinical outcomes.

The good news – at least for Medication Management and Behavior Change solutions – was that improvements in blood pressure over a 10-year window reduced patients’ risk of cardiovascular disease and prevented enough deaths to justify the cost.

  • PHTI found that only Medication Management solutions demonstrated significant blood pressure reductions compared to usual care, and recommended that this is the “most pressing area of integration” for most practice settings.
  • BP Monitoring showed “slightly greater, but not clinically meaningful declines,” but failed to breakeven at current RPM reimbursement levels.
  • Behavior Change approaches produced only “limited incremental declines,” which doesn’t support broad adoption for most patients but could still play a role for underserved populations with difficult access to usual care. 

Those findings naturally led to pushback from some of the companies named in the report. 

  • Omada said that the analysis “inadequately groups companies with very different offerings” and “narrowly focuses on select clinical metrics,” while underweighting user experience and patient-reported outcomes. 
  • PHTI responded to the critics by saying that “patients expect that clinically-focused digital solutions are improving their health. We can talk about competing on user experience… but we need to prove that they work.”

The Takeaway

There’s a high bar for digital solutions that need to justify their cost above standard care, and PHTI just raised that bar even higher for hypertension management. Not all approaches are created equal, and while some companies might not agree with PHTI’s findings, reports like these are a maturity milestone for digital health as a whole.

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