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The Case for Telehealth, Arbiter Launch, and Healthcare’s C Grade
December 1, 2025
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Together with
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“Patients don’t judge their care by a single visit – they judge it by dozens of small moments. Did the system recognize them at check-in? Were they asked to fill out the same form twice? The organizations that succeed in the future will be the ones that deliver seamless micro moments.”
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Verato CEO Clay Ritchey
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The American Telemedicine Association just teamed up with nine major U.S. health systems to deliver one of the most comprehensive looks at Medicare telehealth utilization to date, and the numbers look good for virtual care.
The analysis of 1.67M Medicare beneficiaries from 2019 to 2023 found that telehealth is primarily a substitute for in-person care, replacing office visits rather than adding new ones.
- Despite the pandemic fueling a 31x increase in telehealth use at the health systems, Medicare patients averaged just 0.25 additional visits per year.
- The real-world operational data shows that 74% of those telehealth visits were a substitute for in-person care.
- Not too surprising, except that the CBO has that substitution rate pegged at 30%.
Real-world evidence beats theoretical models. The findings offer a window into how telehealth is embedded in everyday care – with real workflows and patients – suggesting that actual substitution patterns might be a ways away from current budget modeling assumptions.
- The analysis spanned academic medical centers, integrated pay-viders, and rural hospitals – all showing that telehealth was a substitute during both the pandemic and “steady-state operations” in 2023.
- Each of the systems also saw costs remain stable or decrease with telehealth adoption, with one of the rural systems avoiding 2,551 patient transfers and saving $8.1M from sidestepping referrals and transportation costs
- That not only suggests that virtual care is still beneficial post-pandemic, but it might also have lower federal costs than currently forecasted.
The clock is ticking. Medicare telehealth reimbursement flexibilities are set to expire January 30th, and the ATA hopes that these results will inform policy discussions ahead of the deadline.
- “This data represents the current state under a patchwork policy environment. We’re just scratching the surface of what health systems could achieve with predictable legislative frameworks that let us build infrastructure to serve patients regardless of who’s paying the bills.”
The Takeaway
Most qualitative evidence already told us that telehealth is convenient for patients and clearly a substitute for in-person care. The ATA just provided the quantitative data to back that up.
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Nabla’s Marketing Team is Hiring!
If you’re based in NYC and passionate about improving the practice of medicine, Nabla is looking for a Marketing Operations Associate to help it do just that. Nabla’s ambient AI assistant streamlines the workflows that get in the way of the human connection at the heart of healthcare. They’re on the hunt for a new operational backbone for their marketing team, so apply here if that sounds like you.
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Enrollment Timelines, State by State
Provider enrollment delays are shaping access to care, revenue timelines, and even workforce strategy. Ever wonder how they’re impacting organizations near you? Check out Medallion’s 2025 Geography of Payor Enrollments to see state-by-state enrollment times, how delays are compounding workforce shortages, and why you should factor this into your 2026 planning.
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- Arbiter Emerges From Stealth: Former Eli Lilly exec Michelle Carnahan is launching her own AI startup without VC funding, which is probably the move when you can raise $52M from family offices. Arbiter emerged from stealth with the hefty seed round earmarked for building out its platform that connects patient data to automate admin tasks for payors and providers. Acquiring a data platform from SecondWave Delivery Systems apparently accelerated Arbiter’s path to market by 18 months, and its AI agents for scheduling and follow-ups are already live with several health plans.
- More Good News for RPM: A study in Mayo Clinic Proceedings added to the barrage of new evidence supporting RPM in the wake of United Healthcare axing coverage for most conditions. The analysis compared 5,872 patients enrolled in Cadence’s RPM program with 11,449 matched controls across several major health systems from July 2022 to October 2023. The RPM group not only saw a significant reduction in total cost of care ($1,302 per patient per year), but also had far fewer hospitalizations over the study period (-23 admissions per 1k patients vs. +41 per 1k patients in the control).
- Trilliant Transparency: Trilliant Health released a dataset of machine-readable hospital price transparency files with over 5B negotiated rates from 5,000+ hospitals across the country. The press release cited the cottage industry that popped up to provide access to this “data that’s supposed to be public” as a prime example of waste in the healthcare system, so Trilliant decided to take matters into its own hands by consolidating the info into a single accessible location. Better yet, it also rolled out the Oria chatbot for anyone looking to explore the data.
- TeleTracking Decision IQ: TeleTracking introduced Decision IQ to help health systems predict capacity needs and ensure smooth patient throughput. The AI-driven solution unifies system-wide data via a digital twin to create a comprehensive view of patient movement, then anticipates staffing constraints, ED boarding, and delayed discharges to prevent any bottlenecks. University of Louisville Health reportedly opted to expand its partnership with TeleTracking beyond transfer operations after seeing Decision IQ’s ability to reduce manual coordination for its care teams.
- WellBeam Series A: WellBeam landed $10M of Series A funding to bridge the data gap between acute and post-acute care. The WellBeam platform connects fragmented EHRs to streamline clinical workflows and ensure smooth transitions of care, which has reportedly helped its partners achieve a “triple bottom line” return: a 25% reduction in unplanned post-acute care, 75% decrease in manual clinical workflows, and new top-line revenue growth. The fresh funds will help accelerate expansion across new health systems and physician groups.
- Seniors Are Up for a Drive: A new study in JAMA Network Open shows that seniors won’t let a little road trip stop them from getting care from a clinician they like. The survey of 4.5k seniors found that the average acceptable travel time to visit a primary care provider was 53 minutes, although mileage varied by geography. Those in rural areas were willing to drive over an hour to see their PCP (61 min), while those living in urban areas were a bit less flexible (48 min).
- InteliSense Launch: InteliChart announced the launch of its InteliSense platform to bring AI automation “to every part of the patient journey.” Built directly into the Healthy Outcomes patient engagement platform, InteliSense includes a suite of specialized agents designed to address a wide range of use cases: (1) Administrative Agents streamline workflows like scheduling, intake, and eligibility, (2) Clinical Agents assist care teams with patient management, population health, and follow-ups, and (3) HealthMate gives patients tailored guidance based on their aggregated health data.
- Best Buy Scales Back Health: Best Buy had a choppy third quarter, notching a $192M impairment charge after ending its hospital-at-home partnerships with health systems. The retailer entered the space by acquiring remote patient monitoring vendor Current Health for $400M back in 2021, but decided to pull back its healthcare ambitions due to “pressures in the Medicaid and Medicare Advantage markets.” Current Health co-founder Chris McGhee took back the reins in June to hone the company’s focus “on high-acuity services where reimbursement models are crystal clear.”
- Healthcare Gets C Grade: Gallup’s latest State of the States report slapped the U.S. healthcare system with a “C” grade based on survey responses from nearly 20k adults. Nationwide, 47% of respondents said they’re concerned they won’t be able to afford necessary care in the next year, and 1 in 5 said they or someone in their household couldn’t afford a prescription in the past three months. Overall, the healthcare system received a “D+” for cost, a “C+” for quality, and a “C+” for access – plenty of room for improvement.
- Aetna GenAI Search: Aetna debuted a new GenAI conversational experience that allows users to ask natural language questions about their care options and coverage. The “ask me anything” search will be embedded throughout Aetna’s website and mobile app, with session awareness to help members navigate “any point of their health journey.” Updates slated for early 2026 will bring proactive insights to the tool, such as suggesting in-network physical therapists if a member asks about their coverage.
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Using AI to Democratize Performance Data
You’re tracking clinical performance metrics – HACs, LoS, FCOTS, and more – but does tracking translate to better patient care? Tune in to C8 Health’s expert roundtable on December 10th to learn how leading institutions leverage AI to bring quality data to the bedside. Plus: See how this approach saved UTMB Health over $109k in three months. Grab your spot here.
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Measuring Real ROI From Ambient AI
In a groundbreaking report, Abridge shares a new methodology for measuring the ROI impact of ambient AI at a more granular level than ever before. Abridge partners are now getting a precise look at changes in wRVUs, HCC capture, time spent in notes, and much more. Four health systems also share their results across many of these metrics. To learn more about the technology behind this breakthrough and to see some of the data, download the report here.
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- Discover Sleep Rx, the Clinically Validated Sleep Tracking Mat: Sleep Rx offers a contactless, at-home solution to aid in the diagnosis of sleep apnea, addressing a critical issue that affects millions. Available by prescription, this innovative sleep tracking mat is set to transform remote patient monitoring by providing detailed sleep analysis without the need for cumbersome equipment. Learn how Sleep Rx enhances diagnosis rates and ultimately improves long-term outcomes.
- Under the Hood of Navina’s AI: Navina’s AI engine harnesses over 600 proprietary algorithms to transform fragmented patient data into actionable clinical intelligence at the point of care. It’s shaped with the expertise of physicians to turn multiple data sources (EHR, HIE, claims, care gap files, etc.) into contextualized insights like suspected conditions or evidence for care gap closures – each linked back to the original source. Download the whitepaper to see examples of Navina’s AI in action.
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