Weekly Health Tech Reads 11/15/26

Oura’s vision to redefine healthcare. It’s worth revisiting Oura’s IPO narrative to put this acquisition in context. Check out these two statements from Oura CEO Tom Hale’s opening and closing remarks at the roadshow, which emphasize Oura’s vision of redefining health. Hale makes it clear that Oura plans to build capabilities across hardware, software, AI, and services. Counsel seems like a first step beyond the ring, but not the last.

“Acquire once. Monetize for years.” The Oura IPO roadshow highlights its view on CAC:LTV in the slide below. Counsel seems to fit squarely into the right part of the slide here, increasing the LTV of Oura customers. If you think about Oura’s business through this lens, I think it is clear why this is the path it’s heading down, versus continuing to sell hardware. Fitbit has already shown us how that path goes.

Oura’s core user: wealthy women. Oura’s S-1 narrative was that it is a brand for everyone. I’d suggest the S-1 data tells a different story: 72% of its users are women, and 32% have incomes over $200k. Both numbers are significantly higher than the general population. Check out Oura’s income distribution compared to both the general adult population and wearable users:

Expanding in virtual care delivery. If Oura is committed to this strategic path — and if I’m them, I think that is the right move — why stop here? The success that organizations like Maven and Midi have found in women’s health in recent years, combined with CMS’s interest in paying for clinical AI, presents an interesting opportunity ahead for Oura.

Yes, but: This will be a high-degree-of-difficulty move for Oura as it expands its brand beyond an iconic piece of hardware into a broader healthcare ecosystem. Presumably, Oura has seen good early indicators in its partnership with Counsel (and I find it hard not to read this as bullish for ACCESS). But it will require reframing the brand in the eyes of users as it scales, and that is by no means a slam dunk.

A confusing explanation for declining subscribers. Hims’ subscriber count fell 100,000 sequentially, apparently driven by reduced US marketing spend and a brand migration from Eucalyptus to Hims in international markets. Hims argues it is making a strategic choice to trade near-term subscriber growth for a stronger long-term position, but I don’t find that argument particularly convincing: if dialing back marketing costs 100,000 subscribers in a quarter, that looks less like a strategic choice and more like a measure of how much growth was being bought. I’ll touch on this narrative again at the end of the section below on Ro (hint: the long-term orientation narrative was Ro’s public position in 2022 while privately growth had ground to a halt).

Investing in supply chain for peptides. I think the most interesting part of the Hims’ narrative is its investment in building a US-based peptide manufacturing supply chain. This is one of the few areas where Hims does seem like it has a valuable asset it has built. The peptides category will start going live at the end of the month, and Hims seems to be placing a big bet that it will be the next growth driver.

Hims deal with Andrew Huberman. Hims announced famed influencer/neuroscientist Andrew Huberman will join its Board. Huberman will personally be paid up to $6.9 million annually by Hims across a handful of different services:

Other recent news:

A good story, told in hindsight. Reitano’s recounting of the zombie era and Ro’s refounding is a charming story, but ultimately it strikes me as a performative retelling at this point in the journey. If you go back to 2022, Reitano’s narrative about the business was quite different. Ro raised $150 million at a $7 billion valuation in February 2022, and Reitano joined me on HTN in October 2022, describing Ro’s long-term orientation. The phrases zombie or refounding were not in Reitano’s public lexicon at that time, although TechCrunch did pick up on some of the employee tensions. So why share that now, four years later? The answer seems straightforward: a $7 billion zombie unicorn isn’t a great story, but a hero’s journey about transforming in hard times certainly is.

The branded GLP-1 story. Reitano shared data in his X post that allows us to take Buffett’s advice to heart and look at the numbers. The revenue chart below shows how Ro’s growth stalled for several years after 2021, while Hims accelerated on the back of compounded GLP-1s. Ro launched its work with Lilly in December 2024, and Novo in April 2025. Ro catching the branded GLP-1 wave early while Hims dragged its feet seems like a straightforward explanation of the results over the past few years.

Is distributing branded GLP-1s a good business? The revenue growth is impressive, but with Ro being private, it’s hard to see what is going on under the hood. As we’ve seen with Hims, distributing branded GLP-1s has meaningfully eroded its gross margins and forced it to reposition GLP-1s as just the entry point to a broader consumer platform. Further, Q3 results suggest that as soon as Hims pulls back on marketing spend, its customer base starts moving away from the platform. Given the similarities between Ro and Hims branded GLP-1 offerings, I’d imagine Ro is facing similar questions about how it drives customer LTV over time.

What’s next for Ro? The NYTimes article hints that Ro could be active in the capital markets soon. Given this week's marketing wave, it wouldn’t be surprising to see Ro build on it with an upcoming funding announcement that lays out more of its platform plans. It’ll be interesting to see how it articulates the platform build this time around. Recall that back in 2021, Ro sought to build out a platform when it acquired Modern Fertility and Kit, which perhaps seems like part of its challenges in hindsight. We’ve perhaps already seen an indication of Ro’s plans via its recent partnership with Megan Fox to sell ED pills while wearing a red catsuit. Ro says the campaign is about reducing stigma, which is definitely the top reason I can think of that a company would plaster Megan Fox all over social media in a red catsuit selling its fast-acting ED medications. Z shared on Invest Like the Best that it will announce additional influencer partnerships soon, with some interesting commentary about how important influencers will be in an AI content era.

A competency-based approval process. The FDA could regulate based on competency, similar to how physicians are evaluated for credentials today. Post-market monitoring would then test for safety. I’m a bit curious when we’ll see this framework emerge from the FDA at this point. Bergman, Wachter, and Emanuel shared a perspective in JAMA in April arguing for a similar competency-based concept.

Paying for what works. The most interesting question for me is how to reimburse clinical AI. Does CMS allow providers to bill for it on a FFS basis? The document seems to indicate CMS is more focused on VBC arrangements. Check out the two highlighted sentences below:

Will an AI PCP excel in global cap? In theory, it absolutely should given the economics, right? CMS indicates its interest in launching a CMMI model to test this. How much cheaper would an ACA plan centered on this idea be than a traditional plan? As I noted in my recent write-up on Devoted entering the commercial market, the commercial actuary job posting included a sentence about the ACA market, so perhaps Devoted is expecting this. Godspeed to the actuaries who have to price the first iterations of these products.

But… where are the doctors on this? John Whyte, CEO of the American Medical Association, shared his perspective on LinkedIn Friday evening, noting that while there is much to like, he is concerned about autonomous AI decision-making, arguing there’s a fundamental difference between AI supporting clinicians in making decisions and AI making decisions independently. Whyte was also a vocal opponent of the Khosla / Emanuel paper on autonomous AI, on similar grounds.

CMS announced a hold-harmless period as states implement Medicaid work requirements starting on January 1st.

Google announced its Gemini agent for healthcare, aimed at administrative work at payers and providers.

Surgery Partners announced an amended merger agreement with Bon Secours at a higher price. Bloomberg reported that Surgery Partners rejected a higher unsolicited offer from UnitedHealth over concerns the deal may not close.

Kindbody is selling all of its fertility clinics and converting to a fertility benefits management model.

Wolters Kluwer is acquiring AgileMD for $40 million upfront with an additional $60 million in potential earnouts. AgileMD will enable UpToDate Expert AI to expand further into clinical decision support workflows.

Pfizer announced a co-funding agreement with Blackstone Life Sciences under which Blackstone will pay up to $1.5 billion in development costs for a new monthly GLP-1.

Withings reported 20%+ growth in 2026, profitability, and 12 million customers worldwide, as the family buys out some of its existing investors to bring family ownership to ~90%.

Healthcare analytics company Inovalon announced it will acquire DrFirst, an e-prescribing software vendor.

Vumedi, a peer-to-peer clinical education platform, raised $104 million in Series B funding. Oak HC/FT led the round.

Connie Health, a Medicare insurance broker, secured a $35 million credit facility to support both organic and inorganic growth. The facility can expand to $100 million.

Zus, an interoperability platform, raised $33 million. Drive Capital led the round.

Duet, an NP-centric primary care network, raised a $15 million Series A. Kairos led the round.

Mosaic, an intelligence platform for surgical robots, raised a $47 million seed round. 8VC led the round.

Alterra Labs, a startup building training environments for medical AI, raised $12.5 million. Oak HC/FT led the round.

Rae penned an update on Wednesday about the latest election updates and their implications for healthcare.

A team from Bass, Berry & Sims published an article on changes to MSSP that could help the program grow by another million beneficiaries, on top of the 12.6 million already enrolled.

An AJMC article explores the link between 340B program growth and increased overall healthcare spending.