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A Reflection on the Week: HTN’s New Era
TL;DR: We’re welcoming Martin Cech and Caleigh Bachop to the HTN team alongside myself and Abbey as we enter a new era leaning in on creating insightful research content supporting a growing professional learning community in healthcare.
Happy Sunday! As many folks reading this gear up for HLTH the next few days, I thought it’d be a good moment in time to share a slightly different reflection this week — one on our journey at HTN and where we’re headed. And given Folklore is the album I listen to most when writing this newsletter, it feels appropriate to say we’re entering a new “era” of content + community at HTN.
I feel incredibly grateful that I get to spend my working hours learning about the healthcare industry, writing about those learnings, and supporting a community of fellow nerds thinking deeply about the space. I also feel quite lucky that Abbey Peterson joined HTN almost two years ago now leading the business side of the house for our small but mighty team, building on the work Ryan Russell started when we first formally launched HTN in 2021. It’s no small task keeping the lights on for a 32,000+ newsletter audience and 5,500+ active community members.
I like to think of my job as combining the intellectual curiosity of a research analyst with the go-to-market strategy of a creator / media company. I very much enjoy that work, and the fact that I can make a living while focusing on doing just that is quite cool.
It’s an interesting (and dare I say, exciting) time to be at the intersection of those disciplines. The ever-growing healthcare crisis in this country, the technological disruption of AI, and the changing policy environment all make this feel like a particularly uncertain point in time. When you couple that uncertainty with the fraught nature of public discourse today, it feels more important than ever to have a trusted place for thoughtful, nuanced analysis and discussion of complicated topics. I am proud of where HTN is today in supporting that type of dialogue, and the plan is to continue growing on that foundation.
To that end, Abbey and I are excited to grow the team and go deeper creating more insightful research content and community programming, all designed to help members stay one step ahead in learning about key themes and conversations in the industry.
Long-time HTN community member Martin Cech will be joining the crew as our Lead Policy Research Analyst, focused analyzing the strategic implications of key policy topics. I’d argue this is the most important — and probably also uncertain — discussion in healthcare today. You can see some of Martin’s musings over the last few weeks here:
So if you want to stay up on all things at the intersection of healthcare policy and business, you should follow along by subscribing to his newsletter here:
Over the coming months, you can expect to see more focus areas and content types from us — policy is a start, but we’re certainly tracking other key trends across AI, VBC, and the like that often you see discussed here. Stay tuned for more (and let us know if you’d like to help us on that!).
As we enter this new era for HTN focused on thoughtful research and analysis, you should expect this research to serve as a “totem pole” of sorts that guides the energy of the community moving forward. This interplay between content and community is at the core of the HTN model, which I dove a bit deeper to in this post on our website today.
As we continue to build out our community, we’re very excited to share that Caleigh Bachop has joined HTN in a full-time capacity as our Community & Platform Lead. Current members have likely already seen her in Slack this summer, and we’re thrilled she’s joining us in a full-time capacity to support the community. She’s already been instrumental in a number of great offerings for the community, including:
Topical deep dives on timely issues, like our Bridging the Gap summer series with Bonne Fire ATL, connecting public health and health tech leaders
Monthly in-person meetups of Health Tech Nerds in cities across the U.S. (and beyond!)
If you’re looking for a place to connect and learn with other like-minded folks in the industry, you should join the community:
Alright, enough about the merry band of nerds behind HTN for now, lets get into the news of the week. It was a busy one!
HEALTH SYSTEM PARTNERSHIPS
Hospital for Special Surgery and General Atlantic launch a national ASC platform, acquire Legent Health
Hospital for Special Surgery (HSS) has teamed up with General Atlantic to acquire Legent Health, an operator of orthopedic and spine ASCs, which will be used as the foundation of a national ASC platform that HSS and General Atlantic intend to build. The two parties are acquiring Legent from BTG Pactual Strategical Capital, which appears to have invested $165 million in Legent in 2023. Per its website, Legent currently operates eleven ASCs in Texas and one in Florida.
It appears that HSS and General Catalyst intend to drive national growth of the model via acquisitions and de novo facilities, although the press release was light on specifics.
✍ Going Deeper
This seems like a really intriguing combination of capabilities to me. Take a brand name like HSS in orthopedics and combine that with the financing capabilities of a firm like General Atlantic to enter a growing adjacent market that would otherwise likely tie up a lot of HSS capital.
While its not clear what the financing structure was here, in many ways it reminds me conceptually of the financing strategy Humana and WCAS used to grow CenterWell clinics over the past few years, with Humana leveraging WCAS to fund the build-out and initial losses and WCAS having a clear path to generating returns on the investment via a series of put and call options with Humana. I’d imagine the logic for both parties here is similar — HSS gets line of sight to a national ASC strategy, while General Atlantic has a natural exit path for its investment and I’d image line of sight into the IRR it expects to clear.
Seems like a very smart play for both parties.
HEALTH SYSTEM PARTNERSHIPS
Khosla Ventures and the Cleveland Clinic partner to innovate together
Cleveland Clinic Innovations (CCI), the innovation arm of the Cleveland Clinic, will be supporting an innovation partnership with Khosla. The non-exclusive partnership will involve Cleveland Clinic as an early commercial partner to Khosla’s startup portfolio. The two entities will seek to co-develop new ideas as well. The Forbes reporting notes that ten to twelve Khosla-backed startups are in discussions with the Cleveland Clinic. One, Vista AI, is rolling out AI for cardiac MRIs at Cleveland Clinic’s Akron hospital.
It was interesting to note how Cleveland Clinic’s Innovation leader compared this deal to General Catalyst’s acquisition of Ohio-based Summa Health in Forbes:
“I bet the more significant venture investors in healthcare are going to find different ways to get access to that clinical and research expertise,” Cleveland Clinic’s Friedland said. “It certainly costs a lot less money to partner with Cleveland Clinic than to buy a hospital, and it comes with less strings attached and less brain damage.”
✍ Going Deeper
Health system and VC partnerships seem like all the rage these days, and as I’ve shared in previous newsletters, I can certainly understand the appeal in an AI-centric world. Partnering with these large institutions to build and implement new tooling is going to be critical for success. I’d imagine every healthcare VC is thinking about how to secure its relationship with strategics, whether that be as LPs in a fund or relationships like this. I’d also imagine many health system leaders see an opportunity to infuse their organizations with new ways of thinking, while also potentially capturing some financial upside. Seems like a win-win, right?
While the general strategy makes sense, this particular partnership makes me scratch my head a bit. You have a venture firm involved whose namesake is best known in the clinical community for repeatedly predicting that 80% of providers will lose their jobs because of AI. So while I can understand why the innovation arm of a health system might be excited about the opportunity with Khosla, I’m less certain that the providers will be quite as excited. The news this week that Mass General Brigham is already dealing with provider backlash from implementing AI underscores the challenge — the commitment and cultural change required here is high.
I certainly agree with the statement above that this deal will have less strings attached and less brain damage than GC / Summa, but I also think it’s worth recognizing it has a significantly higher likelihood of being innovation theater as a result. We’ve seen other examples of this before where nothing appears to materialize from health system / VC partnerships.
So while the GC / Summa deal may be orders of magnitude harder to pull off — and the Axios headline this week about Marc Harrison’s removal as HATCo CEO certainly isn’t a good sign that things are going well — it actually seems more like the type of organizational redesign that would need to happen for this type of AI-centric VC / health system partnership to really flourish. That, or you have a clear business opportunity like the HSS / General Atlantic model above.
STARTUPS
Shutdowns at Patina and Vesta provide a reminder of the hard realities of venture-backed care
As I read about the eleven new startup funding announcements this week (see below) and the energy around those, I can’t help but also think about the news this week of the challenges that a number of well-capitalized startups from the last wave of venture-backed excitement also faced, just much more quietly:
Patina Health’s website indicates it has quietly wound down operations. Patina raised $57 million from a16z, Google Ventures, and others back in 2021 to build an asset-lite Medicare Advantage primary care model, focused on in-home and virtual care. Earlier this year it pivoted to launch a population health wrapper around primary care services, announcing it was launching that model in Charlotte with Aetna.
Vesta Healthcare’s website indicates that it has also shut down operations. Vesta reportedly raised $160 million since 2019, and it’s predecessor company Hometeam had raised a $27.5 million round in 2016 as well. Investors included Deerfield, Oak HC/FT, Kaiser Permanente Ventures, and others. Vesta was building a platform to help caregivers in the home. It took debt financing in the last funding round, which seems to be a common theme in these sorts of shutdowns.
Having been through startup wind-downs myself, I recognize what a challenging time these moments can be, particularly for the employees working at these organizations. Especially after big launches with so much fanfare and public celebration, these harder moments happen much more quietly as the parade marches on. It was a difficult learning lesson for me — I jokingly tell people I’m going to buy myself one of these pillows one day.
So while it’s natural to be excited about the next wave of venture-backed activity in the sector, these are also a reminder about the challenging realities of building businesses in care delivery and the underlying need to build profitably. Using venture capital to subsidize early losses obviously be an effective financing strategy for high growth businesses, but at the end of the day it’s still a financing mechanism (with a very strong PR machine).
Chart of the Week
Silicon Valley Bank released a helpful report this week, titled The Future of Health Tech 2025. It’s worth checking out all of the slides, but this one caught my attention on the state of mega rounds. Both the charts on the right of the slide were interesting — one in terms of how much the mega rounds have shifted towards provider ops (AI!) and wellness in 2025, and also in terms of how generalist investors impact valuations of the mega rounds.
Source: Silicon Valley Bank report
Going back to the point above about venture-backed care delivery models, it’s interesting to see how that number dropped from 51% of mega deals in 2021 to 9% 2025 in the chart in the upper right.
Quote of the Week
Dr Oz spoke to the Better Medicare Alliance about the state of Medicare Advantage on Wednesday this week. It’s full of interesting commentary with his remarks punctuated by this memorable quote about the potential of the program:
MA is still in its infancy. It’s walking, but can it run? Can it fly? Are there things MA can do that go beyond anything we would ever have imagined possible for people?
What I find particularly interesting about the quote is how Dr. Oz frames MA as a program that is still in its infancy. If you listen later in the session, another speaker gently disagrees with Dr. Oz’s suggestion that MA is in its infancy, calling MA a mature market while speaking to the slide below. It seems hard to argue that point — it’s a huge program today.
Source: Better Medicare Alliance 2025 Medicare Advantage Leadership and Policy Forum
Surely, Dr. Oz is well aware of all this sort of data as well. Given that, the fact that he chose to frame MA as a market in its infancy I think underscores the growth opportunity ahead for the industry in the coming years.
Other Top Headlines
Town Hall Ventures announced a new $440 million venture fund focused on investing in new technologies and AI that supports underserved populations. I had the chance to sit down with Town Hall’s General Partner Meera Mani on Friday to discuss the fund and the thesis around applying technology and AI to support underserved populations, you can watch that here. Town Hall’s first fund performed quite well as reported in this Forbes piece, with Signify Health and Landmark Health exits driving a 33% net IRR.
R1 acquired Phare in order to expand its agentic AI capabilities for inpatient coding and clinical documentation. Phare will join R1’s R37 AI lab, which R1 launched in partnership with Palantir earlier this year. General Catalyst led Phare’s seed round back in 2023, alongside KHP Ventures (now Meridian Health Ventures) and Bertelsmann Investment.
School-based telehealth provider Hazel Health announced it has acquired Little Otter, which comes after another quieter recent acquisition of BeMe Health. It appears from the company announcements that Littler Otter’s clinical model will be integrated into Hazel’s contracts with schools as a key part of the product offering.
Business Insider reports that Tia, a women’s health startup, laid off 23% of staff this week. Tia, which has raised $160 million to date, appears to have made the move in an effort to get to profitability faster as a business as part of its Series C fundraise process. Tia currently operates 11 clinics across Los Angeles, New York, San Franicsco, and Arizona.
Mayo Clinic is leaving UnitedHealthcare and Humana’s Medicare Advantage networks for Jan 1, 2026. Between this and UCare exiting the market, it is going to be interesting to keep an eye on how the Minnesota MA market shakes out for 2026.
Humana lost its Stars lawsuit for a second time, appearing to effectively ending its legal case to improve its Star ratings.
In interoperability market news, Redox and kno2 announced a strategic alliance.
Funding Announcements
Brook.ai, a remote monitoring platform, raised $28 million.
Counsel Health, an AI doctor, raised $25 million.
Sage Care, an AI “air traffic control” for provider orgs, raised $20 million. The funding is across two rounds, with the more recent round $12 million at a $90 million valuation per the Forbes article. Forbes also noted that it expects “a small amount” of revenue this year, and is targeting $5 million in 2026 as it rolls out at a variety of providers. It’s currently deployed at three — a multi-specialty clinic in CA, a health system in MI, and a hospital in NY. Sage notes that it believes that by cutting administrative waste, it can increase provider revenue by 15% - 20%.
Marble Health, a virtual mental health platform for teens, raised $15.5 million. Marble launched in New York last year and has conducted 15,000 teletherapy sessions since.
Medmo, a radiology referral platform, raised $15 million.
WellTheory, an autoimmune care model, raised $14 million.
OutcomesAI, an AI platform expanding nurse capacity, raised $10 million.
Pear Suite, a platform for community health workers, raised $7.6 million.
Altitude, an AI platform for training NPs, raised $5.4 million.
Alleviate Health, a AI platform for clinical trial recruitment, raised $4.3 million.
Vega Health, a marketplace helping health systems implement and track the effectiveness of AI tools, raised $4 million.
What I’m Reading
Zigging when others Zag - Now may be the time to lean into Medicare Advantage by Duncan Reece
Duncan makes the case in this piece that the doom and gloom for Medicare Advantage in 2026 and beyond is overstated, and that the market is actually well positioned to grow nicely. It’s a well-argued counterbalance to the prevailing negative sentiment for MA. I think Dr. Oz’s quote above about the potential of Medicare Advantage is a pretty telling indicator that Duncan’s thesis is correct, although I think the market is still in for a bumpy year in 2026 as it “grows up,” to continue borrowing on Oz’s analogy. Read more
A new wave of middlemen offers 'alternative funding' for specialty drugs. Patients bear the risks by Anastassia Gliadkovskaya
This Fierce Healthcare article does a nice job highlighting the complex world of patient assistance programs for high cost pharma and how a group of companies like Payer Matrix have emerged to try to keep employer health costs down by helping patients apply to the programs that pharma companies offer. While it is always fashionable to critique the middle man, I think it is more interesting to step back and think about the break downs that lead to the existence of these sorts of middlemen in the first place. Read more
The Cell & Gene Therapy Frontier: The Next System Build-Out in Healthcare by Sam Toole and Hannah McQuaid
I thought this was a good quick read on the cell and gene therapy (CGT) market and the investment opportunity that Primary Venture Partners sees to invest in building out the infrastructure to deliver these medications. It seems like we’re approaching a wave of innovation in the specialty pharma market, with this being one of the big drivers. Read more
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