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Hospital Surge, Boosting Risk Scores, and Crystal Ball Compilations
January 6, 2025
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Together with
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“True personalization will come from a people-centered approach… We’re losing sight of how powerful it can be to simply ask patients, ‘How are you doing?’”
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Included Health President Robin Glass
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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.
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Payer-Provider Collaboration Essentials
With the economy shifting and healthcare regulations evolving, Medallion’s Elevate session with execs from MultiPlan and Clover Health tackled the big question: How can payer-provider collaboration future-proof your processes? Head over to the full discussion to see their five actionable takeaways for successful partnerships.
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Join the Nabla Team!
Nabla is scaling up, and it’s looking for a Head of Marketing to lead its next phase of growth. This role will help broaden Nabla’s footprint and showcase the proven impact of ambient AI with a company dedicated to bringing joy back to the practice of medicine. Learn more and apply here.
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Curate, Create, & Share at the Point of Care
It’s hard to find a more unique vantage point on AI than Playback Health co-founder Dr. Langer, whose role as the Chair of Neurosurgery at Lenox Hill allows him to actually use the platform he helped create. Head over to Dr. Langer’s latest blog to see how Playback is helping him spend more time caring for patients and enabling providers to “Curate, Create, & Share” at the point of care.
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- Hospital Care Surges: U.S. spending on hospital care recently saw its largest spike in over three decades. A CMS analysis in Health Affairs showed that total U.S. health expenditures reached $4.9 trillion in 2023, spiking 7.5% year-over-year. Hospital spending alone totalling over $1.5T, the most of any category by a wide margin. Hospitals accounted for 31% of the total, versus just 20% for physician / clinical services, and 9% for retail prescription drugs.
- Oura Adds Another $125M: Hot on the heels of Oura’s $75M investment from Dexcom, the smart ring maker bolted on another $125M to its Series D funding round – catapulting its valuation to $5.2B. Over the past year, Oura’s been making a string of acquisitions to support its large user base along more parts of their health journey, picking up both Sparta Science (data analytics) and Veri (glucose monitoring and meal timing insights). Oura’s healthcare ambitions are very real, and it has a big war chest to make them happen.
- Nabla Dictation Debut: Nabla opened up early access to its upcoming Nabla Dictation solution, a standalone tool that lets clinicians speak naturally to dictate text across any platform. This video does a great job breaking down potential use cases, such as capturing a quick note, adding details after an encounter, drafting referral letters, or replying to patient messages. Anyone interested in trying it out before the general release can find it here.
- Boosting Risk Scores: A Wall Street Journal investigation revealed that doctors employed by UnitedHealth Group handed out some of the largest increases in sickness scores when patients moved from traditional Medicare to the payor’s health plans. Higher sickness scores / risk scores translate to bigger checks from the government, and the largest Medicare Advantage payor reportedly gives its physicians checklists of potential diagnoses to drive those higher. The doctors included in the article unsurprisingly weren’t too keen on the checklists.
- UC Health + Laudio: University of Cincinnati Health is rolling out Laudio’s workforce management platform to help frontline leaders spend less time on administrative tasks and more time on the human elements of good leadership. Laudio aggregates employee data to proactively surface indicators (ex. burnout risk) and AI-driven recommendations (ex. recognition notes), which leaders can take advantage of with built-in capabilities for things like milestone celebrations or team surveys.
- Charging for Patient Messages: It turns out that charging for patient messages decreases patient message volume. Mayo Clinic published data on the first 6 months after its e-visit billing implementation, and the number of patient-initiated medical advice messages decreased by 8.8% compared to the year prior (from 1.8M to 1.6M). Only messages that required a significant amount of physician time qualified as an e-visit (0.3%), but the overall message decline suggests that the billing disclaimer on the patient portal was a highly effective deterrent.
- Rethinking Clinical Training: A great article from Dr. Paulius Mui at XPC laid out how EHR simulations could help clinical training catch up with modern practice. Although EHRs were designed more like QuickBooks than textbooks, incorporating synthetic data to simulate patient care would let trainees practice managing years of disease progression in a matter of weeks. As seasoned physicians leave the industry and less experienced clinicians (APPs) take their place, this type of training seems like a solid way to bridge the experience gap.
- Verily Planning Major Changes: Alphabet’s Verily has some big plans for 2025: raise more capital, pivot to AI, and break up with Google. Unnamed employees told Business Insider that Verily recently separated from many of Google’s internal systems in an attempt to stand independently, and that this year’s focus is shifting the product portfolio to AI, data aggregation, and privacy solutions for healthcare providers and startups. Relaunching the Lightpath diabetes and hypertension management app still sounds like it’s on the roadmap.
- Vitalic Launch: Senior-focused mental health startup Vitalic launched with $4M in seed funding from “venture builder” Redesign Health and nonprofit payvidor VNS Health. Vitalic’s novel treatment model focuses on geriatric psychiatry supported by therapy, coaching, and medication management, which is designed to address the underlying issues that cause older adults with untreated mental health conditions to cost payors more than three times as much as those without.
- Heart Failure At Home: New analysis of Cleveland Clinic’s Hospital Care at Home program found that acute heart failure patients can be successfully treated at home. After comparing data from 194 at-home care HF patients and 201 hospital care HF patients, both groups had similar 30-day mortality rates, GDMT scores, and readmission rates. A majority of at-home patients (84%) completed treatment without needing care escalation.
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Top Systems Scale Primary Care With K Health
Leading health systems are turning to K Health’s AI-driven primary care solution to give their patients access to high-quality care with wait times measured in hours, not months. Find out why K Health is the only clinical AI company partnering with top systems to scale fully integrated primary care experiences.
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Bridging Care Gaps for Underserved Populations
Is your health system, rural health clinic, or federally qualified health center struggling to reach patients with obstacles to receiving in-person care? This Clear Arch Health whitepaper explores how combining RPM with VBC can help facilitate proactive interventions, address social determinants of health, and get the most out of new CMS reimbursement pathways.
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BPM Pro 2: Unparalleled Reliability
BPM Pro 2 increases data reliability with two new features that ensure patients are taking their reading properly and prompting them to rest and retake it if their first reading was abnormally high.
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