Dr. Oz Sheds Light on Potential Priorities at CMS

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.”

AI Misses the Mark on Detecting Critical Conditions

Most health systems have already begun turning to AI to predict if patient health conditions will deteriorate, but a new study in Nature Communications Medicine suggests that current models aren’t cut out for the task. 

Virginia Tech researchers looked at several popular machine learning models cited in medical literature for predicting patient deterioration, then fed them datasets about the health of patients in ICUs or with cancer.

  • They then created test cases for the models to predict potential health issues and risk scores in the event that patient metrics were changed from the initial dataset.

AI missed the mark. For in-hospital mortality prediction, the models tested using the synthesized cases failed to recognize a staggering 66% of relevant patient injuries.

  • In some instances, the models failed to generate adequate mortality risk scores for every single test case.
  • That’s clearly not great news, especially considering that algorithms that can’t recognize critical patient conditions obviously can’t alert doctors when urgent action is needed.

The study authors point out that it’s extremely important for technology being used in patient care decisions to incorporate medical knowledge, and that “purely data-driven training alone is not sufficient.”

  • Not only did the study unearth “alarming deficiencies” in models being used for in-hospital mortality predictions, but it also turned up similar concerns with models predicting the prognosis of breast and lung cancer over five-year periods.
  • The authors conclude that a significant gap exists between raw data and the complexities of medical reality, so models trained solely on patient data are “grossly insufficient and have many dangerous blind spots.”

The Takeaway

The promise of AI remains just as immense as ever, but studies like this provide constant reminders that we need a diligent approach to adoption – not just for the technology itself but for the lives of the patients it touches. Ensuring that medical knowledge gets incorporated into clinical AI models also seems like a theme that we’re about to start hearing more often.

Hinge Files for Long-Awaited IPO 

When the digital health market needed a hero, Hinge Health answered the call.

Hinge officially filed for its IPO, braving the biggest stock market downturn in recent memory to pull the tech-enabled services category out of a years-long slump.

  • It’s a bold move, but Hinge has the business to back it up. Using a combination of virtual care and AI, Hinge delivers MSK treatment programs with comparable outcomes to traditional physical therapy at a fraction of the cost.
  • Hinge has apparently been able to automate 95% of MSK care delivery, saving its clients (primarily employers and payors) an estimated $2,387 per member per year.

Diving into the S-1, Hinge grew its revenue by 33% to $390M in 2024. It also managed to cut its net loss from $108M down to just $12M, generating 77% gross margins in the process.

  • Hinge reported 532k members and ~200M contracted lives across 2,250 clients, and counts nearly half of the Fortune 500 as clients. 
  • Great stats all around, but a nice soundbite from the S-1 was that “current contracted lives only represent 5% of our total addressable market,” and Hinge is now on the hunt for more growth through commercial plans and Medicare Advantage.

Even with the impressive metrics, Hinge’s last private valuation came in at a rich $6.2B at the height of the pandemic, meaning that it’ll need around a 15X revenue multiple just to match it.

  • It’s not out of the question, but Hims & Hers has been one of the lone bright spots for public digital health companies, and it’s trading at just 5X revenue.

The entire tech-enabled services market feels like it hinges on this IPO, at least if you’ve been following this week’s reaction to the S-1.

  • Hinge is going to be the first health tech startup to go public since Waystar last June, and VCs have been hesitant to invest in the category given the lack of major exits.
  • If Hinge’s debut goes well, it would restore some much-needed confidence in the market, and potentially even kick off a revival in the dormant IPO landscape.

The Takeaway

Hinge is a true disrupter, with an outcomes-driven alternative to traditional physical therapy and a ton of momentum in one of healthcare’s largest markets. We’ll definitely be rooting for them when they ring the bell.

Stress Testing Ambient AI Scribes

Providers are lining up to see if ambient AI can live up to its promise of decreasing burnout while improving the patient experience… and researchers are starting to wonder the same thing.

A new study in JAMA Network Open investigated whether ambient AI scribes actually decrease clinical note burden, following 46 clinicians at the University of Pennsylvania Health System as they used Nuance’s DAX Copilot AI ambient scribe from July to August 2024.

  • Researchers combined EHR data with a clinician survey to determine both quantitatively and qualitatively whether ambient scribes actually make a positive impact.

Here’s what they found. Over the course of the study, ambient scribe use was associated with:

  • 20.4% less time in notes per appointment (from 10.3 to 8.2 minutes)
  • 9.3% greater same-day appointment closure (from 66.2% to 72.4%)
  • 30.0% less after-hours work time per workday (from 50.6 to 35.4 minutes)

It’s tough to argue with the data. Ambient scribing definitely moves the needle on several important metrics, and even the less clear-cut stats still had a positive spin to them.

  • Note length was 20.6% greater with scribing (from 203k to 244k characters/wk)
  • However, the percentage of documentation that was typed by clinicians was 29.6% lower compared to baseline (from 11.2% to 7.9%)

The qualitative feedback told a different story. Even though clinicians reported feeling more engaged during patient conversations, “the need for substantial editing and proofreading of the AI-generated notes, which sometimes offset the time saved” was a recurring theme in the open-ended comments.

Ambient AI received a net promoter score of 0 on a scale of -100 to 100, meaning the clinicians were as likely to not recommend it as they were to recommend it.

  • 13 clinicians would recommend ambient AI to others, 13 wouldn’t recommend it, and 11 didn’t feel strongly either way.

The mixed reviews could mean that the ambient scribe performed better/worse for different users, but it could also mean that some clinicians were more diligent at checking the output.

The Takeaway

The evidence in favor of ambient AI scribes continues to pile up – even if the pajama-time reductions in this study didn’t live up to the promise on the box. Big technology shifts also come with adjustment periods, and this invited commentary did a great job highlighting the “real risk of automation bias” that comes with ambient AI, as well as the liability risk of missing its errors.

HIMSS 2025 Recap, Launches, and Major Announcements

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.

OpenEvidence Closes $75M in Series A Funding

OpenEvidence might be the new kid on the medical chatbot block, but it’s already “the fastest-growing platform for doctors in history,” and $75M of Series A funding just made it the youngest unicorn in healthcare.

Founder Daniel Nadler describes OpenEvidence as an AI copilot, with an experience that feels similar to ChatGPT yet is actually a “very different organism” due to the data it was trained on.

OpenEvidence functions as a specialized medical search engine that helps clinicians make decisions at the point of care, turning natural language queries into structured answers with detailed citations.

  • The model was purpose-built for healthcare by exclusively using training data from strategic partners like the New England Journal of Medicine – no internet forums or Reddit threads in sight.
  • The kicker? It’s available at no cost to verified physicians and generates its revenue through advertising. 

Happy users are their own growth strategy, and OpenEvidence claims that 25% of doctors in the U.S. have already used the product since its launch in 2023. It’s also adding 40k new doctors each month through word-of-mouth referrals and glowing reviews of its ability to:

  • Handle complex case-based prompts
  • Address clinical cases holistically
  • Provide really good references

The 1,000 pound gorilla in this space is Wolters Kluwer and its UpToDate clinical evidence engine. 

  • Although Wolters Kluwer has been inking partnerships with companies like Corti and Abridge to bring new AI capabilities to UpToDate, OpenEvidence is built from the ground up as an AI-first solution.
  • If WoltersKluwer is an encyclopedia, OpenEvidence is ChatGPT, and it’ll be interesting to watch the plays that both sides make as they battle for market share.

The Takeaway

OpenEvidence isn’t a solution in search of a problem, it’s a sleek new tool addressing an immediate need for plenty of providers. It’s rare to see the type of viral adoption that OpenEvidence managed to generate, which is a good reminder that many areas of healthcare change slowly… then all at once.

AI Enthusiasm Heats Up With Doctors

The unstoppable march of AI only seems to be gaining momentum, with an American Medical Association survey noting greater enthusiasm – and less apprehension – among physicians. 

The AMA’s Augmented Intelligence Research survey of 1,183 physicians found that those whose enthusiasm outweighs their concerns with health AI rose to 35% in 2024, up from 30% in 2023. 

  • The lion’s share of doctors recognize AI’s benefits, with 68% reporting at least some advantage in patient care (up from 63% in 2023).
  • In both years, about 40% of doctors were equally excited and concerned about health AI, with almost no change between surveys.

The positive sentiment could be stemming from more physicians using the tech in practice. AI use cases nearly doubled from 38% in 2023 to 66% in 2024.

  • The most common uses now include medical research, clinical documentation, and drafting care plans or discharge summaries.

The dramatic drop in non-users (62% to 33%) over the course of a year is impressive for any new health tech, but doctors in the latest survey called out several needs that have to be addressed for adoption to continue.

  • 88% wanted a designated feedback channel
  • 87% wanted data privacy assurances
  • 84% wanted EHR integration

While physicians are still concerned about the potential of AI to harm data privacy or offer incorrect recommendations (and liability risks), they’re also optimistic about its ability to put a dent in burnout.

  • The biggest area of opportunity for AI according to 57% of physicians was “addressing administrative burden through automation,” reclaiming the top spot it reached in 2023.
  • That said, nearly half of physicians (47%) ranked increased AI oversight as the number one regulatory action needed to increase trust in AI enough to drive further adoption.

The Takeaway

It’s encouraging to see the shifting sentiment around health AI, especially as more doctors embrace its potential to cut down on burnout. Although the survey pinpoints better oversight as the key to maximizing trust, AI innovation is moving so quickly that it wouldn’t be surprising if not-too-distant breakthroughs were magical enough to inspire more confidence on their own.

Abridge Lands $250M and Debuts Contextual Reasoning Engine

One of the top stories to come out of last week’s ViVE conference was Abridge closing $250M in Series D funding, yet that somehow wasn’t even the biggest news in the announcement.

On top of raising a nine-figure round at a $2.5B valuation, Abridge hit the 100 health system milestone after adding to a string of recent deployments at organizations like Mayo Clinic and Johns Hopkins.

  • Newly announced systems included Akron Children’s, Endeavor Health, Inova, Memorial Sloan Kettering Cancer Center, and Oak Street Health.

The real headliner was the debut of Abridge’s new Contextual Reasoning Engine, “an AI architecture that produces more clinically useful and billable notes at the point of care.”

The Contextual Reasoning Engine bolsters Abridge’s generative AI platform for clinical conversations with:

  • Contextual awareness – integrates data from retrospective patient encounters, health system-specific revenue cycle guidelines, and clinician documentation preferences to create more comprehensive notes. 
  • Problem detection – recognizes and groups medical problems, describing them with language that aligns with appropriate billing codes.
  • Actionable outputs – captures medical orders and integrates them into the EHR for clinician review.

Ambient scribing has been one of the hottest segments in digital health, helping clinicians spend more face-time with patients and less pajama time on administrative tasks.

  • That’s led to rapid adoption from providers, but it’s also caused plenty of vendors with core competencies outside of scribing to bolt the functionality onto their feature sets.
  • As a result, ambient AI startups are moving beyond clinical documentation to differentiate themselves with new use cases like coding or clinical decision support – and Abridge’s Contextual Reasoning Engine is only just the beginning.

The Takeaway

The ambient AI market is at an inflection point, and companies like Abridge are quickly raising capital and pouring it straight into R&D to own the workflows downstream from documentation. It’s a race to outrun commoditization and reach distribution before incumbents can catch up, and Abridge now has another $250M to help pick up the pace.

ViVE 2025 Recap and Major Announcements

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

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.

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