Category: Digital Health

ViVE 2026 Recap and Major Announcements

Posted on by Jason Barry

Not even our second generational snowstorm of the year could stop ViVE Los Angeles from bringing the heat.

Agentic AI was the theme of the show, but it’s clear that category lines are only going to keep getting blurrier as agents break down the barriers to entry.

It felt like every startup had just finished supercharging their engine with the latest frontier models, and even though most healthcare orgs are open to adopting faster solutions to their problems, the toughest competition in the exhibit hall might have been buyer bandwidth.

As always, ViVE kept the spotlight on the innovation, so we’ll go ahead and follow their lead with our recap of the biggest announcements from the show.

  • athenahealth launched new agentic patient communication tools across its provider network, giving patients around-the-clock access to a virtual assistant at their doctor’s office that can help with tasks like answering basic questions or scheduling appointments.
  • Artisight integrated Epic MyChart Bedside TV with its smart hospital platform, transforming in-room televisions into an Epic-aware hub for inpatient care and patient engagement.
  • b.well Connected Health kept its hot streak going with bailey, a white-label health AI assistant. Orgs can embed bailey directly into their own apps to deliver modern patient experiences – finding care, managing medications, scheduling appointments, navigating benefits – without doing the heavy lifting of building the AI from scratch.
  • Canvas Medical showcased its new Canvas Plugin Assistant that effectively eliminates any coding skill requirements for customizing the Canvas EMR platform or building agents on top of it.
  • Care Continuity debuted CarePath IQ to give health systems better visibility into their patients’ follow-up care plans, navigation pathways, and provider handoffs – inside and outside the network.
  • CLEAR rolled out its CLEAR1 platform at Mount Sinai Health System to give patients and employees a single, secure identity across the entire ecosystem.
  • DiMe announced that CMS made the DiMe Seal a required on-ramp for digital health applications in the upcoming Medicare App Library, meaning they’ll have to complete a defined benchmark across evidence, security, and usability if they want to get in front of 86M beneficiaries.
  • Dock Health deployed its productivity platform at Mayo Clinic to streamline referral workflows and optimize operations across its cardiovascular, econsult, and specialty contract programs.
  • Fabric took the lid off Evo, a nationwide virtual care benefit that consolidates high-demand services into a unified experience: Urgent Care, Talk Therapy, Mental Health Med Mgmt, and Weight Loss.
  • Heidi was everywhere at this one. They scored a hat trick with the launch of a fully integrated Heidi Evidence tool that brings clinical evidence to workflows without any advertising baggage, the acquisition of UK-based clinical AI pioneer AutoMedica, and the debut of Heidi Comms to give care teams an AI partner for coordinating patient communications.
  • Hyro equipped its AI agents with clinically validated content and decision logic courtesy of WebMD Ignite, moving conversational AI flows beyond simple Q&As with guided actions like specialty routing and appointment scheduling.
  • Innovaccer joined forces with Allina Health Minneapolis Heart Institute to expand access to guideline-directed heart failure management from Story Health, its recently acquired virtual specialty care and patient monitoring platform that not-so-coincidentally has one of the best HF management programs in town.
  • Kontakt.io added to its flurry of new solutions with Patient Flow Agent, an orchestration agent that puts real-time operations signals from RTLS and the EHR in context so frontline caregivers can make the best decision for the patient and hospital. The RTLS component stands to unlock some big improvements for length of stay and delays, AKA revenue and experience.
  • Luma Health shared updates on its Operational AI platform that executes complex healthcare workflows from start to finish rather than optimizing isolated tasks. Over 50 health systems used Luma-powered AI workflows to save two million staff hours in 2025.
  • NewDays laid out its unique cognitive treatment platform that blends human and AI elements to help patients delay symptoms and preserve independence. The approach combines clinical assessments and psychotherapy with an AI companion named Sunny for exercises and support between visits. Their CIO Daniel is also awesome.
  • RevSpring debuted its first dedicated MCP server to give developers a grounding layer that connects AI models with data like provider quality, real-time availability, plan networks, and cost transparency – without the usual agent lag. The launch arrives as the ink is still drying on RevSpring’s acquisition of Trust Commerce.
  • TigerConnect took the lid off its new AI-powered Operator Console to replace legacy operator favorites (spreadsheets and Post-Its) with a cloud-native smart switchboard. Operator Console centralizes calls, code activations, and facility alarms in a unified interface, along with intelligent call routing and AI-recommended next best steps.
  • Wheel expanded its Horizon virtual care platform with a Clinical Action Layer that ingests patient and partner data (AI, wearables, labs, records), generates clinician-ready summaries, and intelligently routes patients into orchestrated workflows. It also debuted its new WheelX exchange that connects enterprises with the AI experiences built on Horizon.
  • Withings Health Solutions was showcasing its BPM Pro 2 connected blood pressure monitor and Body Pro smart scale, the dynamic device duo that MedStar Health is bringing to its Signature concierge medicine service to make the patient and provider experiences feel like consumer experiences. Their VP of VBC Patrick Sheehan also happens to be a fantastic interview.
  • Wolters Kluwer opened up its expert-curated medication data to AI developers with its Medi-Span Expert AI MCP that lets them easily spin up their own agentic AI workflows. Medi-Span’s safety guardrails have made it the go-to medication support for pretty much everybody that values accuracy over off-the-shelf convenience.

Many thanks to all of our awesome readers who caught us up on the latest and greatest at the show, and we’re looking forward to running it back at HIMSS in a couple weeks. Smash that reply button and let’s set something up!

ACCESS Might Be InACCESSible

Posted on by Jason Barry

The wait for CMS’ new ACCESS model payment rates is finally over, but the debate over whether or not they’re financially viable is just getting started.

Advancing Chronic Care with Effective, Scalable Solutions. ACCESS was designed to move more Medicare beneficiaries away from fee-for-service toward outcomes-driven models.

  • The program’s core mechanism for accomplishing that is Outcome-Aligned Payments (OAP), a per-beneficiary annual allowed amount to cover integrated care management for chronic conditions.
  • The end goal is to get more tech-forward companies to lean in on Medicare by rewarding them for using technology to improve patient outcomes.

That goal might be hard to reach. Here are the annual OAPs by clinical track and care period:

  • Early Cardio-Kidney-Metabolic (eCKM) – $360 initial, $180 follow-on
  • Cardio-Kidney-Metabolic (CKM) – $420 initial, $210 follow-on
  • Musculoskeletal (MSK) – $180 initial, N/A follow-on
  • Behavioral Health (BH) – $180 initial, $90 follow-on

Those numbers present some real challenges. They’re considerably lower than expected, and many of the companies that had already announced plans to participate are now being forced to reevaluate the decision.

  • For the sake of comparison, Medicare’s average annual Part B spending for a diabetic patient is around $700 under fee-for-service.
  • Asking providers to deliver comprehensive, tech-enabled care for half of that is a tall order, especially for services-heavy companies with humans in the loop.
  • Companies with an AI-first approach and an established patient pipeline might perform better, but even then the rates are so low that they’ll likely do little to motivate new entrants to Medicare given the infrastructure needed to comply with the program and achieve the desired outcomes.

The Takeaway

CMS has made it clear that it’s going to start taking bigger steps to control costs, but it also has to find rates that actually encourage companies to participate. Striking that balance is an unenviable task, but the initial consensus seems to be that ACCESS missed the mark.

Will Oracle Offload Cerner to Fund Datacenters?

Posted on by Jason Barry

The rumor mill was working overtime last week after a TD Cowen research note claimed that Oracle will have to offload Oracle Health – formerly known as Cerner – to fund its AI datacenter commitments.

It’s a tale of the times. A research note isn’t an official announcement, but the EHR market could be heading towards its biggest shakeup since Oracle first acquired Cerner in 2022.

  • The speculation revolves around Oracle’s massive $300B datacenter contract with OpenAI, which will apparently take $156B of capital expenditures to fulfill.
  • Add in contracts with Meta and Nvidia, and Oracle’s commitments swell to over $500B.

That’s a ton of CapEx. TD Cowen says Oracle will have to make some deep cuts to round up enough funds. That includes:

  • Selling Cerner to the highest bidder
  • Axing up to 30k jobs, about 15% of the current workforce
  • Exploring “bring your own chip” arrangements to lighten the load on Oracle’s books

Oracle’s back is against the wall. It’s already raised $58B in the last two months, and U.S. banks have started pulling back their lending.

  • Foreign banks are still supporting Oracle’s datacenter projects, but they’ve also raised their premiums to levels typically reserved for non-investment grade companies.
  • On top of that, Oracle is going to have a hard time recouping the $28B it just paid for Cerner. Since the acquisition, Cerner’s had a brutal VA implementation, a tough rollout with the DoD, and Epic’s been eating its lunch.

Who has deep enough pockets to acquire Cerner? It’s a short list.

  • Microsoft is a prime suspect. It’s already heavily invested in healthcare through Nuance and Azure, so an EHR could potentially create a compelling end-to-end cloud lineup for its existing customers.
  • Google and Amazon also probably wouldn’t mind having Cerner’s customer base as an anchor for their cloud ambitions. They both have full war chests and established healthcare ventures like Verily and One Medical, but they also share a track-record of expensive lessons in the industry. 

The Takeaway

Recent struggles aside, Cerner is one of healthcare’s true industry titans. It shaped decades of innovation and thousands of careers. Now it might end up as a line item to fund GPU clusters.

Crystal Ball Compilation: Digital Health in 2026 

Posted on by Jason Barry

Welcome back to the first Digital Health Wire of 2026! The healthcare industry doesn’t take any days off, but we hope our readers managed to catch a break over the holidays to recharge for the big things to come in the new year.

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

Let’s get right into it.

CommonSpirit Health – Five Health Tech Predictions for 2026, Dr. Minal Shah

  • Favorite Forecast: In 2026, AI projects without strategic alignment are heading straight to the pilot graveyard. When organizations chase what’s possible instead of what’s strategic, they burn human capital on change efforts that never scale to real impact.
  • Big Idea: “Platform vs. point solution is a false dichotomy – and I think we’re asking the wrong question. The real question isn’t which approach to take. It’s whether we’ve done the hard work of understanding what the organization actually needs before we choose a path forward. That means moving from ‘what can we do with AI?’ to ‘what should we be doing with AI?'”

Out-of-Pocket – Out-Of-Pocket’s 2026 Predictions, Nikhil Krishnan

  • Favorite Forecast: Intellectual property lines will be drawn for AI. We’ve already seen a ton of legal battles around copyrights, but the dealmaking is just getting started.
  • Big Idea: “Healthcare has a TON of companies that have copyrights and IP ownership over critical parts of healthcare information. OpenEvidence for example has signed several agreements with medical societies, NEJM, etc. Who will the AMA partner with for CPT codes? Which companies will the EHRs partner with to license their data?”

Second Opinion – Healthcare in 2026, Christina Farr & Annalisa Merelli

  • Favorite Forecast: The largest digital health companies will start flocking to CMS’ new ACCESS program to find a better business model in Medicare, while also duking it out for a slice of the available rural health funding. 
  • Big Idea: “There’s no question digital health companies will be the beneficiaries, particularly given that the executive and policymaker running Medicare – Chris Klomp – has an entrepreneurial background and formerly sat on the board of venture-backed Maven Clinic.”

Becker’s – How the AI conversation will change in 2026, Zachary Lipton

  • Favorite Forecast: Clinical decision support has been trapped in a frustrating middle zone for years: better than manually searching guidelines, but worse than talking to a specialist. CDS will finally start evolving beyond search with contextual awareness.
  • Big Idea: “This is the year CDS evolves past glamorized search. Next-generation CDS will reason jointly over medical literature, the patient’s record and current visit context, helping clinicians apply knowledge, not just retrieve it.”

Forbes – 10 Healthcare Industry Predictions For 2026, Sachin Jain

  • Favorite Forecast: Healthcare’s AI revolution will hit speed bumps. While AI has shown considerable promise for relatively straightforward uses like ambient dictation, its application in other domains will be more challenged and problematic.
  • Big Idea: “Agentic AI holds significant promise, but legacy operators will be slow to change deeply ingrained processes, values, and attitudes. AI snake-oil salespeople (fueled by venture capitalists chasing outsized returns) have flooded the zone, a phenomenon that is sure to fuel false starts and threaten the pace and depth of true organizational change in the short-run.”

Hospitalogy – 8 Predictions for Healthcare 2026, Blake Madden

  • Favorite Forecast: In 2026, enterprise buyers will start demanding consolidation. The operational model shifts from “best of breed for each use case” to “who can orchestrate AI across our entire administrative and clinical workflow?”
  • Big Idea: “This is where the Palantir playbook becomes relevant. The firm is already working with HCA and others to deploy AI infrastructure that spans clinical, operational, and financial domains. The value proposition isn’t any single algorithm. It’s the orchestration layer that ties disparate data sources into unified decision support.”

Notable – Healthcare’s pivotal year for AI transformation, Dr. Aaron Neinstein

  • Favorite Forecast: New practices will be built from scratch around AI Agents to support panel sizes three to five times larger at equal or higher quality and dramatically lower cost. At the same time, human connection will take center stage again.
  • Big Idea: “AI will handle pattern analysis and routine adjustments, so clinicians can shift from memorizing facts to focusing on meaning… Because of this, nurses, MAs, and care coordinators will move up the value chain, as they can spend more time on empathy, clinical judgement, and complex situations rather than administrative tasks.”

The Takeaway

Healthcare still has its fair share of challenges, but it has just as many tailwinds pushing it toward new solutions. Cheers to everyone making those solutions a reality in the new year.

Rock Health: Innovation at the Turn of 2026

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 2025 and sharing its predictions for what lies ahead.

The curve uses three major data points to plot innovation:

  • 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.

The pace is picking up. Here’s a look at the categories that defined the year:

Longevity (Maturity Score: Developing) – Companies are pushing past one-off diagnostics to see whether personalized baselines can anchor ongoing care. Function Health just hauled in a massive $298M Series B for its “operating system for human health,” and other players like Hone Health have started expanding their models with in-home services.

  • Keep an eye on: How much will insights on hormones or heart health translate into adjustments that patients actually act on? Rock Health expects this segment to hinge on turning long-arc patterns into timely guidance that’s both credible and valuable.

Mental Health Chatbots (Maturity Score: Emerging) – Some AI chatbots might be shutting down, but just as many are doubling down. Slingshot burst onto the scene with $93M to build “the world’s first foundation model for psychology,” and incumbents like Spring Health have even started launching bots to evaluate the safety of other bots.

  • Keep an eye on: Regulatory scrutiny is intensifying as states begin banning AI-driven therapy. Some startups might be able to navigate the roadblocks, but Rock Health thinks others might pivot to lower-risk territory like keeping patients engaged between visits.

Health Benefits 2.0 (Maturity Score: Emerging) – OOP spending continues to climb, while employers just notched the steepest benefit cost increase in 15 years. Those pressures cracked a window for non-traditional models to gain traction, such as ICHRA frontrunners Thatch and Venteur.

  • Keep an eye on: The benefits pressure cooker is heating up in 2026, which means this category isn’t going anywhere. As more costs shift to consumers, Rock Health anticipates the benefits experience to start looking even more like a set of adjacent marketplaces rather than a single plan.

The Takeaway 

Digital health is moving faster than ever, and AI is only going to keep accelerating innovation. Rock Health’s full report is well worth checking out for more details on these categories and other up-and-coming segments like wearables (smart rings are especially hot), precision medicine (digital twins had a big year), and climate health (think allergies and air pollution).

TrumpRx and the GLP-1 Land Grab

Posted on by Jason Barry

It’s a bad day to be a pharma middleman. The White House announced the launch of TrumpRx in 2026, kicking off a wave of cost reductions on some of the most popular drugs in the world. 

TrumpRx looks exactly like it sounds. Here’s the website.

  • The site will serve as a portal for patients to find the best rates on prescription medications, AKA “Most-Favored-Nation Pricing.” 
  • Unlike other billionaire-run pharma projects like Mark Cuban Cost Plus Drug Company, TrumpRx won’t actually fulfill anything. 
  • Instead, it will send people to pharmaceutical companies’ direct-to-consumer sites to process orders, a strategy that Cuban applauded as having “no downside for anyone.” 

It gets better. TrumpRx was part of a broader initiative to lower drug costs for Americans, and included major partnerships with Novo Nordisk and Eli Lilly to expand access to GLP-1s.

  • Novo’s Ozempic and Wegovy will be listed at $350 per month on TrumpRx, significantly lower than the $1k per month that many patients are used to.
  • The same goes for Lilly’s Zepbound, and both manufacturers agreed to list their upcoming oral GLP-1s at $150 “in the event that the FDA later approves them.” That seems pretty likely at this point.

What does pharma get out of it? Medicare coverage.

  • The “historic reductions” will enable Medicare and Medicaid to cover GLP-1s for adults with obesity, as opposed to confining coverage to those with diabetes or heart disease.  

Things snowballed from there. Novo revealed this week that it will immediately slash its GLP-1s to $349 on its DTC platform, with doses available at $199 for new patients.

  • GoodRx was quick to match them at $199 for the first two months, and Ro hopped on the same introductory bandwagon.
  • Omada also completely changed its tune within hours of the TrumpRx announcement and said that it will begin prescribing GLP-1s for the first time in 2026.

The Takeaway

The GLP-1 landscape just got tossed on its head, and the oral versions haven’t even come out yet. Drug manufacturers are already throwing down the direct-to-consumer gauntlet, but so far it looks like patients might actually come out on top.

U.S. Healthcare is an “Abominable Creature”

Posted on by Jason Barry

If a picture is worth a thousand words, then this chart from industry consultant Andrew Tsang might be worth a million.

America’s healthcare system is “An Abominable Creature.” That’s also the title of Tsang’s stellar blog post that meticulously maps out every dollar that flows through it.

  • The flows in the diagram represent $4.9T, but they’re also a glimpse at every medical decision that was made in the U.S. last year. Every diagnosis. Every birth. Every death.

The charts don’t just map spending, they map our decisions. We built the healthcare system brick by brick with the choices we made, and although they might have all made sense individually, the end result is a monster of our own design.

Decision 1 – Workers fund healthcare twice… or more [Chart 1]. 

  • Federal, State, and Local Taxes – $2.4T for Medicare, Medicaid, and public health.
  • Payroll Taxes – employers fund Medicare even though most employees aren’t 65.
  • Premiums – $688B gets deducted from paychecks for employer plans.
  • Out-of-Pocket Costs – Americans shell out another $506B when they actually get care.

Decision 2 – We look after our seniors [Chart 2]. 

  • Medicare accounts for $1T every year.
  • Nursing homes account for $218B every year.
  • Home health & hospice account for $100B (and 22% of all Medicaid spending).

Other Decisions – The full U.S. diagram can tell whatever story you want it to [Chart 3].

  • Treatment is more important than prevention – $100B goes to public health while $1.5T goes to hospital care annually.
  • Innovation is a bigger priority than price controls – $441B is spent on prescription drugs.
  • Repairing old age is better than investing in children – $120B goes to children’s health compared to $1T for Medicare.

The Takeaway

The U.S. healthcare system was pieced together through a long chain of isolated decisions, each one solving a specific problem at the time. Tsang just gave us a beautiful illustration of the end result: a kraken with countless tentacles that all seem to have a mind of their own.

HLTH 2025 Recap and Major Announcements

Posted on by Jason Barry

Hard to believe that was already Digital Health Wire’s fourth trip to HLTH – a few more flights out to Vegas and we might be getting close to “legacy media” status.

The more the conversations change, the more they stay the same. Last year’s “Be Bold” theme and LLM mania gave way to tales from healthcare’s “Heroes and Legends” and an AI agent avalanche.

The industry is still facing most of the same challenges, but it was amazing to see how quickly new innovations are compounding in the solutions that it’s using to conquer them.

Here’s our (non-exhaustive) roundup of some of those solutions from the expo hall:

  • Arbital Health debuted its Merlin AI value-based care assistant built to make actuarial analysis transparent and actionable. Merlin AI interprets complex risk contract data, explains performance drivers, and instantly recommends next best steps.
  • Abridge is bringing CDS into the flow of clinical conversations through a partnership with Wolters Kluwer. The UpToDate integration adds to a white-hot October for Abridge, which already included heavy-hitter roll outs at UPMC and Northwell.
  • Brook.ai hauled in $28M of Series B funding to expand its personalized remote care platform to more patients and conditions. Providers can get up and running on the platform in 30 days with no CapEx required, and the results in the announcement speak for themselves. More to come on this one next week.
  • Cedar debuted an aptly named Cedar Cover enrollment tool to make sure patients aren’t caught in the rain when the dark cloud of Medicaid cuts gets here. Cedar Cover’s key capabilities include Medicaid enrollment, proactive renewal, and denials resolution.
  • Ellipsis Health is teaming up with NVIDIA to leverage its Parakeet ASR model and build out the AI infrastructure supporting Sage, an emotionally intelligent AI care manager that expands staffing capacity through proactive patient engagement.
  • GE HealthCare is collaborating with The Queen’s Health Systems and Duke Health to advance the development of its upcoming AI-driven hospital operations solution. The solution will leverage insights from both systems and the 500+ hospitals using Command Center to surface actions for improving care quality, patient flow, and resource utilization. 
  • hc1 unveiled hc1 IQ to deliver precision insights that transform lab data into life-saving action. hc1 IQ unifies lab, clinical, and supply chain data into a single AI-powered platform to produce enterprise-wide intelligence for improving outcomes.
  • IntelePeer launched a SmartAnalytics Starter Pack that gives providers the most approachable entry-point we’ve seen to the AI agent ecosystem. It includes one patient engagement automation from IntelePeer’s menu, along with real-time dashboards and call analysis to drive immediate operational improvements.
  • League introduced League Agent Teams to its AI-first consumer experience platform. The multi-agent system guides users through complex health journeys using a suite of AI agents fine-tuned for specific tasks and an orchestration layer to coordinate them.  
  • Lorikeet debuted a healthcare-specific extension for its Team of Agents (deja vu, definitely one of the biggest themes at HLTH), which coordinates actions across multiple agents to call vendors, text doctors, and take action to “actually solve customer issues.”
  • Nabla debuted Nabla Connect, a plug-and-play module that enables any EHR to seamlessly integrate ambient AI. Nabla already has one of the widest EHR footprints in the space, and CEO Alex LeBrun gave us the live walkthrough of how Nabla Connect extends that foundation to smaller EHRs looking to unlock the same capabilities.
  • Optum took the lid off its Optum Real claims system that delivers instant coverage validation. The multi-payor platform enables real-time data exchange between payers and providers, allowing any issues to be intercepted at the point of submission.
  • Penguin Ai is joining forces with UPMC Enterprises and leveraging its Ahavi data platform to validate new AI models in a secure testing environment. Ahavi will allow Penguin to refine its Small Language Models for real clinical use cases like record summarization and prior auth optimization.
  • Solera Health showcased its Precision Insights Suite for AI-driven cost containment and care navigation. The two core components include Precision Intercept, which identifies patients at risk of significantly increasing costs within a year, and Precision Navigate, which delivers personalized provider recommendations based on similar patients.
  • Suki launched a nursing-focused AI consortium with several leading health systems and AvaSure on the inaugural roster. The consortium will co-develop Suki for Nurses while integrating ambient AI capabilities into AvaSure’s virtual care platform.
  • Vital announced the launch of Vital Urgent Care, an AI-powered platform that provides patients in urgent care settings with real-time updates, wait times, and personalized guidance – without requiring a single download or additional staff bandwidth.
  • Wellsheet is rolling out across Ascension to give providers a unified view of previously overlooked data. The “GenAI front-end” allows care teams to access patient-specific EHR data on a single screen, accelerating diagnoses and clinical decisions.
  • Withings Health Solutions unveiled best practices for obesity care management programs built on a decade of partnerships across the segment. Those include: (1) continuous monitoring for real-time adjustments, (2) on-device communications, (3) data-driven outcome tracking, (4) addressing comorbidities, (5) measuring more than traditional BMI metrics. All great practices for maternal health as well!

Welcome to all the fresh faces scrolling through DHW for the first time, and shoutout to all the long-time readers we caught up with at the show – the OGs have officially been here longer than a lot of the exhibitors have existed!

We picked up as many announcements as we could carry, but if we missed anything exciting and you don’t see it below, hit reply and let us know what to circle back on next week.

2025 State of Digital Health Purchasing

Posted on by Jason Barry

What better way to kick off HLTH week than with a new survey from the Peterson Health Technology Institute showing that healthcare decision-makers are still hungry for new solutions?

PHTI’s 2025 State of Digital Health Purchasing Survey showed that health plans, employers, and health systems are all investing heavily in digital health, but spending patterns are starting to diverge.

  • The headlining stat: 61% of health plans and 44% of health systems plan on increasing digital health spending in the coming year, compared to just 14% of employers.

Employer spending has leveled off. Two-thirds of employers plan to hold spending steady as they maintain their current suite of solutions.

  • In contrast, health plans and health systems are ramping up to offer a wider variety of solutions (81%) and keep up with patient engagement (77%).
  • The top priorities across the board? Improve access, reduce costs, and strengthen user experiences, especially in areas like diabetes, mental health, and primary care.

Purchasers are more hawk-eyed than ever… especially when it comes to their contracts. Nearly half of purchasers are already using performance-based contracts, and the majority plan to use them in the next year.

  • 73% of contracts now have a duration under two years – up from 59% last year – leaving a short window for solutions to prove their value.
  • Short-term contracts, annual portfolio reviews, and a laser focus on engagement and ROI are the new normal. Building long-term relationships hinges on demonstrating both.

Vetting isn’t getting any easier. When comparing vendors, employers (66%) are more likely than health plans (23%) and health systems (42%) to cite cost as the deciding factor.

  • Payors and providers both prioritize a proven track record above cost, but the report points to other ways to gain an edge.
  • Although performance-based contracts are gaining traction, few purchasers are satisfied with their current models, and they’re looking for vendors that can offer either better outcome thresholds or attribution methods.

The Takeaway

Health plans, employers, and health systems all still have an appetite for new solutions, and PHTI just gave vendors a way to stack their decks with more data on each of their unique priorities.

2025 Trends Shaping the Health Economy

Posted on by Jason Barry

Trilliant Health just released its 2025 Trends Shaping the Health Economy Report, delivering a uniquely holistic perspective on the healthcare market through the lens of supply and demand.

Here’s the state of play. Health expenditures are growing faster than the rest of the economy, and they’re projected to represent 20.3% of GDP by 2033. 

  • The U.S. spends more and gets less than peer nations, which might have been tolerable when our federal debt was at $800B in 1980, but definitely isn’t now that it’s at $37T.

What levers can we pull? This year’s 115 page analysis looks into six macro trends driving the healthcare economy, and underlines each of them with concrete stories from real-world data.

  • 1) Affordability concerns are reshaping demand. Medical prices are up 54.5% since 2009, and they’re pressuring patients and employers to weigh their options – especially when rates for an inpatient procedure can vary as much as 7x within the same facility depending on the payor (p. 19).
  • 2) Stakeholders are slow to adapt to demographic trends. Mortality rates among adults aged 18-44 have been rising as the fertility rate falls, shrinking the share of Americans with employer-sponsored coverage (p. 22).
  • 3) Specialty care intervention is incentivized over primary care prevention. In 2024, behavioral health visits rose 11.4%, while primary care visits declined 5.6%, marking the first time behavioral health utilization surpassed primary care (p. 43).
  • 4) Fraud, waste, and abuse are pervasive. The share of high-complexity ED visits has risen sharply, increasing from 36.6% to 47.8% of visits between 2018 and 2024, underscoring the financial impact of upcoding (p. 57).
  • 5) Alternative therapies are accelerating. GLP-1 utilization increased 745% from 2018 to 2023, while bariatric surgery volumes were flat to declining, illustrating how high-margin procedures face growing competition from medications (p. 86).
  • 6) If the industry won’t deliver value, the government will. Federal programs have consistently failed to bend the cost curve (MSSP savings are less than 1% of Medicare spending), and there’s mounting political pressure for top-down structural reform (p. 89).

The Takeaway

The U.S. healthcare system is at a crossroads. As Trilliant put it so nicely, the choice for all health economy stakeholders is whether to implement “radical change from the inside” or “to be subjected to such change by external forces.”

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