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Pessimistic Execs, AI Payment Models, and Klinic’s Payday
By Jack Troy
July 30, 2026
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Together with
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“If you’re a TPA or a regional health plan, this is worth staring at directly. The fastest growing segment of the employer market is being built without you at the table.
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MacroHealth executive Kevin Thoresen on the rise of alternative health plans
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Predictions are a funny thing. Like, it’s funny how wrong they can be. Let’s hope we’re all doubled over in laughter looking back at some of the more dour predictions in Venrock’s latest survey of healthcare leaders. I promise there’s some palate cleansers in the Wire.
-Jack
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Venrock’s 10th annual survey of healthcare insiders reveals they’re a pessimistic bunch lately, harboring cynicism about recent policy developments and the future of health tech IPOs, though views on AI were more of a mixed bag. Let’s break down the results.
But first, a bit about the survey. More than 200 leaders from all corners of healthcare shared their thoughts with Venrock. Some areas were better represented than others.
- Respondents skewed toward the private sector (28%), investing (20%), life sciences or pharma (16%), professional services (8%), and academia (7%).
Venrock loaded up the questionnaire with AI inquiries. Big picture: Insiders are becoming more comfortable with the tech, but remain mindful of its downsides.
- Trust in AI grew for 73% and fell for 2% (unclear who hurt them).
- Just 9% view AI as the most overrated trend in healthcare.
- HIPAA breaches (24%), harmful hallucinations (19%), and overspending on healthcare-specific platforms (28%) ranked highest among possible AI pitfalls.
- Most expect AI to create an costly arms race between payers and providers (63%) as each side rolls out bots specifically designed to argue with other bots.
Here’s another fun one: M&A targets. There’s no consensus on who will get snapped up next, but the industry seems confident it will be a big name in AI-powered services.
- OpenEvidence (21%), Komodo Health (18%), Abridge (14%), and Sword Health (11%) were the top answers out of 10 companies, but only after none of the above (46%).
So the hottest firms are going public? Nope — that’s one thing people can agree on.
- Only 3% think health tech IPOs will be back in style this year, with the rest split roughly down the middle between 2027 and 2028 or beyond.
- For those keeping score, 42% of last year’s respondents predicted a health tech firm would go public in the first half of 2026. Tumbleweeds…
In fairness, it’s hard to predict the future, especially with $1.15T in Medicaid cuts looming over everyone’s heads.
- Will they harm rural hospitals? Empty state coffers? Ruin MCOs? Strain blue-state safety net hospitals? Most checked all of the above (65%).
The Takeaway
Some of the smartest folks in healthcare think we’re heading toward a world of payer-provider bot wars, sluggish health tech IPOs, and brutal fallout from Medicaid cuts. Here’s to hoping Venrock’s survey missed the mark.
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- Hims in Hot Water: The FTC is suing Hims & Hers over claims the telehealth giant shared patient data with Meta, Snap, and other advertisers, despite promising privacy. The complaint, filed in federal court in California, also alleges deceptive billing practices, including charging users for prescriptions before they talked to a doctor and hiding the cancellation button for its subscriptions. Hims criticized the lawsuit as “baseless” and “an effort to generate headlines.”
- How to Pay for AI? A new Peterson Health Technology Institute report calls for clinical AI reimbursement models that are deflationary, outcome-based, and favorable to early adopters. The recently launched CMS ACCESS Model pretty much checks these boxes, but it’s limited to care for Medicare beneficiaries with certain chronic conditions. Standard payment structures are mismatched to clinical AI, the report argues. Fee-for-service risks AI overuse, while fee-for-performance and capitation don’t do enough to incentivize rapid adoption of this technology.
- Klinic Kashes In: Klinic secured $24M in Series A funding to expand its provider enablement platform. The startup aims to level the playing field for independent specialists, who may lack the administrative wherewithal to compete with large health systems, by providing tools for patient acquisition, care coordination, revenue tracking, and more. To borrow the company’s words, it’s like Shopify for healthcare. Founded in 2021 with a focus on behavioral health, Klinic has expanded to 12 specialties.
- Headspace Extends Specialty Care: Headspace now provides specialty care referrals for eating disorders, neurodiversity, substance abuse, and other complex needs. Patients coming through DTC or employer-sponsored channels are directed toward one of four clinical partners: Charlie Health, Cortica, Prosper Health, or Equip. Explaining the move, Headspace says nearly a third of referral requests in the past year have been for complex speciality care. How far the humble mediation app has come.
- AI Savings Potential: A new NEJM Catalyst paper estimates all-in AI adoption would cut annual U.S. healthcare spending up to $811B in as little as five years. Private payers have the most to gain, with a maximum savings of $357B, followed by hospitals ($220B), public payers ($107B), and physician groups ($90B). Across all corners of healthcare, labor productivity and administrative automation hold the largest savings potential.
- Assured Banks $19M: Provider credentialing and payer enrollment platform Assured is expanding to privileging after scoring a $19M Series A. Founded in 2024 by the duo behind Dawn Health, Assured draws from over 2,000 primary sources to prepare applications. It claims to have a 95% first-pass approval rate, good enough for more than 100 providers, health plans, and digital health firms to use its AI agents. Once a doctor is credentialed, Assured monitors for issues that could pull them out of network.
- Included + Firefly: Included Health is acquiring clinically integrated insurer Firefly Health in a clear double-down on its recent foray into alternative health plans. The move is a minor one, as Firefly serves just over 20,000 people, but it shows Included is serious about scaling health plans that empower PCPs and slash employer costs. Alternative plan designs are really catching on in the U.S., with a 2025 WTW survey finding 41% of employers are at least considering adoption.
- Specialist Consults for All: Telehealth provider Beam Healthcare and clinician collaboration platform Simvuly are offering free specialist consults to all U.S. medical professionals — no enterprise deal required. After submitting a question online, clinicians can generally expect a specialist to call or message them within the day. The offer targets independent practices and community hospitals, which often lack deep specialist networks, and comes after test runs at over 20 facilities.
- TJM Labs Raises Profile: After a quiet first two years of business, pharmacy AI firm TJM Labs made some noise by disclosing $100M in funding, including a $75M Series B. The company’s AI agents handle prescription intake, refill processing, and other repetitive tasks for 450+ pharmacies. If the nine-figure war chest wasn’t big enough news, TJM acquired data entry automator EncoreRx and voice AI startup Pharmesol.
- Claude the Cardiologist: A new Anthropic report shows 1.2% of professional Claude usage in the U.S. is cardiology related, more than any other part of healthcare. Chiropractic inquiries ranked a distant second at 0.4%. AI may be transforming medicine, but clinicians and technicians aren’t such Claude junkies in relative terms, making up just 4.3% of the country’s work-related usage. That’s good for eighth place.
- Dexcom Ups the TEMPO: Dexcom just became the first member of the FDA’s TEMPO pilot, allowing its AI-based glucose monitoring program to skip some premarket requirements. The program combines data from Dexcom’s glucose biosensors with information on nutrition, exercise, sleep, and stress to help patients monitor their metabolic status. It’s also meant to aid screening for prediabetes and Type 2 diabetes. TEMPO applications are still open, and the FDA plans to select up to 40 companies.
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- How Clinicians Are Using AI to Find Relief: Clinicians are facing a documentation burden that’s outpaced every attempt to contain it, and they’re adopting AI to tackle the crisis faster than health systems can keep pace. Download Heidi’s new report to see how over 1,800 clinicians around the world are already using AI to find relief, and what that means for the institutions still catching up.
- State of Payer Enrollment and Credentialing: Over half of provider orgs are losing revenue due to credentialing delays – with many missing out on over $1M annually. Medallion’s new report unpacks the forces quietly undermining operational and financial performance, and how leaders across the industry are addressing them. Check out the full report to get insights tailored to your role and org type.
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