Weekly Health Tech Reads 2/15/25

CVS posted another solid quarter as it continues to climb out of the hole it fell into in 2024. As I mentioned on Slack, I find CVS’s general narrative compelling at the moment — they’ve effectively shifted away from the emphasis on VBC care delivery to a broader narrative centered on insurance discipline, growth in pharmacy services offerings, and its overall physical footprint. The earnings call itself was largely uneventful strategically — the insurance business moving back towards target margins, CVS sees the value prop for Caremark and pharmacy services as more important than ever, and the PBM legislation is viewed as manageable. CVS, like the other insurers, noted that the 2027 Advance Notice does not align with industry medical trends, but it also said it does not expect it to affect long-term guidance for the business. Humana made similar comments during its earnings call later in the week, which seems like an interesting point in the broader negotiation at hand with CMS. If I’m CMS leadership, I’m listening to those comments and wondering to myself: if the 2027 Advance Notice is so crippling, why does there seem to be so little concern expressed to investors about its long-term impact? Certainly, I’d imagine it is because the payors will pull the various benefit levers at their disposal to preserve margins in the business. The result is an interesting political game theory exercise for CMS ahead of the 2026 midterms.

Humana managed itself quite well in its first investor test of 2026, with its stock only down a few percent this week. While I described CVS’s earnings call as largely uneventful, Humana’s was the opposite, and Martin and I spent our Wednesday mornings digesting it all live. Humana shared the massive MA growth number everyone had been waiting to hear — it grew by approximately 1 million MA lives, or 20%, during AEP. In total, it expects to grow 25% in 2026. Humana spent the earnings call addressing the questions it is getting from investors while continuing to express confidence that it will be able to manage the influx of new members. It shared a number of data points on the membership influx designed to give investors confidence. The most notable to me were that 70% of new members are in 4+ Star plans and that only 12% of lives from competitive plan exits went to Humana. Humana expects individual MA margins to be “slightly negative” in 2026, but, interestingly, it expects new and existing membership to be at the same margin due to that Stars performance in new members. Meaning that Humana expects that having 70% of new membership in a 4+ Star plan will provide a revenue lift that offsets the higher medical expense for new members, making it roughly equal to the returning population, which should have lower medical expenses, but only about 25% are in 4+ Star plans. Humana’s whole play seems to be betting on unlocking the LTV of the MA memberships it is acquiring, and the 2027 Advance Notice presents another huge obstacle in that regard. The analyst Q&A here was the biggest thing that gave me pause in the overall narrative — when pressed on whether Humana would prioritize margin or membership given the rates in the 2027 Advance Notice, the answer was a version of “both,” a muddied response that I’m sure will be fun for Humana’s actuaries to decipher as they get into the 2027 planning cycle. The next test will come a few months from now, when Humana reports on how 2026 is trending and whether they adjust the strategy for 2027, if at all.

The market didn’t react much to Oscar’s earnings, which reported meaningful ACA membership growth for 2026. Oscar expects to grow by ~1 million members between Q4 2025 and Q2 2026 while also returning to profitability in 2026. Oscar noted it expects ACA market attrition in line with the lower end of its 20% to 30% estimate as we move through the year. Oscar reported seeing substantial shifts in its membership mix — Silver plans have declined from 71% of membership to 36%, Gold plans have increased from ~4% to 25%, and Bronze plans have increased from 25% to 39%. Oscar noted that members have plans with higher deductibles as a result; Oscar’s Bronze and Gold plans don’t have very rich benefits. On the whole, Oscar appears to be executing well as a maturing insurance business in the ACA market. This seems to be simultaneously a blessing and a curse for Oscar — given the state of the ACA market, I’m not sure any insurer wants to be a single-line business on the exchanges these days. Oscar’s attempts to diversify into other products continue to struggle to take shape — ICHRA may well present an interesting long-term growth opportunity, but it is not clear how it will become a meaningful business for Oscar in the near term. Oscar noted that its ICHRA membership doubled, but it still isn’t meaningful enough to share any data on it. That seems like great news for startups in the market, but also challenging as a public company growth narrative. +Oscar again is nowhere to be found in this earnings call. Oscar mentioned its brokerage services and enrollment platform — assets it acquired in 2025 across multiple small acquisitions — as a meaningful revenue opportunity for the business as the ICHRA market grows. In many ways, the fact that a series of small acquisitions in 2025 is being highlighted as a key revenue opportunity for Oscar underscores the issue here. I think the much more interesting long-term growth opportunity lies in Bertolini’s talk track on decoupling the insurance purchasing decision from the financing decisions for individuals. If government risk pools migrate to a world where individuals on ACA, ICHRA, Medicare, and Medicaid are purchasing the same set of product offerings, it is not hard to envision Oscar benefitting meaningfully from that.

Tenet posted another strong quarter, with its stock jumping almost 20% on the week. Adjusted EBITDA grew to $4.57 billion in 2025, coming in $500 million ahead of the midpoint of initial expectations for the year. Over the last year, Tenet stock is now up 71%, and 350% over the last five years. Tenet’s USPI division generated $2.0 billion of Adjusted EBITDA, growing 12% over 2025 while achieving a 39.2% Adjusted EBITDA margin for the fourth quarter. Meanwhile, the Hospital segment generated $2.5 billion in Adjusted EBITDA in 2025 at a 15.7% margin. Those growth and margin numbers indicate the strength of Tenet’s approach at the moment in both the hospital and ambulatory settings. Tenet noted that it sees the phase-out of the inpatient-only list as a gradual tailwind for USPI over the next several years, particularly around high-acuity spine and urology procedures. Choppier seas may lie ahead, as Tenet noted that it expects to lose $250 million this year from the expiration of ACA subsidies. It expects to see a 20% reduction in overall ACA enrollment driving an increase in the uninsured population, particularly in states like Arizona, Michigan, and California.

Hinge Health saw its stock increase ~21% on an impressive quarter for the virtual MSK provider, bringing it back close to the price it started trading at when it IPO’ed almost a year ago. Hinge noted that it blows the “rule of 40” metric out of the water, as its combined revenue growth % and free cash flow was 81% for the full year 2025. That result highlights the momentum Hinge has at the moment, as it is growing quickly in the employer segment while deploying technology to keep costs relatively flat, resulting in meaningful cash flow improvements for the business. Its free cash flow margin grew from 12% in 2024 to 31% in 2025. Hinge noted that many of its customer wins are still from organizations adopting digital MSK for the first time, but it is also seeing conversations from customers using competitive products. It’s going to be interesting to keep an eye on how Hinge pursues growth options from here — as Endpoints noted earlier this week, Hinge has posted a few jobs recently hinting at an upcoming expansion into mental health.

CMS released January and February 2026 enrollment figures for Medicare Advantage, which mirror what we’ve been tracking along with in HTN Slack as companies have shared results over the last few weeks. Overall, the market grew slightly, with Humana, Devoted, SCAN, and Clover dominating growth. It appears growth in Special Needs Plans are driving the market, with SNP plan enrollment up around 5% in total while general MA enrollment declined slightly. C-SNPs plans are up 14%, while D-SNPs are up 4%. Devoted and Humana both appear to have had substantial membership growth in SNP products. While CVS shed membership overall, it appears to have experienced strong growth in C-SNP plans. More to come this coming week on the MA enrollment picture.

HHS / DOGE shared that they’ve released Medicaid spending by provider between January 2018 and December 2024. It is fascinating to see how reactions to this data differ on various social media sites. LinkedIn has very little discussion I’ve seen, save for a few thoughtful posts like this from Yubin Park, which looks at diverging growth rates across various ABA practices over the past few years and ponders why those growth rates might differ. X, on the other hand… I’m not going to link to the many fraud spotters pointing out where they think fraud has occurred based on the data. Generally, I think transparency like this is a good thing for the system, though I fret about our societal capability to wade into a conversation like this at the moment.

Humana announced the acquisition of Florida-based primary care provider MaxHealth, which has 82 owned and affiliated clinics and 80,000+ VBC members. MaxHealth was previously owned by Arsenal Capital Partners, which assembled it by acquiring a handful of assets in Florida between 2020 and 2022, a very different time for valuations in the VBC market. Bloomberg reported the transaction value is ~$1 billion, and sell-side analyst reports indicate the transaction was for ~13x EBITDA. Those numbers imply MaxHealth is generating ~$72 million in EBITDA and a mid-single-digit EBITDA margin. Back in December, it was reported that Towerbrook and Guidewell (aka Florida Blue) were putting an offer here, and it appears Humana stepped in. Lots of interesting discussion in HTN Slack around the strategy at play here. Humana appears to be moving aggressively in a market where valuations have compressed significantly. If you do the math on MaxHealth, it’s being acquired for ~$14k per VBC life, down substantially from the ~$66k per VBC life Oak Street was acquired for a few years ago.

Longevity cult leader guru Bryan Johnson made a splash on social media by announcing a new $1,000,000-per-year longevity product called Immortals, which they are launching for three lucky individuals. It’ll include a concierge team, AI support, and a battery of testing and other nonsense that Bryan does to reverse his biological age. Apparently, almost 1,600 people have now applied for this offering, which, if you’re doing the math, implies a $1.6 billion revenue opportunity (I don’t think there is any filter on ability to pay for joining the waitlist, so obviously take that with a grain of salt). Nonetheless, it does seem indicative of the excitement around longevity at the moment. Johnson apparently plans to release $60,000-a-year and free tiers of the product as well for those interested.

Harbor Health acquired dementia care startup Rippl Health. This is Harbor’s second acquisition in the last few months as it aims to build a new payvidor model in Texas. It also announced the acquisition of 32 VillageMD clinics back in September. While it appears that Rippl’s virtual dementia care model will be integrated into Harbor’s care offering, my guess is that this deal is more about a cash infusion going into Harbor — it buys Rippl using equity and receives a cash infusion from Rippl’s investor base. Worth noting that General Catalyst co-led Harbor’s $130 million round in September and also led Rippl’s Seed round back in 2022. Not hard to imagine a win-win where Rippl finds a soft landing spot and Harbor gets additional cash.

Senators Elizabeth Warren and Josh Hawley introduced a new bill this week, called the Break Up Big Medicine Act. It's notable that two congresspeople from both sides of the aisle are teaming up on this, which appears intended to serve as a kind of Glass-Steagall Act for healthcare. While I understand the general public dislikes vertically integrated healthcare at the moment, and so this sentiment plays well in DC, I’d be curious to learn what specifically Congress thinks legislation like this will improve. Setting aside the large public companies for a second, this sort of legislation seems likely to have wide-ranging impacts on models like Kaiser and other integrated care models.

In the D2C longevity space, Function Health filed a lawsuit against Superpower, alleging deceptive advertising. It’s curious to me to see two startups that have been touting rapid growth recently, only to now be involved in a lawsuit that reads like a squabble between teenagers. I can’t help but wonder if that is a signal that market momentum is cooling off quickly here as two well-financed startups fight over market share, seemingly taking a “red ocean” approach early in what should be a massive “blue ocean” opportunity for longevity adoption.

OpenEvidence announced a new partnership with Sutter Health, integrating Open Evidence’s clinical search tool into Epic’s EHR workflows for Sutter Health physicians. It seems like a natural growth lever for OpenEvidence to pull as it continues to gain momentum with providers.

PE firm Madison Health Group is buying behavioral healthcare provider Magellan Health.

Talkiatry, a virtual psychiatry group, raised $210 million in equity and another $190 million in a debt facility. As I mentioned on Slack, Talkiatry seems to have strong momentum at the moment, building on a strong core business. It currently employs 800 psychiatrists, almost 2% of psychiatrists in the country. It’s working on partnerships with HCA and other health systems to become the integrated referral partner, and it seems like a really strong position to build upon. Building a best-in-class provider organization always seems like a winning strategic move, and that seems to be what Talkiatry is doing here.

Solace, a patient advocacy model, raised $130 million at a $1+ billion valuation. IVP led the round. Solace has relationships with 2,000+ “advocates”, all of whom appear to be clinically licensed individuals on 1099 contracts. Based on Solace’s website, it looks like a Solace-employed clinician does an initial consult, and then the advocacy work is done by one of these advocates “incident to the initiating clinician.” That last language is from Solace’s website, which would seem to imply that it uses incident-to billing for its advocates. I think we’d all agree that every patient could use a good advocate to navigate the healthcare system. Yet if the mechanism is to pay for advocates using incident-to billing in a grey way to capture incremental Medicare dollars, I’m not as sure how I feel about that. It feels more financial arbitrage-y than the feel-good startup narrative that advocates-for-all might suggest.

Garner, a doctor quality analytics platform for employers, raised $118 million at a $1.4 billion valuation. Kleiner Perkins led the round. It’s a huge funding round for a company that is seeing solid traction among large employers, with its data helping employees find high-quality, low-cost providers. I can’t help but wonder if we’re going to see Garner use this funding to expand its product offering to employers — it would seem like a logical step given the pressures employers are under, given the savings Garner appears to be driving.

Loyal, a canine longevity drug maker, raised $100 million. It has plans to expand into us humans one day, too. Age1, Baillie Gifford, and others invested.

Anterior, an AI operations platform for health plans, raised $40 million. NEA, Sequoia, FPV, and Kinnevik participated. The press release notes that Anterior counts Geisinger Health Plan as a client, and it has partnered/integrated with HealthEdge. The press release also notes that Anterior’s approach is more focused on implementation than it is on technology, which seems like a wise focus to me in healthcare.

Atlas Oncology Partners, a VBC oncology platform, raised $28 million. Flare Capital led the round with participation from Rubicon Founders.

Somethings, a peer support mental health model for teens, raised $19.2 million. Catalio Capital led the round, with General Catalyst and Tusk Ventures participating.

Kyra Health, an ICHRA platform, announced an undisclosed amount of seed funding. FlyOver Capital and Wavemaker 360 led the round, with support from 25Madison, the venture studio that incubated Kyra.

Habitat Health, a PACE provider, raised an undisclosed amount of venture debt from Hercules Capital.