Health Tech Nerds Kevin O’Leary and Martin Cech go live weekly on Mondays, usually at 12p ET / 9a PT to discuss healthcare technology, policy, and financing with guests from across the industry.
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A very good morning and happy Monday to Health Tech Nerds everywhere.
Can you believe it’s only been one week since the MA final rate notice was published? Since then, we’ve seen some interesting investments across alternative plan designs, insurance brokerages, and maternal and infant health, plus some new proposed rules from CMS and comment-worthy pieces from Brendan Keeler on MEDVi and Brian Dolan from Exits & Outcomes.
Today’s Guests
1:00pm-1:15pm ET: Gabe Drapos, COO of Pearl Health
1:35pm-1:50pm ET: Conor Green, Partner at Truehelm
2:00pm-2:15pm ET: Will Gordon, Senior Advisor at Manatt Health
2:30pm-2:45pm ET: Andrea Ippolito, CEO & Founder of SimpliFed
Puts & Takes
“If we want things to stay as they are,
things will have to change.”
I first heard this memorable line during the Great Financial Crisis. As it turns out, it was written in the aftermath of a different sort of crisis in post-World War Two Italy, but spoken by a character during an even earlier time of incredible disruption: the Unification of Italy in the mid-19th century.
Reading Kevin’s Weekly Health Tech Reads this weekend, it struck me how apropos the sentiment is today for those of us in the health care industry: for Medicare Advantage plans that are hearing strong rhetoric from CMS warning about future rate increases in excess of GDP growth and risk adjustment gamesmanship; for MA beneficiaries losing access to their subsidized Life Time memberships; and for state Medicaid agency directors and budget writers navigating incredibly tough choices as they stretch a dwindling number of dollars across a larger or sicker pool of patients.
I wasn’t a good enough Italian student to connect the thread to the Risorgimento, but during the Great Financial Crisis, Eurozone politicians deployed the quote to underscore the need for implementing structural economic reforms to pension programs and the austerity measures required to get emergency financing.
This rhymes with many of the issues we’re debating today in health care. Take, for example, the solvency of the Medicare trust fund. The board of trustees, in their 2025 report, notes the magnitude of the changes needed to keep Medicare the same: “The standard 2.90-percent payroll tax could be immediately increased by the amount of the actuarial deficit to 3.32 percent, or expenditures could be reduced immediately by 9 percent.”
Of course, these options are merely illustrative, and CMMI is hard at work trying to figure out alternatives to some combination of raising taxes and lowering benefits with programs like ACO LEAD and ACCESS. I’m dispositionally an optimist about American health care. But I think it’s worth a nod to Lampedusa’s memorable framing as we discuss and debate what we want to stay as it is, and what we’re willing to change.
Deals
Yuzu Health, infrastructure for alternative plan design, announces a $35 million Series A led by “General Catalyst and Chemistry with participation from Anthropic’s Anthology Fund, Bain Future Back Ventures, Timeless Ventures, Lachy Groom, and Neo.
Insight Health, a voice-first clinical AI agent company, announced an $11m Series A “led by Standard Capital, with participation from Pear VC, Kindred Ventures, Eudemian, ElevenLabs, and 43.”
Chapter, a Medicare brokerage/navigation platform, raised $100 million at a $3 billion valuation. The company reports it tripled revenue in 2025, hitting $100 million in ARR while also noting it kept headcount flat.
Other Headlines
CMS released the IPPS and LTC proposed rule factsheet here, with a proposed 2.4% increase, which “reflects a projected FY 2027 hospital market basket percentage increase of 3.2%, reduced by a 0.8 percentage point productivity adjustment.” In the proposed rule, CMS also floats expanding Comprehensive Care for Joint Replacement (CJR) as a mandatory, nationwide model.
CMS also released the proposed 2026 CMS Interoperability Standards and Prior Authorization for Drugs Proposed Rule, fact sheet here, which, among other provisions, includes prior authorization for drugs.
Talkspace merger docs, which include the merger background/fairness opinions sections, include some interesting nuggets like an unnamed "Party I" which had formed a consortium with two financial backers that own Party I to do a reverse merger of Party I into Talkspace, with an implied enterprise value of $517 million for Talkspace and $285 million for Party I.
The Trump administration acknowledges an error in the New York State Medicaid Fraud probe, first noted by the Fiscal Policy Institute.
Modern Healthcare reminded us that Nebraska is implementing the OBBBA community engagement requirements on May 1st, 2025. KFF had a nice overview of Nebraska Medicaid and how it varies in implementation from OBBBA via a state plan amendment
More from Health Tech Nerds
Weekly Health Tech Reads
April 13th, 2026: A musing on 2027 Final Notice, a payor / provider spat between Jefferson and Aetna, Teladoc's valuation issues, BCBS MN's financial issues, and more. Read here.