Weekly Health Tech Reads 7/13/25

👋 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 (in this case, two weeks) that I found interesting. Buckle up, this is a long one at ~3,700 words.

With the One Big Beautiful Bill becoming law on July 4th, the past few weeks have been a whirlwind of news as everyone digests the most consequential piece of healthcare legislation since the ACA.

One of the more interesting dynamics I’ve heard a few times this week is the perspective that the OBBB is just the first inning of a much broader reform of healthcare markets in this country. Between the chaos in the ACA market (more on this below in the Centene discussion), the cuts to Medicaid, and the reform in Medicare Advantage, I don’t think it is hard to imagine a scenario where the next few years will bring significantly more change to healthcare markets in this country. I’m not sure there’s a single insurance market that is on solid footing at the moment.

What might that change look like? Ezekiel Emanuel published a thought-provoking piece this week arguing how Democrats need to use the OBBB as an opportunity to move towards universal healthcare. I’d highly recommend reading it. Central to the argument is the creation of a single national health exchange that combines Medicaid, CHIP, and the ACA. This would create a more actuarially sound — and simpler — exchange covering 120 million Americans. Emanuel’s proposal goes into a handful of other specifics — i.e. limited competition, longer-term contracts, and standardized benefits. I have lots of questions about how the specifics would play out, but it doesn’t seem hard to imagine a scenario where multiple stakeholders, including insurers themselves, could prefer this single national exchange approach moving forward. While Emanuel’s proposal didn’t touch on ICHRA, would it be that hard to imagine a scenario where the small group insurance market moves into that exchanges as well? All of a sudden you have the beginnings of a very American-flavor of a single payer system, right?

While so much attention has been on health policy at home over this year, I also spent a good amount of time this week perusing the 10-year plan that the NHS published for fixing the NHS. The document outlines how the NHS is in a dire state — starting off acknowledging that nobody defends the status quo, and it needs to implement radical changes as it chooses whether to “reform or die”.

Leaving aside for now the questions I have about how a system like the NHS gets to a place where nobody will defend the status quo, the document outlines three “radical” changes to fix things: 1. Move from the hospital to the community. 2. Implement new technologies and move from analog to digital. 3. Focus on prevention versus treating people when they’re sick. All very logical, and all very obvious. So obvious, in fact, its a similar narrative to the last long term plan the NHS shared back in 2019 for fixing the system. The urgency appeared to be less at that time, but the key points remain, which makes me question whether the approach is right. It reminds me of that old saying about the definition of insanity being doing the same thing over and over and expecting different results.

Anyways, as it seems clearer and clearer that we’re move toward massive structural change in healthcare markets here in the US in the next few years, I think the crisis the NHS is currently facing provides an interesting lens on the changes that need to happen in the US.

Enough single payer musing for now, on to the other news of the week!

Kevin

Microsoft’s research prompts a discussion about AI and “medical superintelligence”

Microsoft’s AI team caused a kerfluffle before the 4th, publishing new research in a blog post titled “The Path to Medical Superintelligence”. Perhaps not surprisingly given a title like that, the work invited a large amount of pushback from the medical community online. The criticism was highlighted well in this Stat article, which I’d summarize in two parts:

1. Complex cases like the NEJM cases chosen for the research are not normal medical practice

2. Providers were hamstrung in the exercise by not being able to use reference resources they typically use in day-to-day work

This chart highlights the takeaways from the work, which in part is notable because of the cost estimates it applies to these diagnoses:

The criticism of the work does seem valid, but for me it also doesn’t take away from the work itself. While much of the criticism centers around the notion that the AI performance is overblown and that AI won’t be replacing doctors anytime soon, it actually seems like the Microsoft team agrees with that. Check out this Q&A from the Microsoft blog post:

I think the Microsoft team absolutely has it right in suggesting that AI will be a complement to doctors, rather than replacing doctors. For the folks who think that AI will indeed replace doctors, I think this research actually presents a really good case study in why that seems far-fetched to me. It has less to do with technological capabilities of AI and more the human side — and specifically the PR battle — associated with all this change.

• I think this recent NYTimes article talking about how the Mayo Clinic radiology department has grown by leveraging AI provides a good example of how we should expect providers and AI to co-exist in the coming years (and who will benefit from that change). While thinking of AI as the next generation of clinical decision support is not as headline grabbing as the idea of medical superintelligence, it does seem like the path this is all headed down.

Other Top Headlines

• This Washington Post article highlights the efforts of a two-year investigation dubbed Operation Gold Rush, which revealed an elaborate medical fraud scheme involving individuals buying small companies with Medicare contracts and using them to fraudulently bill for urinary catheters and other DME. The story includes examples of companies like Priority 1 Medical Billing, a front in Bowling Green, Kentucky that was purchased for $200k in early 2024. Priority 1 was then used to bill Medicare for $667 million as it falsely claimed to provide catheters and glucose monitors to 50,000 Medicare beneficiaries. Officials estimated that they were able to stop roughly $10 billion in fraudulent Medicare payments, but the conspirators still collected ~$1 billion from other insurers.

• KPMG and Hippocratic AI announced a new partnership where it appears KPMG will do consulting work with provider organizations to identify opportunities for Hippocratic AI’s agents to help augment existing workforce with AI. Nothing screams healthcare innovation quite like big consulting firms identifying opportunities for AI agents, right?

• In a big exit in the VBC analytics market, Nordic Capital announced it is acquiring a majority stake in Arcadia, a population health and analytics company that works with payers, providers, and ACOs. Terms weren’t disclosed.

• Walgreens shareholders voted to approve Sycamore Partners $10 billion deal, expected to close later in 2025.

• Commure and Canopy announced a new strategic partnership in what appears to be a rather amicable resolution to the legal battle between the two parties over Commure’s Strongline product offering, a panic button for clinical staff. It appears that Canopy will essentially be taking over operations of Strongline moving forward, ending the stalemate between the two organizations. Back in May, Business Insider reported on how Commure was ordered to stop selling Strongline, which was reportedly Commure’s only growing product when it merged with Athelas at a $6 billion valuation in late 2023.

• Mayo Clinic announced a $50 million philanthropic gift to support Mayo Clinic’s Innovation Exchange, a marketplace connecting innovators with Mayo Clinic expertise.

• Samsung acquired Xealth, a digital health platform that embeds third-party digital health tools into provider workflows via EHR integration. Xealth was the first spin out of Providence Health back in 2017 with the idea that providers could prescribe apps like they could medications. It’s an interesting move by Samsung, indicating its ambition to build a connected care platform.

• Rush Health is partnering with Fabric Health to launch Rush Connect+, a DTC telehealth product. Members will pay $19 per month for access to 24/7 virtual urgent care nationally.

• Healthline Media agreed to a $1.55 million settlement with the State of California over deceptive advertising tied to sponsored content.

• CVS Health’s Omnicare subsidiary will pay $948 million in a False Claims Act settlement to resolve allegations of dispensing prescriptions without valid physician orders, among other violations. The case stems from whistleblower complaints dating back years, and the nearly $1 billion penalty puts it among the largest ever under the False Claims Act.

• Lorient Capital, a healthcare investment firm, closed a $500 million fund to invest in healthcare companies.

Funding Announcements

• Phil, a software platform that helps pharma companies drive access to and commercial success of speciality medication, raised $60 million.

• Vytalize Health, a VBC enablement platform for providers, raised $55 million. The Axios report noted that Vytalize turned profitable this year, projecting to generate $40 million of EBITDA on ~$3 billion of revenue. It expects to use the funding to pursue acquisitions.

• Circulate Health, a startup offering a plasma exchange therapy for the longevity market, raised $12 million.

What I’m Reading

The Vertical Review: Voice AI in Healthcare by Euclid Insights
A solid Q1 roundup on voice AI in healthcare, with $2.7 billion raised across 150+ deals. Read more

H1 2025 market overview: Proof in the pudding by Rock Health
The Rock Health crew shared data from the first half of 2025, highlighting among other things the buzz around AI funding. Read more

What WISeR Gets Right About Medicare Reform by David Ohta
A really helpful breakdown of CMS’s new WISeR model, which brings prior auth into Original Medicare using AI and machine learning. Ohta makes the case that this one might actually work, since it’s targeting a few very specific, high-waste areas like skin substitutes and knee arthroscopies. It seems like a CMMI model that feels both focused and operationally doable. Read more

How Public Health Discredited Itself by John Tierney
A rather thought provoking piece in The Atlantic, arguing that public health has become increasingly politicized and needs to return to original principles in order to restore trust. Read more

VC-Backable TAM in Healthtech: Challengers and Enablers by Julie Yoo
This lays out a helpful framework for how to think about venture-scale outcomes in healthcare innovation and how both “challenger” (companies that take on incumbents directly) and “enabler” (companies that provide infrastructure) models are needed in the ecosystem. Read more

Transforming Employer Health Benefits: Large Employers’ Activist Role by a team at McKinsey
This McKinsey piece looks at how large employers are getting more hands-on with their benefits strategies, integrating navigation, shifting toward outcomes-based contracting, and trying to move past the one-off point solution mess. Read more

High-cost claim and Injectable Drug Trends Analysis by Sun Life
Sun Life’s stop-loss data provides a helpful window into where employer-sponsored plans are feeling pressure. The latest report shows continued growth in high-cost injectable drug claims, especially from specialty and cell and gene therapies. Read more

The Rise of Healthcare Jobs by The New York Times
An interactive breakdown of how healthcare has become the fastest growing sector in the U.S. labor market since 2020 with strong gains in roles like nursing and home health aids and slower growth in other areas like support staff and technicians. Read more

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