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Clinical AI, DiMe Seals, and Medicare Apps
March 2, 2026
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Together with
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“We’re at the ‘inflection point’ inflection point. That’s a joke, but everyone seemed to agree that the U.S. healthcare system is seriously messed up and big changes are imminent (and those big changes will favor their specific Series A startup’s strategy).”
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Insight Links CEO Jake Fishman on the buzz at ViVE.
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PHTI’s new Clinical AI report delivered exactly what we’ve come to expect from their research: top tier industry analysis through the lens of actual stakeholders.
They assembled the A Team for this one. The report was built from an in-person workshop that PHTI convened with senior industry leaders – from health systems and health plans to tech firms and federal agencies – to explore what’s needed to safely scale clinical AI.
- The workshop underscored the policy, reimbursement, and evidence gaps holding back adoption, with several key themes emerging from the discussion around their example use cases (hypertension management and mental health chatbots).
Theme 1: Evidence standards should compare AI to current standards of care and scale with risk.
- That means comparing AI to the care that patients actually receive today rather than idealized care, then having different standards that align with the clinical risk of using the tool.
- Highlight: Evidence should assess whether the full workflow (including multiple models, devices, and human oversight) improves outcomes, not merely model performance.
Theme 2: Performance benchmarks should be based on clinical outcomes, and safety standards should adapt as the evidence grows.
- Ambiguity around what constitutes “good” performance is a persistent barrier. Metrics need to be anchored to specific clinical outcomes instead of vague process measures.
- Highlight: Across both use cases, participants emphasized the need not only to set benchmarks but to set minimum safety floors, which could adjust dynamically over time on the basis of observed outcomes, changing patient risk profiles, & emerging evidence.
Theme 3: New technologies may be initially tested in lower-risk populations, but should scale quickly to high-risk populations to maximize impact.
- Low-risk patients are tempting on-ramps, but AI’s greatest benefits come from reaching the high-need patients, and reaching them carries higher evidence expectations and more clinical risk.
- Highlight: For mental health, engagement and retention are huge barriers to treatment. Participants cautioned that overly restrictive AI deployments risk limiting access and instead emphasized the need for appropriate care routing following LLM engagement.
The Takeaway
Even the most effective clinical AI tools still have plenty of questions to address before adoption can scale, and PHTI just crowdsourced some promising answers straight from the boots-on-the-ground in the healthcare trenches.
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State of Payor Enrollment and Credentialing
AI is changing the way that healthcare leaders tackle provider network management. Medallion’s latest report breaks down the biggest challenges, emerging trends, and how automation is transforming the landscape. Get the insights you need – read the full report today.
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Episode-Based Care: Making TEAM Work
The TEAM model represents one of the largest mandatory reforms in Medicare history, and forward-thinking perioperative leaders are leaning into it. Watch the on-demand recap of C8 Health’s recent fireside chat to explore how episode-based care is reshaping quality improvement – and why the orgs succeeding under TEAM are treating it as a catalyst for transformation, not just a regulatory checkbox.
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- DiMe Seal for Medicare Apps: CMS designated the DiMe Seal as a required on-ramp for digital health applications in the Medicare App Library, an upcoming federal marketplace of patient-facing apps that integrate directly with CMS Aligned Networks. The library is designed to be the backbone of the Medicare App, which CMS will (allegedly) have up-and-running by the Fourth of July. Solutions that want to be listed and put in front of 86M+ Medicare beneficiaries will now have to go through DiMe to get there, meaning they’ll have to complete a defined benchmark across evidence, privacy and security, and usability.
- Fabric Debuts Evo: 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 Medication Management, and Weight Loss. Evo is the “successor” to the MeMD platform that Fabric grabbed from Walmart’s telehealth garage sale back in 2024, and it takes an asynchronous-first approach to streamline care. Employees can receive personalized treatment plans in as little as 15 minutes through Evo’s Quick Care guided intake, and 90% of members opt to go that route over other options with longer wait times.
- Honest Raises $140M: Honest Health raised $140M of growth capital to fuel its health system-focused approach to value-based care. The approach boils down to helping health systems succeed in taking risk through “technology-enabled care coordination, quality improvement, and actionable insights.” That’s apparently worth at least nine figures, but those were literally the only details included in the announcement and the website didn’t quite color in the picture much either.
- Agentic AI for Radiology Follow-Up: Patients are notoriously bad at getting follow-up imaging, so a study in NEJM Catalyst explored whether agentic AI can help. Parkland clinicians developed an AI agent that extracts insights from clinical impressions and integrates them into patient outreach workflows. In tests on 10k radiologist notes, the agent had significantly higher sensitivity than Parkland’s previous macro-based follow-up system (99% vs. 16%), better overall accuracy (99% vs. 58%), and scored high marks for identifying follow-up timing, recommended procedure, and underlying abnormality (94%). As always with radiology research, The Imaging Wire has the best breakdown in town.
- athenahealth Agentic Communications: athenahealth launched new agentic patient communication tools across its provider network, which currently serves more than 1 in 5 Americans. The expanded suite gives 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. That’s all naturally embedded into existing athenaOne workflows and supports both text and voice functionality, as well as a two-way texting feature that’s currently in alpha ahead of a wider roll out during the first half of the year.
- Veradigm’s Off the Hook: The SEC concluded its investigation into Veradigm with no enforcement action taken. The company formerly known as Allscripts hit choppy waters due to reporting irregularities that caused heads to roll in the boardroom, but it laid the groundwork for a turnaround – or strategic merger – with the acquisitions of ScienceIO (GenAI capabilities) and Koha Health (RCM expertise). Turns out that even the SEC knows everyone makes mistakes, and they can be surprisingly understanding when you forget to file quarterly reports for a couple years.
- Hyro + WebMD: Hyro is equipping its AI agents with clinically validated content and decision logic courtesy of WebMD Ignite. The partnership moves conversational AI flows beyond simple Q&As that often leave patients with more information but no clear next step, providing guided actions like specialty routing and appointment scheduling. It sounds like initial deployments will focus on guided symptom-assessment and care-navigation journeys before expanding into other use cases.
- Medicare Depends on Telehealth: New research in Annals of Internal Medicine shows that 1 in 6 Medicare beneficiaries depend on telehealth for key medical care. Between 2021 and 2023, nearly half of all mental health visits were conducted virtually, but beneficiaries still leaned on telehealth to manage other common conditions to the tune of 29M visits per year. The non-mental health conditions most commonly treated virtually were diabetes (2M visits during the study period), hypertension (1.5M visits), and sleep-wake disorders (1.5M visits).
- Teladoc Posts Mixed Results: Teladoc’s Q4 financials wrapped up the fiscal year on what we’ll call a mixed note. Fourth quarter revenue came in at $642M, with its Integrated Care segment growing 4.7% YoY on the back of higher visit volume. Despite the decent performance, Teladoc expects Integrated Care membership to fall as much as 5% due to the lapse of ACA subsidies. The acquisitions of Catapult and TeleCare contributed to double digit growth internationally, but BetterHelp continued to be the pebble stuck in Teladoc’s boot after seeing revenue slide 9% as it transitions from DTC to health plans.
- Luma Operational AI Updates: Luma Health shared updates on its Operational AI platform that executes complex healthcare workflows from start to finish rather than optimizing isolated tasks. Operational AI coordinates agents and workflows across patient access, engagement, intake, and RCM, with the Spark AI core ensuring a shared context across the EHR and downstream systems. Over 50 health systems used Luma-powered AI workflows to regain two million hours for their employees in 2025.
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VBC 202: Intro to VBC and Risk Adjustment
Navina and Out-of-Pocket teamed up to create VBC 202, a three-part online course for anyone looking to build or scale value-based care programs. Watch the first session on-demand to learn why VBC emerged, how policy shapes provider behavior, and the fundamentals of risk, quality, and financial performance. Gary Pilling II joins as the guest instructor to dive into risk adjustment basics, including RAF scoring, HCC coding, and the CMS-HCC V28 model.
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Abridge Named #1 Best in KLAS – Again
KLAS just named Abridge #1 Best in KLAS for Ambient AI for the second year in a row. The recognition was based on direct customer feedback from the nation’s largest and most complex health systems, which gave Abridge the highest overall satisfaction score and A+ ratings across Culture, Loyalty, Relationship, and Value. Discover why Abridge is the market-leading AI platform for clinical conversations.
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Best Practices for Obesity Care in the GLP-1 Era
Healthcare leaders need scalable, evidence-based approaches as obesity care evolves in the GLP-1 era. Withings rounded up its practical best practices from real-time biomarker tracking to value-based data strategies that help care teams improve adherence, tailor interventions, and deliver accountable, high-impact care. Get the best practices here.
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