Weekly Health Tech Reads 6/22/25

Humana's Investor Conference, Advisory Board & BDO on industry trends, Summa / HATCo deal approved, & more

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👋 Hey all! Kevin here. Welcome to this edition of my free weekly newsletter, where I share my perspective on healthcare innovation news from the past week that I found interesting.

One of the questions that I get asked a lot is some iteration of: what is the most exciting company in healthcare that I should [go work for / invest in]? I must admit, I never know how to answer that, A. because I think so much of the answer is unique to the circumstances of the individual asking, and 2. because I’m constantly reminded that I generally have no clue.

Case in point: this week I spent a lot of time thinking about the Axios report regarding Medically Home’s merger with Dispatch Health, with a leaked merger document suggesting Medically Home was in a very difficult spot financially, even after having raised $287 million in funding over the years. The gist of the report is that Medically Home’s hospital-at-home model was bleeding cash and reliant on cash infusions from investors including Mayo Clinic and Kaiser to keep it afloat long enough to be sold to Dispatch.

From the outside, Medically Home seemed like it should have had everything going for it:

  • A no-brainer idea: Hospital-at-home seems like one of those obvious ideas to improve healthcare in this country with decades of supporting evidence that the model should work

  • An innovation catalyst: COVID-19 should have been the perfect catalyst for the hospital-at-home model to boom

  • A who’s-who of partners / investors: Mayo. Kaiser. Cleveland Clinic. All were working with Medically Home. And that was just the beginning of the list!

Looking from the outside in, I’m not sure you could ask for a better possible combination of circumstances for an impactful opportunity to make healthcare better.

I don’t know why Medically Home faltered as it did. Certainly, it seems a key driver is that the broader hospital-at-home market has completely stalled post-COVID, as also evidenced by the recent Best Buy Health write-down. But even that statement invites a whole host of interesting questions — why are all these partners seemingly reversing course so quickly? The answer seems fairly obvious, its because of the underlying financials for hospitals. All-in-all, it’s another good example of just how hard it is to drive transformative change in this industry, and how fickle even the most well known institutions can be as partners.

It reminds me of an excellent episode of the Healthcare is Hard podcast with JP Morgan’s Lisa Gill from last fall in which she made a comment along the lines of this: one of the hard parts about healthcare services companies is that there is no real moat for these businesses, even for the large public companies Gill covers. You’re essentially just betting on the competency of the leadership team and their ability to allocate capital effectively.

I can’t help but look at this example in the context of the rest of the news this week, including the chart of the $900 million that has gone into a handful of AI scribe rounds over the last two years. I know it’s going to be interesting to watch that market evolve, but that’s about all I know. If you really want to assess the likelihood of success for these companies, you really have to get under the hood to understand whether you trust management’s ability to allocate capital effectively. That seems like the name of the game here.

Happy Sunday reading!

Kevin

PUBLIC MARKETS

Humana’s Investor Conference provides updated outlook on Medicare Advantage business

Humana hosted its bi-annual-ish Investor Day earlier this week, providing Wall Street with an update on its strategic direction over the next several years. As always, it provides a great look into both the state of Humana’s businesses, but also more broadly indicative of broader industry trends for Medicare Advantage. Humana’s stock was up 3% on the week, providing some indication that the session was generally what investors expected. I shared my takeaways from the presentation earlier this week for HTN members here.

Links:
Humana transcript
Humana slides
My Key Takeaways (Humana’s 2025 Investor Day)
My Key Takeaways (Humana’s 2022 Investor Day)

✍️ Going Deeper

As I walked away from the session, the broader narrative I took away was this: by 2028, Humana expects the Medicare Advantage industry will stabilize at historical 3% margin levels and Humana will make needed operational improvements to make the business less reliant on Stars over-performance and position it as a best-in-class business. Adjacent opportunities in Medicaid, CenterWell primary care, and CenterWell pharmacy provide longer term growth opportunities where Humana will deploy capital.

It’s a straightforward, focused narrative, albeit one that underscores the magnitude of the headwinds that both Humana and Medicare Advantage face over the next several years. I think these two slides sum it up well as Humana articulates the trajectory and potential of the business:

  • Humana’s earnings recovery trajectory through 2028. This slide highlights the magnitude of the Stars challenge for Humana, with earnings declining in 2026 before returning to 2025 levels in 2027 and then growing in 2028. Humana made it a point during the session to note that it needs to reduce its reliance on Stars performance moving forward, a point that seems fairly obvious with the benefit of hindsight.

    Source: Humana Investor Conference Slide 115

  • Humana’s gap in performance today relative to future potential. I’m not quite sure what to make of looking at this slide and listening to Humana’s narrative. I definitely understand the optimistic lens the new management team is taking here — there’s a lot of opportunity to close the gaps identified. I also can’t help but scratch my head and ask myself why those gaps exist today when it seems clearly within Humana’s control to improve performance. If you go back to the 2022 session, a key theme coming out of that was that Humana needed to demonstrate it could execute operationally on the plan it was laying out. This slide seems to pretty clearly indicate that did not go as planned.

    Source: Humana Investor Conference Slide 14

INDUSTRY TRENDS

Advisory Board + BDO share an industry trends report

Folks at Advisory Board and BDO published a portion of an industry trends report on LinkedIn on Saturday. It provides some excellent food for thought for folks thinking about across a number of key topics in the industry — the regulatory environment, Medicare Advantage, financial pressures for providers, population demographics, etc. It’s worth checking out if you’re interested in healthcare services strategy, which I assume you are if you’re reading this sentence. I’ll highlight two the slides I found most interesting slides below:

  • Perhaps the most interesting slide to me was this one, highlighting the distribution of hospital operating margin from March 2024 - February 2025. I’m used to hearing the idea that recently some health systems are doing very well while others are doing very poorly, and this chart drives it home. While the median hospital operating margin over that period is 7%, the 95th percentile hospital operating margin is 37% while the 5th percentile is at -16%. 37% of hospitals have a negative operating margin. It’s a staggering spread in margins indicating the variability in care delivery performance.

  • The presentation also highlighted the growing importance of specialty pharmacy in the PBM world, including a slide noting it has grown from 16% of PBM gross margins in 2012 to 39% of PBM gross margins in 2023. It is going to be really interesting to watch the impacts of the coming wave of high cost drugs, as highlighted in the slide below. I didn’t realize the stop-loss market doubled in size between 2017 and 2022.

M&A

Ohio’s AG approves the General Catalyst / HATCo / Summa Health deal

Almost eighteen months after the LOI was signed, Ohio’s Attorney General has approved the General Catalyst / HATCo acquisition of Summa Health, with some small modifications to the deal terms. The purchase price of Summa Health was increased from $485 million to $500 million, and the AG added some stipulations to ensure that Summa Health continues to provide community benefits.

It is going to be fascinating to watch what General Catalyst does with Summa Health from here. If I put myself in the shoes of the Ohio Attorney General, I’m not sure if I’d be excited or terrified to have a VC own a key health system in my state and use it as a test bed for all the AI-driven innovation expected over the coming years. At the same time, this seems like a fascinating opportunity to apply AI to transform a legacy institution, hopefully for the better. It’s going to be one of the more interesting experiments to keep an eye on in the AI-meets-healthcare world over the coming years. I am hopeful, although admittedly probably not very optimistic, that it provides a blueprint for how to transform health system operations in a sustainable, positive way for communities around the US. That seems like a win for everyone.

Other Top Headlines

  • Surgery Partners, a publicly-traded ASC operator, formally rejected a take-private offer from Bain Capital this week. Bain currently owns ~39% of Surgery Partners, offered to take Surgery Partners private at a $3.2 billion valuation back in January, and at the time it was noted that the offer was perceived as low. Surgery Partners expects to generate revenue of $3.3 - $3.45 billion in 2025 along with EBITDA of $555 - $565 million.

  • CMS finalized a new ACA rule that shortens open enrollment, adds stricter income verification, and ends the monthly special enrollment period (SEP) for low-income individuals—moves aimed at curbing churn and reducing fraud. While CMS projects $12B in savings and a ~5% drop in premiums, up to 1.8 million people could lose coverage in 2026. These changes are technically temporary but could stick around depending on the political winds.

  • Hinge Health announced that it is launching an in-person MSK provider network, HingeSelect. The press release notes that the Hinge network will be up to 50% cheaper than traditional PPO rates for employers. It’s interesting to juxtapose this move with Sword’s announcement this week (see more in funding news) — Hinge seems to be going deeper / narrower in the MSK market by adding this MSK network, while Sword seems to be going shallower / wider in the employer digital health market by expanding into mental health.

  • Bloomberg reported that HHS Secretary Robert F Kennedy Jr is exploring ways to limit direct-to-consumer advertising by the pharmaceutical industry. The US is the only country in the world aside from New Zealand that allows D2C pharma ads. As always, what seems like a pretty straightforward decision to make is complicated by the various business interests at hand — an outright ban of these ads seems quite unlikely, given pharma spends over $10 billion a year on advertising. Banning that would be a huge hit not only to the pharma industry but the broader media industry.

  • The WSJ published a good piece exploring how a nursing home is piloting an AI solution, Meela, to combat loneliness among seniors through personalized, weekly phone calls. The startup behind Meela is scaling the solution to other nursing homes, charging $65 per member, per month.

  • Abridge announced it rolled out two new products on its AI platform — outpatient medication ordering and ambient scribe for inpatient settings.

  • Mark Cuban Cost Plus Drug Company has partnered with 9amHealth to offer low cost oral medications as part of 9amHealth’s obesity program for self-insured employers.

Chart of the Week

Mario Aguilar’s article in Stat on Nabla’s $70 million funding round featured this chart highlighting $900 million that has been invested in seven companies across ten rounds of funding over the last two years.

Quote of the Week

Business Insider featured a good read this week on New Mountain Capital’s investment playbook, describing New Mountain as “private equity meets venture studio”. New Mountain applies a PE-style roll-up model to health tech companies, providing a viable off-ramp for VC investors who can feel good about their returns, as the quote summarizes well below:

"They're great deals for investors," said a healthcare banker who asked to remain anonymous because they weren't authorized to speak to the media. "If your company can't get to an IPO, order the New Mountain special."

Startup Funding Announcements

  • Commure, an AI platform for health systems, raised $200 million in growth financing from General Catalyst. The press release notes that Commure has hundreds of millions in annual recurring revenue, a number that has doubled for three consecutive years. This funding comes from General Catalyst’s Customer Value Fund, an interesting investment model that sounds like debt financing, with GC pre-funding sales / marketing spend.

  • Tennr, an AI platform for patient referrals, raised $101 million at a $650 million valuation. This funding round comes less than a year after Tennr raised $37 million, as Tennr noted it has tripled revenue since October and is now in "the eight figures of revenue".

  • Nabla, an AI scribe, raised $70 million. Nabla reports that 85,000 clinicians across 135 health care organizations use its AI scribe tool.

  • Sword, a virtual MSK platform, raised $40 million at a $4 billion valuation. As Sword’s CEO shared on LinkedIn, it appears the purpose of this funding was primarily to update Sword’s valuation. The $4 billion valuation prompted a good conversation in the HTN community about the comp between Sword and Hinge and why Sword is apparently receiving this investment at a higher revenue multiple than Hinge is trading at. Sword announced as part of this that it is launching a new AI-based mental health product, Mind, which will integrate AI, a wearable headband, and clinicians to provide always-on therapy for individuals with anxiety or mild depression.

  • HOPPR, AI infrastructure for medical imaging, raised $32 million.

  • Veracity, a metabolic health supplement company, raised $6 million.

  • Quilt Health, a platform streamlining clinical trials to help provide patients with access to new therapies for complex diseases, raised $6 million and announced their partnership with National Alliance of Sickle Cell Centers (NASCC).

What I’m Reading

HTN Deep Dive: Medicaid Market Entry Playbook for FQHC-Enablement Startups by Claire Trautz
We recently shared a framework on go-to-market strategy for startups selling into FQHCs—sparked by a thoughtful question from a startup in the HTN community. It was a fun one to unpack, so we tapped a few experts for their perspectives and pulled together a playbook we hope others find useful. Read More

  • P.S. Have a similar question you'd like us to dig into? We’d love to hear it—this kind of collaborative thinking is right up our alley. There’s a form here where you can submit your questions!

Understanding Behavioral Reimbursement: Transparency Data, Trends, and Tactics by Blake Birmingham
The Serif Health team digs into how 2025 pricing transparency data is shedding light on behavioral health reimbursement—one of the most historically opaque areas in healthcare. It’s giving MSOs, provider groups, and startups real leverage to benchmark rates and rethink their payer strategies. Super relevant as more hybrid models push for better contracts and real parity in behavioral health. Read More 

Red Tape, Real Consequences: The Kafkaesque Nightmare of Medicaid Work Requirements by Sara Ratner
This LinkedIn post highlights how even compliant, working individuals are losing coverage due to convoluted monthly reporting rules that are part of Medicaid work requirements. It’s provides a good example of how administrative complexity—not eligibility—is driving disenrollment. As states double down on redeterminations, this piece is a reminder of how policy design choices directly impact access, equity, and trust in public programs. Read more 

What UnitedHealth Can do to Revive its Battered Stock by David Wainer and Johnathan Weil
This WSJ piece highlights how UnitedHealth’s public reporting is under the spotlight as investors are pressing for clarity on internal revenue flows between UHC and Optum amid its recent 40% stock slide. With each of its three core businesses—UHC, Optum Health, and Optum Rx—large enough to be a standalone Fortune 500 company, how UNH responds could reshape perceptions (and valuations) of platform-scale healthcare. Read More 

Catching the right wave in Digital Health by Tiffany Ramos and Rachel Hill
This Rock Health article provides a strategic guidepost for digital health innovation: avoid hype-driven distractions, focus on domains where innovation can scale, and spot early unicorn signals through measurable market fit. Read More

Vice President of Population Health at Morgan Health, JPMorgan’s healthcare innovation arm. Learn more
$NA | Boston, New York, or Washington DC

Senior Product Manager, Digital Health at NVIDIA, a maker of AI hardware and software. Learn more
$168k - $328k | Santa Clara, CA

VP Marketing at Nabla, an AI scribe. Learn more
$NA | Remote

Operations Associate, Healthcare at Risant Health, Kaiser’s VBC enablement platform for hospitals. Learn more
$89k - $118k | Remote

Chief Nephrologist at Strive Health, a VBC kidney care provider. Learn more
$266k - $345k | Hybrid / Remote

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