The Oracle shoe dropped: Oracle lays off 18%–20-30K–of global employees, in their largest ever layoff (Updated 2 Apr)

March 31, 2026 | by

A bad wake up this morning for too many people. To absolutely no one’s surprise to close out this month, including Mr. Market (right), Oracle Corporation laid off an estimated 20-30,000 staff globally, or a reported 18% of its 162,000 employees. Emails signed by “Oracle Leadership” went to affected employees as early as 6 AM US Eastern Time.

It is the largest layoff in the company’s history, by a company not shy about rolling layoffs. It was rumored to be this extensive at the top of this month with the departure of five key executives and a TD Cowen analysis [TTA 6 Mar]. As is typical, Oracle stock on the NYSE rose close to 4% as of 1pm ET today.

What we know:

There were no HR calls, no videos, no manager calls, no advance warning, which is the current cold and human-free style one now expects. Many surviving managers up to senior levels weren’t told in advance of team layoffs, based on Reddit postings.

As anticipated, Oracle Health, as part of the RHS area, was hard hit with 30% layoffs, based on press reports and Reddit/The Layoff.

Early reports (to be updated) out of primarily India, where Oracle employs many thousands in IT and development, indicated the layoffs hit hardest in these areas–FTA RollingOut via Times of India:

  • RHS (Revenue and Health Sciences) — employees described a reduction in force of at least 30%, with 16 or more engineers from individual business units cut in a single action. (Editor’s Note: this includes the Oracle Health EHR team which was the former Cerner) 
  • SVOS (SaaS and Virtual Operations Services) — similarly reported a 30% or greater reduction, with manager-level roles included in the sweep.
  • NetSuite’s India Development Centre (IDC) — cuts spanned project management, individual contributor, and manager roles across multiple seniority levels.

The terse email informs employees that “we have made the decision to eliminate your role as part of a broader organizational change. As a result, today is your last working day.” Employees are also instructed to provide their personal email in order to receive FAQs and separation documents to sign off via DocuSign, as their Oracle emails will be deactivated “soon”. They are also warned against downloading any Oracle “confidential information”. Reports indicated that Mac laptops have new tracking software to determine violators, and that access to systems was already disconnected for those released. Full email text is available on Business Insider.

Some employees noted April 3 as their formal last working day, with a one-month “garden leave” period to follow. Based on TheLayoff postings, some in the US have later dates such as June 1. 

Details for India employees indicate that the normal “N+2” severance package of salary paid in months=years of service was offered. Unvested stock (e.g. RSUs) was lost. Those with vested stock still had access via Fidelity.

Many of those laid off in the US are in Kansas City Missouri (the former Cerner HQ), and have 10-20 years with the company. Most dates are before vesting of unvested RSUs. Slack counts indicate at least 10,000 gone, and likely more. Layoffs also took place in Canada and Europe, according to reports.

US labor laws about layoffs are at two levels, Federal and state; the latter varies. To this Editor’s knowledge, no Federally required WARN (Worker Adjustment and Retraining Notification) notices nor information under OWBPA (Older Workers Benefit Protection Act, which applies when employees over 40 years old are laid off) have been filed. Federal WARN starts with 50 or more employees 60 days before a plant closing or mass layoff. Many states have their own WARN laws and triggers.

What does this mean?

Oracle has taken on a massive debt load that has halved the stock from last year’s highs. For starters, Oracle took on $58 billion in new debt in just two months. Without exception in these reports, the need for layoffs and restructuring are being laid at the feet of the debt required for an extraordinary and costly change in company direction–from a provider of rapidly eroding SaaS to cloud computing services and AI datacenter contracts. This is  despite a strong Q3 and year projections [TTA 11 Mar] which had some but not enough positive effect. It is not just the debt load dragging down Oracle though–it is the time that these datacenters take to build out, get online, and generate cash flow.

TD Cowen’s report, covered in our 5 February article, nailed this quandary to the max. Oracle has entered into multiple contracts with OpenAI, Meta, and Nvidia. Lenders have doubled their interest rates on these Oracle projects to near non-investment grade levels, Oracle’s credit default swap (CDS) spreads have tripled, and private datacenters for lease are scarce because of limited market financing. Oracle can transfer some of these buildout costs to clients, but takes on risk for the bulk of it. In this Editor’s view, Oracle trapped itself into a classic squeeze. FTA: If the company doesn’t build the datacenters, it risks falling behind its massive strategy to dominate the AI datacenter business. Yet the price of this is to abandon its massive investment in healthcare, a linchpin strategy, and the customers there.

Oracle is in a tight spot without a lot of options other than more unattractive debt that further depresses the stock price. Their buildouts of datacenters, such as Stargate in Abilene, Texas, have been fraught with conflicts–the long ‘taffy pull’ of buildouts versus the annual development of ever more powerful chips that AI clients want before cash flow gets going. The difference in timelines is the killer [TTA 10 Mar]. And I suspect that Nvidia doesn’t take exchanges on their chips, once purchased.

Their largest shareholder with 40% of voting stock, executive chairman/CTO/founder Larry Ellison, still took his dividend. Unlike other founders in the past, he hasn’t mortgaged a yacht, an island, or sold a share to help stake the company in this transformation [TTA 6 Mar]. Instead, he seems to be focused on supporting his son’s Skyhorse media endeavors, the latest being the besting of Netflix in buying Warner Bros. He is also 81. These are factors to investors. Our Readers will recall that in 2022, Michael Neidorff, 25-year CEO of Centene, was forced out at age 79 by an activist shareholder group (Politan Capital, later famous for upending Masimo) that referred to both his age and tenure.

One does wonder how many of the laid off employees had specific skills that would have been useful in changing over to cloud/AI. It’s doubtful that Oracle had any process to evaluate individual competencies or capabilities for future fit. Having gone through a mass layoff when Centene absorbed WellCare Health Plans, this Editor knows first hand that companies do not evaluate individuals–they cut based on category, place, title, compensation, and other factors. Survivors either are in the right place, category, or sprint through internal contacts to another berth. This post on LinkedIn by a company that has created a ‘verification infrastructure’ to do this evaluation, instead of layoffs “based on broad assumptions about job categories rather than verified assessments of individual capability” makes you wonder whether an IT giant like Oracle even considered this approach before spending easily half a billion dollars on ‘restructuring’. 

What are the consequences of fewer people at Oracle Health? This month (April), the massive 13 facility EHRM rollout with the VA begins. And Congress, by this late spring and summer, which is budget time, will be turning the full force of scrutiny on Oracle if it doesn’t go as smooth as 30 momme silk satin. And what will it mean to health system clients and prospects? Where is their reassurance that when an IT person emails or picks up the phone with a problem, that there will be someone at Oracle Health who even knows them? Based on Reddit posts, some employees were doing their onsite support jobs when they got their termination notices and had to leave. “Is anybody there? Does anybody care?” may be the cry of hospital IT managers. That’s not good for sales or account teams…if anyone at Oracle cares about new sales and retentions.

Is Health, once the focus of Oracle’s Big Transformation, now just a used and broken toy? What’s the future of Oracle Health if the strategy is AI 24/7 and EHRs and healthcare system SaaS just do not fit the picture anymore?

Updated 31 March PM: Oracle is not admitting the cuts or the volume of them publicly. CNBC’s sources are stating only that the cuts are ‘in the thousands’. This corresponds to the early reports in Business Insider (link above). This Editor wonders if they ever will beyond a filing with the SEC. Also Wall Street Journal.  One wonders how long they can keep mum to customers and shareholders.

In addition, if WARN notices aren’t filed at locations with 50+ employees and layoffs aren’t delayed for 60 days, expect blowback at the US and state department of labor levels plus class action lawsuits. Oracle may actually sneak under this particular wire with dispersed locations and remote workers. Updated 2 April: A WARN notice was filed in Missouri, home to most of Oracle Health’s employees at the Kansas City campus. 539 employees have been laid off effective 26 May-1 June, which fulfills the 60 day notice requirement. Reportedly they are on payroll but not working. As of now, Oracle will keep the campus open. We previously noted that KC gave Cerner and later Oracle considerable incentives to build that campus. Fox 4 Kansas City

Chutes and Ladders: UnitedHealth sued by faith-based investor group, Qualified Health raises $125M, Cerebral acquires Inflow ADHD app, Flourish Care’s $5.7M seed

March 26, 2026 | by

In the Chutes department, once again UnitedHealth Group can’t catch a break. This time it’s a shareholder lawsuit by a Quebec-based religious non-profit group, Fond des Missions (formerly the Fond Durocher). They had submitted a proposal to UHG for inclusion in its proxy materials for the 2026 Annual Meeting. It requested a report from the Board of Directors that describes the healthcare consequences of its acquisitions over the past 10 years–a very interesting take on UHG’s acquisition strategy, how it runs a reported 2,700 subsidiaries, and whether this strategy benefits member health.

UHG declined the request on the basis that it related to “ordinary business” and attempted to “impermissibly micromanage” the company’s operations. The Securities and Exchange Commission (SEC) did not object to (not agreed with) UHG’s decision due to shutdown-related backlogs at the agency. This decision to omit the proposal made Fond des Missions unhappy enough to file a lawsuit this week in the US District Court for the District of Columbia. The suit seeks to enjoin UHG’s decision to omit the proposal from a shareholder vote as unlawful under SEC regulations and award Fond the costs for the suit.

Fond des Missions was founded as a Canadian charity by the Roman Catholic Congregation of the Sisters of the Holy Names of Jesus and Mary. Their missions are active in Africa, South America, and North America. It is a member of the Interfaith Center on Corporate Responsibility, a coalition of more than 300 faith-based investors. For last year’s annual meeting, Interfaith had submitted a proposal for a vote on the effect of healthcare delays and denials on the public. This was also rejected. Whether this suit will be decided in time for this year’s proxy materials and the annual meeting, usually mid-year, is to be determined. Healthcare Dive

In Ladder-land, Qualified Health raises $125 million in a fresh Series B. The new funding was led by New Enterprise Associates, Inc. (NEA), with participation from new investors Transformation Capital, GreatPoint Ventures, Cathay Innovation, and Menlo Ventures’ Anthology Fund, an AI innovation fund created in partnership with Anthropic. Earlier investors also participated, bringing the public benefit company’s total raise to $155 million. Qualified Health’s platform provides health organizations with the infrastructure to deploy and scale generative AI in areas such as governance frameworks, post-deployment monitoring and role-based access controls. The new funding will enable the PBC to further deploy their platform to additional health systems such as Mercy, Emory Healthcare, University of Rochester Medicine, Jefferson Health, and University of Texas System. Release, Mobihealthnews

Cerebral expands its mental health platform with ADHD app Inflow. The Inflow app will add additional support options to telementalhealth provider Cerebral’s ADHD patients via Cognitive Behavioral Therapy (CBT) and personalized tools. Neither acquisition cost nor management transitions were disclosed, although both will operate separately. Cerebral has come a long way from their near-death controlled substance distribution violations, finally settled with the DEA and DOJ less than two years ago [8 Nov 2024]. Release, Mobihealthnews

And in the burgeoning women’s health segment, Flourish Care gets a boost with a $5.7 million seed round.  Their hybrid services combine both virtual care and in-person maternity care delivered by local, credentialed doulas. The doulas are maternity experts who guide mom through pregnancy, birth and baby’s first months at home. Over 40 health plans offer the service with minimal or zero out of pocket cost. The raise was led by Zeal Capital Partners with participation from Rogue Women’s Fund, Collide Capital, Symphonic Capital, Capita3, Slater Technology Fund, Create Health Ventures, Catalytic Impact Foundation and others. Release, Mobihealthnews

‘AI doctor’ Doctronic raises $40M Series B, but faces controversy on autonomous Rx renewals in Utah and effectiveness claims

March 26, 2026 | by

Doctronic’s raise impresses, but so do the questions around its AI tech. Earlier this week a hot AI telehealth startup announced a hefty (for these times) $40 million Series B raise that topped off a Series A of $20 million last September and a $5 million seed round in April. The $40 million was funded by Lightspeed Venture Partners, Union Square Ventures, MANTIS Venture Capital, Davidovs Venture Collective, and Abstract. The New York City-based company was founded in 2023 and only constructed its clinician network in early 2025. It claims to be on track to earn $10 million in revenue in 2026.

The basic health tech sounds not that unusual: a chatbot discusses your medical concerns and questions, much like a Claude for Healthcare, Microsoft Copilot Health, Teladoc, Ro, or even Google Gemini. The next step is a clinician referral, available 24/7 in all 50 states, for a low $39. It also claims to securely retain your information and timeline/meds/labs, not using the data for AI training.

Where the controversy centers is Doctronic’s first-ever state-approved autonomous AI test with the state of Utah. Announced in January, it will test whether a chatbot agent can evaluate and renew existing prescriptions for Utahns without human clinical oversight. In the pilot first phase, the renewals, which include 192 drugs for chronic conditions, will be overseen by clinicians before being sent to a pharmacy, but the intent is to move through this phase quickly to a pilot of full prescription renewal autonomy. Utah is permitting this through the Utah Department of Commerce’s Office of Artificial Intelligence Policy. The goal is to speed renewals of maintenance medications, the majority of activity, thus reducing medication noncompliance. Non-compliance is a leading driver of preventable health outcomes and with health decline, avoidable spending. Utah Department of Commerce release, Doctronic blog

Benefit manager Healthesystems outlined the process for its blog, with a view to the issues. “At the Doctronic prescription renewal portal, patients must confirm that they are located in Utah, enter the medication they want refilled, and then select an in-state pharmacy for fulfillment. Users must then upload their ID, along with a verification selfie and proof of an old prescription and then pay a $4 service fee. The AI system reviews the information to ensure a prescription history exists, after which a health assessment is given, where patients must answer certain questions before the program issues a refill. If the AI is uncertain if a prescription should be renewed, it refers the patient to a Utah-licensed human physician.”

A big reveal is here. The physician review prior to being sent to the pharmacy is for only the first 250 patients; the next 1,000 patients will be reviewed retrospectively. After that, only 5-10% of renewals will be audited after the fact, monthly. The issues for the two Healthesystems reviewers are risk–missing a loss of stability or extended renewals beyond original intent, for instance–and maintenance of oversight. Who is ultimately held accountable for the chatbot’s actions? 

A JAMA Health Forum article (19 March) raises additional issues. There apparently has been no pretesting of the prescription chatbot, only simulation testing. The application references a preprint study in medRxiv, written by equity owners in the company and only about the existing website chatbot. Moreover, the agreement is well-hedged to protect Doctronic. FTA:

If prescription errors injure patients, Doctronic’s accountability is murky. Its contract requires it to compensate Utah for any liability costs the state incurs and Doctronic took out a special malpractice insurance policy. Yet, the terms of service that users of the prescription renewal system must agree to—which seem to have been developed for the company’s AI doctor system—currently state that Doctronic disclaims all responsibility and liability for system accuracy or harmful outcomes.

A further oddity is that the Utah contract relieves Doctronic of the obligation to “generate, maintain, and make available to each patient” the patient’s medical records.

It closes with a short discussion of ‘scope creep’ (Editor’s emphasis): “Once an AI system has secured acceptance, vendors may be able to push updates that include substantial changes without attracting the same degree of scrutiny as the initial adoption. Concerns that low-risk pilot programs may legitimize higher-risk deployments at scale have been expressed about the Centers for Medicare & Medicaid Services’ new pilot program using AI to conduct prior authorization reviews of some services in traditional Medicare plans.”

And where is the proof that the AI chatbot can’t be spoofed? STAT (Mario Aguilar), who has been following Doctronic, located a February test by UK-based cybersecurity firm Mindgard that tested Doctronic’s existing chatbot and fooled it into into believing deliberate “official” misinformation, a bogus guideline that allowed triple the standard adult normal dose of Oxycontin, a Schedule II controlled substance. Sergei Polevikov in AI Health Uncut (subscription required, but you should) describes it in far greater and scary detail, including his own test. He also points out and analyzes other Doctronic questionable claims, such as volume (claiming 24 million ‘helped’ not borne out by website traffic), problems with the Utah formulary and refilling several problematic drugs, an odd connection with a Belarus company, and whether this should be regulated by FDA.  To be continued.

Drafted House bill may threaten VA/Oracle EHRM rollout

March 25, 2026 | by | 1 Comment

The VA’s EHR modernization (EHRM) plans may be hearing screeching brakes or a swerve if this bill sees daylight. Last week’s House Committee on Veterans’ Affairs reviewed 27 bills plus five discussion drafts as part of its sweeping reauthorization initiative to review, improve, and reauthorize specific programs and sectors at the Department of Veterans Affairs (VA). Many of these programs haven’t been reauthorized by Congress in three decades. House VA Committee release 18 March

A two-year leash. Of most interest re the EHRM plans is the 33-page discussion draft (PDF) of a bill proposed by Rep. Nikki Budzinski (D-IL), “To provide for the modernization of the electronic health record system and other health information technology activities and systems of the Department of Veterans Affairs, and for other purposes.” It specifies a series of reports from the VA Secretary that constitute ‘guardrails’ on the EHR  implementation–a noun used extensively by both Chairman Bost and member Budzinski. At the 18 March meeting, according to FedScoop, Rep. Budzinski’s proposed bill would require the VA to “create a baseline of clinical and business workflows, as well as technical requirements, to ensure the standardization of VA practices and systems.” It would also set new “health care quality metrics” based on the VA’s own Strategic Analytics for Improvement and Learning Value Model, and new reporting and independent verification and validation requirements.” If the bill becomes law, the VA secretary has two years to certify that the system’s requisite baselines and metrics “show consistent improvement” and that at least two VA facilities implement the Oracle EHR with the certifications in place. What this bill does introduce is to prevent any renewal or options for the Oracle contract if the requirements aren’t met. 

The question that this Editor would pose to Rep. Budzinski is: isn’t this bill and its requirements coming a little late in the day? 13 health system EHR rollouts are already planned, starting in April for the year, announced in February by the EHR Modernization Integration Office (EHRM-IO) [TTA 8 Feb]. The VA stopped Oracle EHR rollouts in 2023 save for Lovell in Chicago. Since then, the original six disastrous installs have been overhauled and tested. There have been multiple hearings, floggings of Oracle executives, and extensive reports from the VA’s Inspector General. What does this bill add to the mix, and do these ‘guardrails’ add meaningfully to performance?

The Committee chair, Rep. Mike Bost (R-IL), reportedly wants to use an NDAA-style process (named after the National Defense Authorization Act) to unify the bills into one ‘must-pass’ legislative bill. One can expect that some of the bill’s language will be written into the final bill, but it will be, in true House fashion, picked over and simplified from the elaborate language in the draft.

It makes Oracle’s clean performance on the upcoming VA EHRM implementations even more critical, yet…

Yet another factor. By end of month, the rumored 20-30% Oracle layoffs, outlined with some specificity on boards such as Reddit, will  undoubtedly hit Oracle Health hard. Oracle has a contract, governmental, and regulatory obligation with the VA. Despite that, the rumors also say that even those areas will be hit, perhaps less hard, but still reduced in size–sacrificed for the financial obligations tied into the New Shiny Object, datacenters. [TTA 6 March, 10 March] This is also despite Oracle’s strong Q3 showing which didn’t break out Oracle Health. Something has to give, and it’s politely called ‘restructuring’. 

News roundup: Microsoft debuts a rebooted Copilot Health, Stryker whacked by Iranian cyberattack, Amazon buys Rivr robotics for delivery, Turquoise Health’s $40M raise, Verily raises $300M to shake off Alphabet control

March 20, 2026 | by

Microsoft joins the AI health chatbot club with a rebooted Copilot Health. Copilot Health will be much like its competitors:  OpenAI/ChatGPT for Health and Anthropic’s Claude for Healthcare [TTA 28 Jan]. It allows consumers to upload their medical records, health histories, and data from wearables and connected devices, then draw on that information to organize, analyze, and provide guidance to individuals. It’s a reboot because, as Sergei Polevikov of AI Health Uncut revealed, Microsoft debuted Copilot for Health last October. The earlier iteration lacked access to EHRs and medical records other than personally held. Copilot Health now uses HealthEx to connect to EHRs, hospitals, and patient portals, and pull that information after consent–same as Claude for Healthcare. (ChatGPT uses b.well) Mr. Polevikov makes the logical argument that the HealthEx API (and b.well’s) already have the full framework standards and compatibility to be marketed DTC, for the consumer to do as he or she pleases. Unlike ChatGPT and Claude, there is no provider version. (ChatGPT’s consumer version is still in slow rollout.) Healthcare Dive, AI Health Uncut (subscription required)

Orthopedics device and robotics giant Stryker cyberattacked, recovering, Iranian hacktivists identified. Last Wednesday (11 March), Stryker revealed that a severe, global cyberattack disrupted its customer support, ordering, manufacturing, and shipping operations, wiping information from . It affected operations within the Microsoft environment. It has not affected products including connected products.  As of Tuesday, Stryker reported that it had been “contained” on the damage they are aware of and that systems are starting to be restored, though the full scope of the disruption is not yet known. Other reports indicate disruption and wiping on multiple systems. 

According to DataBreaches.net and Bleeping Computer, the Iranian-linked Handala hacker group claimed that they had stolen 50 TB of data, then wiped tens of thousands of systems and servers across the company’s network including applications such as Intune Company Portal, Teams, and VPN clients often used on personal devices. Handala is “linked to Iran’s Ministry of Intelligence and Security (MOIS) that targets Israeli organizations with destructive malware designed to wipe Windows and Linux devices.” Their message on Bleeping Computer positions the hack as retaliation against Israeli attacks on Iran and calls Stryker a “Zionist-rooted corporation”, which is rather ‘rich’ for a company founded and HQ’d in Kalamazoo, Michigan. Healthcare Dive 13 Mar, 17 Mar

Amazon buys Rivr to test robot delivery. The Swiss startup has limited information on its website (but plenty of video). It has developed 4 wheeled “General Physical AI” robots with legs that can negotiate steps and drop off packages. Amazon intends to test the Rivr robot for doorstep delivery to assist its third-party delivery contractors who perform the arduous and highly pressured ‘last mile’ delivery from Amazon warehouses to customer doors. Amazon has been investing in robotics since 2012 for warehouse operations. It previously invested in Rivr’s $22 million seed round last March through its Industrial Innovation Fund and Bezos Expeditions, Jeff Bezos’ VC firm, for a valuation of $100 million. Rivr tested the delivery robots last year in Austin with Veho, a package delivery service, though the final outcome (scaling to 100 robots) is not confirmed.  CNBC, TechCrunch

Turquoise Health scored a $40 million Series C funding. Turquoise is a pricing and payment platform that connects data, contract intelligence, and revenue cycle workflows for clear pricing transparency and to reduce the cost of errors in administration, claims, and reimbursement. The round was led by Oak HC/FT, with participation from existing investors including Andreessen Horowitz, Adams Street Partners, and Yosemite, for a total raise of $100 million. Release, MedCityNews 

And winding up the week, Verily raises $300 million–and independence from Alphabet. Now rebranded as Verily Health Inc., it is now a precision health solutions company. It has pivoted since at least 2016 from various iterations as originally the Google X life sciences ‘skunkworks’–devices, bioelectronics, smart contact lenses, smartwatches, smart diapers…  The funding was led by Series X Capital, with participation from Alphabet, UCHealth, the University of Colorado Anschutz and other investors. Alphabet remains a significant minority investor in Verily, while no longer having a controlling stake.  Release 

Perspectives: Telehealth as Infrastructure–Building a Financially and Clinically Sustainable Virtual Channel

March 19, 2026 | by

TTA has an open invitation to industry leaders to contribute to our Perspectives non-promotional opinion and thought leadership area. Today’s topic is how clinicians can take advantage of the telehealth flexibilities extension to 2027 by integrating telehealth and virtual care fully within their operational workflow and within patient care. The author, Matthew Order, is Vice President of Business Development at Yosi Health. He has more than 20 years of healthcare technology and SaaS experience including previous roles at MEDITECH, athenahealth and Buoy Health. At Yosi, he leads enterprise adoption across health systems, translating product integrations into measurable operational improvements for practices and patients.

The Centers for Medicare & Medicaid Services (CMS) recently extended many Medicare telehealth flexibilities through December 31, 2027. That policy decision signals what providers already know: telehealth is no longer a short-term option to expand access to care, but a permanent channel of care delivery.

That policy certainty is welcome, but it also exposes a hard truth: simply offering video visits won’t deliver value unless telehealth is embedded into the day-to-day operational workflows of the practice. Clinics that want telehealth to reduce cost, improve access, and protect revenue must redesign the patient journey so virtual care is predictable, reimbursable and measurable.

Here are the practical, operational steps clinics should take now.

Move pre-visit upstream

The biggest operational losses happen around patient visits, e.g. when intake is incomplete, insurance is unknown, or staff must chase missing information. One way to change this is by moving pre-visit work upstream: require or encourage patients to complete digital intake forms before an appointment and surface those discrete data fields directly into the chart. This isn’t just a patient convenience, it fundamentally changes how front-office work gets done. Studies show that centralizing reminders and automating pre-visit tasks improves appointment utilization and reduces no-shows, two levers that matter for telehealth ROI.

Treat eligibility as clinical infrastructure, not an afterthought

Nothing kills collections faster than an unpaid copay or an ineligible telehealth claim. Embed real-time eligibility and benefits checks into the pre-visit flow so patients see their financial responsibilities before the encounter and staff can resolve red flags ahead of time. Organizations that operationalize eligibility verification as a revenue-cycle control point report fewer denials and faster time-to-cash. This is the difference between telehealth being a marginal convenience and a reliable revenue stream.

Design rule-based automation for phone and scheduling channels

Studies show over 60% appointments are still made by phone. If your telehealth offering can’t integrate with phone volume and scheduling rules, it is difficult to scale. Deploy rule-based automation that reads live availability, applies clinic booking policies, verifies benefits, and either completes the booking or hands off with full context to a human. For transactional tasks, rule-based systems often outperform free-form AI systems because they reduce follow-ups, corrections, and operational risk.

Measure clinical and financial outcomes, not vanity metrics

Define a tight set of KPIs tied to margin and access: completed telehealth visit rate, no-show reduction, denial rate for telehealth claims, point-of-service collections, and staff minutes reclaimed per patient. A simple 60–90 day pilot with baseline and target thresholds will tell you whether integration and automation are working. And instrument technical reliability as well; API success rates, data mapping accuracy, and escalation quality matter just as much as outcomes.

Protect equity and patient experience as you scale

Telehealth should expand access, not create new disparities. Make digital intake mobile-first and low-bandwidth, provide multilingual options, and maintain assisted touchpoints (phone registration, in-clinic support) for patients who need them. Evaluate patient satisfaction specifically by channel; a good telehealth system should reduce friction, not shift it elsewhere.

Make governance non-negotiable

Without clear operational ownership, telehealth programs drift and performance deteriorates. Who owns booking rules? Who maintains payer mappings? What are clear escalation policies for clinical red flags? Assign cross-functional ownership (e.g. operations, revenue cycle, clinical leaders, and IT) and lock in a change-control cadence that prevents “rule drift” as policies and payer contracts change. Evidence that EHR workload-per-visit can rise even when visit volume falls illustrates why governance and workflow redesign must accompany modality shifts.

Pilot pragmatically—and scale what earns results

Don’t rip-and-replace overnight. Start with two tightly scoped pilots: for example, telehealth follow-ups for chronic care and virtual urgent visits for same-day access. Keep pilots time-boxed, assign a process owner, and require week-over-week reporting on the KPIs that impact margin and access. If real-time eligibility and pre-visit intake reduce denials and nursing callbacks in the pilot, scale; if not, iterate.

Why this matters now

Policy windows like CMS’s telehealth extension present a rare opportunity – but only practices that pair clinical intent with operational discipline will secure lasting gains. With continued Medicaid churn and administrative pressure on primary care, clinics can’t afford telehealth programs that add friction or unpredictability. Integrating intake, eligibility verification, automation, and governance turns telehealth into a reliable channel for expanding access and stabilizing revenue. Recent analyses from KFF highlight how enrollment volatility is already increasing administrative burden across care settings.

By operationalizing telehealth – moving work upstream, protecting revenue at intake, automating predictable tasks, and measuring what counts – clinics can shift from friction to flow. That’s the difference between telehealth that breaks even and telehealth that delivers sustainable access, better outcomes, and measurable financial returns.

Short newsy takes: Amazon Connect Health AI, UHS buys Talkspace for $835M, Oura buys Doublepoint, Science Corp.’s $230M raise, VSee’s debuts first autonomous telehealth robot

March 12, 2026 | by

Our roundup is up!

Amazon adds Amazon Connect Health agentic AI for provider workflows to their roster. Amazon’s multiplicity of niches in healthcare adds a new solution, this time targeting providers. This is part of AWS’ health suite for EHRs, designed to handle high-volume administrative tasks such as appointment scheduling, clinical documentation, and medical coding. It also targets builders in EHR companies, healthcare ISVs (independent software vendors), and tech-enabled providers through a unified software development kit (SDK)  to directly integrate Amazon Connect Health’s point of care capabilities into their existing workflows. It is based on the company’s Amazon Connect cloud contact center platform. Netsmart, Veradigm, and Greenway Health all use it, with Netsmart claiming an increase in ambient documentation adoption by 275% in its 1,300+ client network. Amazon release, HIStalk 3/6/26, Mobihealthnews

UHS beefs up its behavioral health capabilities with Talkspace. Universal Health Services (UHS) is a national for-profit provider of health services that include acute care hospitals, behavioral health, healthcare management, and even a health plan. For UHS, expanding their behavioral health services faced staffing shortages that has stymied patient utilization and growth, plus creates a continuum of in-person and virtual telemental health.

Talkspace was a fairly early entrant in virtual behavioral health services. It has grown to national coverage with over 6,000 therapists despite being a cracked SPAC from June 2021. Back then, it went public at $8.90 on Nasdaq with approximately 152 million shares outstanding for a valuation of $1.4 billion. Six months later, shareholders sued for securities fraud, and by June 2022 shares had plunged to the dollar level, becoming a Cracked SPAC Poster Child. But they patched the cracks (unlike others) and closed 2025 with $229 million in revenue, profitable with an adjusted EBIDTA of nearly $16 million, and 1.6 million patient sessions. They rebuffed buyers until this week. UHS is acquiring for $835 million or $5.25 per share, a 10% boost on their closing 8 March, subject to the usual Talkspace shareholder and regulatory approvals. There is no mention of management or employee transitions. Closing is expected during Q3 this year. Talkspace release, Healthcare Dive, Becker’s

Really Short Takes!

  • Biometric ring Oura is buying Helsinki-based Doublepoint, a private company that enables gesture recognition in wearables. Doublepoint staff including the founders will join Oura and remain in Helsinki. Acquisition cost is not dislosed, but Oura seems to have enough cash on hand with last year’s $900 million Series E leading to an $11 billion valuation. Mobihealthnews
  • BCI implant developer Science Corporation raised $230 million in Series C funding. Lightspeed Venture Partners, Khosla Ventures, Y Combinator, IQT and Quiet Capital were the main funders for a total funding of $490 million. Science is a competitor of Elon Musk’s Neuralink, but is concentrating on a BCI retinal implant aimed at restoring form vision to patients blinded by macular degeneration. PRIMA in a clinical trial restored vision to those blinded by geographic atrophy due to age-related macular degeneration. Mobihealthnews
  • And veteran telehealth robotics company VSee debuted the VSee AI Robot at HIMSS. According to their release, it is the first fully autonomous telehealth robot. It uses LiDAR (Light Detection and Ranging) for navigation. VSee’s market is hospitals, ICUs, and health systems. Remote clinicians can independently navigate the robot directly to a patient’s bedside without engagement by onsite staff for rounding, telestroke response, and specialist coverage. Pretty neat! VSee release

FDA warns 30 telehealths on compounding GLP-1s, while Hims & Hers cuts deal with Novo Nordisk, buys Australia’s Eucalyptus for $1.1B

March 12, 2026 | by

Wasn’t this GLP-1 compounding tussle supposed to be over by now? FDA has sent warning letters to 30 telehealth companies warning them about their continued sale of compounded GLP-1 drugs. The warning letters centered on the companies promoting false and misleading claims regarding compounded GLP-1 products offered on their websites and are sent from FDA’s Center for Drug Evaluation and Research (CDER).  According to FDA’s release, “primary violations identified in the letters included making claims implying sameness with FDA-approved products and obscuring product sourcing by advertising drug products branded with the telehealth firm’s name or trademark without qualification, implying they are the compounder.” The letters were sent out since September when the agency cracked down on misleading DTC pharmaceutical claims.

Companies with letters listed on FDA’s warning letter page (search on GLP-1) with false and misleading claims on GLP-1 drugs as the subject include LeanRx/SkinnyRx, GoodGirl Rx, Kin Labs, Better Health/Measured, Zeuss, Eli Lilly (3 letters!), Novo Nordisk (!), . A compounder, Boothwyn Pharmacy, LLC, Darmerica, and Chengdu Brilliant Biopharmaceutical received letters for adulterated drug products.

More than misleading claims, many of the letters warn more seriously of the “unlawful sale of unapproved and misbranded drugs to United States Consumers over the Internet”. These companies dating back to 2024 include Hims & Hers, the HCG Institute, GenLabMeds, Villas Health, FitRx/Zealthy, FWD Care, Elevate Your Wellness/Elevated, Sprout Health, Mane & Steel, Lumimeds, GLP-1 Solution, Body Good Studio, www.buynetmeds.com, USApeptide.com, Xcel Research, Summit Research Peptides, Veronvy, Prime Peptides, Swisschems, Nomida.biz, Bioverse, Synthetix Inc./Helix Chemical Supply, US Chem Labs, www.semaspace.com, and www.gorillahealing.com.

A clinical investigator/sponsor, Ralph A. DeFronzo, MD, also received a warning letter.

Compounded drugs are not FDA-approved. GLP-1 drugs were approved in 2024-2025 for compounding because there was an extreme shortage, driven by demand, of approved GLP-1 drugs. FDA also permits a custom, compounded version of a drug if the branded drug is in some way inappropriate for the patient requiring a customized version, e.g. with adjusted dosage, method of dosing, or added/deleted ingredients. With both injectable and pill versions of GLP-1 drugs widely available, the compounding approval was withdrawn in February 2025. [TTA 25 Feb 2025]

FDA Commissioner Marty Makary, MD, MPH was quoted in the release as stating “It’s a new era. We are paying close attention to misleading claims being made by telehealth and pharma companies across all media platforms—and taking swift action. Compounded drugs can be important for overcoming shortages or meeting unique patient needs—but compounders should not try to compound drugs in a way that circumvents FDA’s approval process.” EMJ, The Hill, Advisory

Hims & Hers not only received an FDA warning letter, plus a referral to DOJ, but also was sued by Novo Nordisk over patent infringement in February. Novo charged that Hims infringed on its semaglutide patents and introduced an unauthorized compounded GLP-1 pill right after Novo introduced its FDA-approved Wegovy pill. The lawsuit was filed on 9 February in the US District Court for the District of Delaware. Release  Hims pulled the compounded drug within days. In addition, Health and Human Services (HHS) had referred Hims to the Department of Justice (DOJ) for potential criminal violations. Sometimes it doesn’t pay to be the showiest horse in the ring.

But…a month later, on Monday, Novo and Hims arrived at an agreement that permits Hims to sell Novo’s Wegovy and Ozempic, in both pill and injectable versions, while Hims no longer markets compounded GLP-1 drugs. Novo dropped the lawsuit but reserved the right to resume it if there were further violations. Patients will be transitioned from present compounded drugs to “FDA-approved alternatives when clinically appropriate in consultation with a healthcare professional”. CNBC, Novo Nordisk release

Hims stock also staged a remarkable recovery, rising on Monday from $15 to $23, closing today at nearly $26, a nearly 10% rise.

In the interim, Hims didn’t stand still. It announced the acquisition of Eucalyptus, an Australian telehealth provider, on 19 February. Eucalyptus is Australia’s largest telehealth company and operates several virtual clinics and brands, including weight loss platform Juniper, men’s health program Pilot and fertility and reproductive care platform Kin. It also accelerates Hims’ international growth and push into APAC markets, since Eucalyptus markets in Japan as well as UK, Germany, and Canada.

According to the release, Hims is paying “up to US$1.15 billion, subject to customary purchase price adjustments. Approximately US$240 million will be payable in cash upon closing of the acquisition. The remaining consideration consists of guaranteed deferred payments over the 18 months following closing, and additional earnout payments tied to the attainment of specified financial targets through early 2029.Hims & Hers has the option to settle the majority of deferred and earnout payments in cash or stock, at its election. The company is currently prepared to finance most of the transaction with existing cash on hand and future operating cash flows from its U.S. operations.” The transaction is subject to closing and regulatory approvals. MedCityNews

Oracle’s ‘beat the Street with a club’ Q3 performance

March 11, 2026 | by

Oracle had good news yesterday. Its Q3 2026 closed with strong earnings per share ($1.79 adjusted EPS versus expected $1.70), GAAP adjusted EPS at $1.27, and revenue topping $17.19 billion versus the expected $16.91 billion. All three were up versus prior year by 20% or more for the first time in 15 years. They had $8.9 billion in total cloud revenue, including infrastructure and SaaS, beating analyst estimates of $8.85 billion. Q4 revenue is also expected to grow in the 20% range versus prior year, while EPS in the 17-20% range. Oracle’s Q3 closed 28 February, making for an unusual quarterly structure.

For FY2026, Oracle projects revenue of $67 billion and capital expenditures of $50 billion. FY2027, starting 1 June, is pegged at a stunning $90 billion, again beating industry analysts’ consensus of $86.6 billion. 

In terms of financing and raises, Oracle last month had announced that they intended to raise an additional $50 billion dollars in debt and equity financing. Beyond this, they do not expect to issue any additional bonds in CY2026. There is a substantial backlog of what’s called “Remaining Performance Obligations” that more than quadrupled to $553 billion from a year earlier, but from the release, “Most of the increase in RPO in Q3 related to large scale AI contracts where Oracle does not expect to have to raise any incremental funds to support these contracts as most of the equipment needed is either funded upfront via customer prepayments so Oracle can purchase the GPUs, or the customer buys the GPUs and supplies them to Oracle.”

Overall, it looks like a good year for Oracle as they focus on cloud and AI infrastructure. But the stock, which rose late today by 8-10%, still is beaten down 50% from its high last September. There is still a lot of skepticism by Mr. Market about hyperscaling AI, how fast this can be done, profitably, and specifically about Oracle’s hefty debt burden. 

There is not one word about Oracle Health, either in their release or on reporting this Editor has reviewed about the investor call–or about layoffs which would impact Q4.  Yahoo Finance, CNBC

Oracle’s rock-and-hard place in Abilene TX: building out a data center with Nvidia chips that are already obsolete–and the financing it takes (updated)

March 10, 2026 | by

Another mystery solved, not looking good for Oracle. In yesterday’s update to pending record layoffs at Oracle, affecting Oracle Health, new reporting mentioned the breakdown of Oracle’s expansion agreement with OpenAI in building out a leased data center for OpenAI in Texas. Additional details have now come to light in reporting by Bloomberg (hat tip to Brody Ford and team), with separate reporting by CNBC.

The overall impression is not a good look for Oracle. This analysis combines both articles from their sources, plus additional background.

  • The location is part of a 1,000 acre site in Abilene. It is not just any datacenter build site. It is the first part of the $500 million Stargate Project, announced last year by the White House–a multi-year, public-private initiative with the objective of creating leading AI infrastructure within the US. The initial equity funders are OpenAI, Oracle, MGX, and SoftBank. OpenAI release 21 Jan 2025
  • Several parts are already built by the developer, Crusoe, and are up and running. But power for much of it won’t be on for another year.
  • Oracle has already filled the Abilene site with servers which are used by OpenAI for training and deployment. These facilities are on track.
  • Oracle, Crusoe, and OpenAI had been discussing since midpoint 2025 about expanding the facility by almost double, from 1.2 to 2 gigawatts of power demand. (See below for explanation of how big a gigawatt is.)

The differences between Oracle and OpenAI, two of the Stargate equity investors, apparently center on timing for opening the expansion site, which won’t be till next year; the use of a now older generation of Nvidia chips; and Oracle’s financing for the site. There are also differences with Crusoe, the developer.

  • Oracle had already committed to the site expansion, ordered the hardware, and already spent billions on construction and staff. The processing power would be based on Nvidia’s Blackwell chips.
  • The problem: Nvidia is now bringing out chips every year. It is already producing its Vera Rubin* chip, unveiled at January’s CES. Vera Rubin delivers five times the inference performance of Blackwell. Inference is critical to AI actually doing a job based on real world data.
  • OpenAI was not happy about being tied to Oracle’s commitment to Blackwell, already a less powerful and capable chip. There was also Oracle’s unhappiness over OpenAI’s often-changing demand forecasting.
  • Crusoe was also unhappy about the current Oracle facility’s downtime for days during the winter, attributed to weather affecting some of the liquid cooling machinery. This points to Oracle’s planning and building leading to reliability problems.

Three part unhappiness=plan cancellation. Meta is considering leasing the expansion site, brought to Crusoe by Nvidia, according to Bloomberg’s sources.

The ‘hard place’ that Oracle is in is this: the construction of data centers and their power sources is a 12 to 24 month taffy pull. At minimum. Things change in that time, like chips. Meanwhile, one ‘rock’ is that computing power for AI, whether Nvidia or AMD, is growing every year. First line AI companies like OpenAI (or Anthropic for that matter) want the latest, because that is critical to their business. Another ‘rock’ that Oracle has is that the datacenters are being financed via at least $100 billion in debt. Google, Amazon, Meta, and Microsoft are able to finance datacenter builds via their cash-generating businesses, even if this hyperscaling means that the cash cows become somewhat starved for feed. Oracle has to advance money in construction and equipment it must raise in debt markets for a return that may come in a year, two, or even more. [TTA 5 Feb] In other words, Oracle is in a tight spot compared to competition. The likely solution? Further downsize its businesses and employees to afford the Ellisonian Transformation as noted yesterday. 

The ‘rub’ of course is that what the OpenAIs and Anthropics want–the latest and greatest chip in their datacenters–isn’t possible in the brick-and-mortar world. Not even if you have tremendous cash flow out of your faucets and Blackbeard’s Chest in your bedroom.

Update 10 March: Oracle denies all of the above reporting. Here is Oracle’s reply on X.

Recent media activity about the Abilene site are false and incorrect. First, Crusoe and Oracle are operating in lockstep to deliver one of the world’s largest AI Data centers in Abilene at record-breaking pace. Two buildings are completely operational and the rest of the campus is on track. Second, Oracle has completed leasing for the additional 4.5GW to deliver on our commitments to OpenAI.

Unpacking this, Abilene is already a center for Oracle and OpenAI, as noted above. The expansion was only supposed to be 2 gigawatts, not 4.5, but Oracle and OpenAI have other sites that this could be referring to.

In effect, Larry Ellison, a 40% shareholder of Oracle, should bet the farms, the boats, and Lana’i to make these AI datacenters happen–if he really believes this is the future. Will he? And will they be revenue positive–quickly–to pay off the bet? Mr. Market’s stock price is still stuck on skepticism.

A corollary issue: there is major pushback against datacenters, rising up like daffodils in the early spring, but far less beautiful:

  • Extreme power consumption of datacenters causes rising rates for commercial and residential users. The Crusoe Oracle facility, according to the Bloomberg article, uses about 1.2 gigawatts and was seeking to expand to 2 gigawatts. One gigawatt is equivalent to one nuclear reactor and power to 750,000 homes.
  • Their massive, brutalist landscape footprint. If you like warehouses, you’ll love datacenters filling what used to be fields.
  • Their low employment after they are built, the scale of tax incentives that are being dished out, versus the capital investment required. This article from Futurism reports that one heavily subsidized datacenter facility run by Ark Data Centers in Ohio will employ upon completion exactly 10 people. Yet it is being heavily subsidized by Ohio through a 50%, ten-year sales exemption covering mainly new equipment–estimated to total $4.5 million. That is $450,000 per person over the 10 year span, or $45,000 per year subsidizing generally lower wage jobs in IT and security. One cited analysis, which could be exaggerated, indicated that in Virginia, one datacenter job took 100 times the capital investment for similar jobs in other industries. (Editor’s note: yes, these are single analyses and could be biased, nor factor in cash flow.)

Returning to Oracle, we await another shoe drop today on their earnings, projected layoffs, and their impact on Oracle Health.

*Named after the pioneering American astronomer, known for her work on galaxy rotational rates and the discovery of ‘dark matter’.

Breaking–Oracle to lay off thousands due to AI data center cash crunch, possibly as early as next week. What’s next? (Updated)

March 6, 2026 | by

We now know another piece of the puzzle on why so many Oracle Health top executives have departed. Bloomberg’s Brody Ford has followed up his earlier report on five departures  of key executives at Oracle Health [TTA 3 Mar] with the not-unsurprising news that there will be thousands of layoffs at Oracle, starting as early as this month. The reason why is Oracle’s aggressive expansion into data centers and the shortage of free or loaned cash available for that expansion, necessary to remain competitive in cloud computing with Amazon and Microsoft. (That situation, and the speculation around it, is explored in more detail in our article here.)

The pennydrop was as early as last September in a filing, according to Mr. Ford. It was estimated in the filing that $1.6 billion in restructuring costs will hit this FY, which ends in May. Oracle as of last May had 162,000 employees worldwide.

According to Mr. Ford’s sources, the layoffs will not be the ‘usual’ rolling layoffs, but wider reaching. He cites an internal announcement that “it would be reviewing many of the open job listings in its cloud division.” Some of the cuts will be targeting jobs Oracle needs fewer of because of AI. He cites the reception of Microsoft’s AI-related layoffs and Block, Inc, founded by CEO Jack Dorsey, laying off nearly half of its staff due to supposed leaps in AI (but more likely due to ballooning hiring not compatible with cash flow).

The scuttlebutt on Reddit indicate the cuts could be as high as 20% with the US operation hard hit, and strike as early as next week. Since Oracle has not been shy about cutting jobs over the years (see Mr. Ford’s article), this high number is a surprise. Another bit of information gleaned off Reddit is that the OHAI reporting line has changed from TK Anand to “Clay”–possibly co-CEO Clay Magouyrk, versus Mike Sicilia who testified before Congress two years ago when the VA implementation cratered?

Editor’s analysis and opinion: With five major executives leaving OHAI (Oracle Health and AI), she continues to believe that many of the cuts will hit the health area. Yet OHAI is the area that has taken tons of flak from current customers, from Congress on Veterans Health, from the VA, and from health systems. 

  • Oracle has major Federal contracts. The prominence of the VA contract and rollout timing makes cuts in this area problematic. Just because EHR problems have supposedly been fixed and that both the VA and Oracle are set to roll it out, VISN by VISN, does not mean that AI can do it. It is a long and customized implementation due to the sheer number of VA locations and diversity of functions [TTA 8 Feb]. And for that, you need people with deep experience and buckets of patience who know the system and can get along with their Federal counterparts. VistA in over two decades of implementation was so highly customized for both patient care and additional areas such as research that Oracle, in replacing it to VA satisfaction and to be better than VistA, has to accommodate a lot of, shall we say, discovery along the way.
  • In health systems, the discontent with Oracle was about declining vendor partnership and communication. This points to problems with people and continuity. This was highly apparent in the KLAS survey from October 2025 cited here. When half of the interviewees tell KLAS that they would not buy the system again, that is disastrous.

Apparently missing in action is Seema Verma, the general manager of OHAI.

When your current customers providing your business and cash flow are restive, yet what’s coming out of Oracle has been about 1) refocusing on cloud computing and AI datacenter contracts, not health, 2) massive job cuts to pay for them disproportionately affecting Oracle Health, 3) rumors about a sale of Oracle Health to pay for the datacenters, and 4) still paying a $1.4 billion dividend to shareholders that largely benefits Larry Ellison, holder of 40% of stock–what are the next pennies to drop? Stay tuned!

Sources for this article: Bloomberg, Investor.com

Updated 9 March. SimplyWallSt pegged the layoffs at 18%. One of Oracle’s data center contracts is with OpenAI, but they canceled a large planned AI data center expansion in Texas. Other potential tenants, including Meta, reportedly are interested in the site. Their analysis depicts Oracle as “trying to reconcile very large capital commitments to AI data centers, negative cash flow pressure, and debt and equity raises, with the operational reality of supporting customers such as OpenAI, xAI and Meta.” Yet they are aggressively pushing AI through promotion in healthcare, F1 racing, and construction. Their rock-and-hard place is making commitments versus not having the cash to quickly fulfill them. This returns to our 5 February report. Tuesday is the day that Oracle reports results.

Oracle’s Ellison set last quarter the company’s transformation as three steps: From the Fortune article:

  • Oracle making its database available inside its competitors’ clouds, including Amazon’s AWS, Alphabet’s Google, and Microsoft’s Azure.
  • “Vectorizing” the data to make it readable by AI models, which makes the data customers have in Oracle’s systems more valuable.
  • Building an “AI Lakehouse,” which vectorizes all a company’s data and not just what’s in Oracle databases or applications.

But what if you don’t want your data ‘vectorized’ to be read by AI models? Something called proprietary information and data comes to mind, like business and marketing plans. What about PHI and PII? Those could be the danger points to consider in this ‘transformation’. (Forgive me for being oh-so-tired of ‘transformation’–the last time Mr. Ellison trumpeted this was for…Oracle Health, which may be hollowed out to finance this.)

Some more Ladders, tall and short: telepsych Grow Therapy’s $150M Series D, UnityAI’s $8.5M Series A; Health Recovery Solutions buys Rimidi

March 5, 2026 | by

Standalone telementalhealth continues to be generously funded. Grow Therapy’s $150 million Series D brings their total funding to $328 million and their valuation to $3 billion. Their combination of in-person and telehealth visits with clinicians and psychiatrists is targeted to health plans, employers, and health systems. In-network plans include Humana, Cigna, UnitedHealthcare and Aetna. The fresh funding will be for expansion to the employer benefits market, within health systems for integration with primary care, and additional advanced AI tools. Grow claims that in 2025, they facilitated seven million visits, for a total since inception of 10 million therapy and medication management appointments. The round was led by TCV and Growth Equity at Goldman Sachs Alternatives, which had previously led Grow Therapy’s Series B and C respectively. Participating were new investors BCI and Menlo Ventures plus existing investors Sequoia Capital, SignalFire, and Transformation Capital. Grow joins well-funded competition Spring Health, with a valuation of $3.3 billion and Headway, with a $2.3 billion valuation.​ Blog/Release, Mobihealthnews, MedCity News, Reuters

UnityAI passes the Series A bar with $8.5 million. The round was led by Third Prime, with participation from Nashville Capital Network, Whistler Capital Partners, Max Ventures, Company Ventures, and other existing investors for a total funding of $15 million. Nashville-based UnityAI is a startup developing agentic AI to assist healthcare staff in scheduling for outpatient and specialty care practices. The agents assist with scheduling and rescheduling, confirmations, follow-ups, and referrals. It also integrates staffing operations – capacity optimization, shift management, PTO, and coverage–with the agents into what they call a “single continuously operating system”. The new funding will support continued efforts to scale go-to-market execution and extend its AI-powered operational capabilities. UnityAI integrates with major EHRs and is currently operating 300,000 patient interactions per month across hundreds of sites of care. UnityAI release, Mobihealthnews

And in local (to this Editor) news, Health Recovery Solutions buys Rimidi. Not the Italian Adriatic resort, Rimidi is an Atlanta-based software and services provider for chronic disease management and remote patient monitoring for diabetes and cardiometabolic conditions. Physician founded, it targeted to health systems, physician practices, value-based care organizations, and community health centers such as FQHCs and RHCs. No acquisition cost nor staff transition were disclosed. Dr. Lucienne Ide, MD, PhD Rimidi’s CEO and founder, joins HRS as chief medical officer.

Health Recovery Solutions (HRS) provides remote patient monitoring (RPM), chronic care management (CCM), and longitudinal virtual care. Headquartered in Hoboken, NJ across the Hudson from NYC, its last raise was $70 million in Series C funding back in 2021 via Edison Partners and LLR Partners. Several online sources report a revenue run rate between $23 and $50 million. Rimidi was relatively small, with its last funding in 2023 for $5 million, totaling $12.9 million from investors such as Eli Lilly and Village Capital. Notably, it was woman-led. The acquisition is expected to strengthen HRS’ EHR integrations and in managing diabetes and metabolic diseases within HRS’ PatientFirst Pathways care model. Release

Chutes & Ladders: UnitedHealth’s sideways ’26, longtime exec Cianfrocco departs; CHAI’s concept failure and future; KeyCare’s $27M Series A

March 4, 2026 | by

Having put a strained 2025 in the rear view mirror, it’s time for UnitedHealth Group to drive on. 2026, as previously noted on the Day the Stock Cracked [TTA 29 Jan] will be the first year that UHG expects to report less, rather than increased, revenue to $439 billion. Yet their adjusted earnings per share (EPS) is projected to be over $17.75, versus $13.23 in 2025, a decline from 2024. This is all assuming, of course, that medical utilization further stabilizes from the ‘hangover’ of the pandemic and thus the medical loss ratio improves. See pages 5-6 of UHG’s 2025-6 report (PDF). Even with a hard Q4, UHG issued a stock dividend of $2.21 per share for Q4, to be paid on 17 March, making shareholders happy. BusinessWire release  UHG was also the most profitable payer at over $12 billion, twice as much as Cigna and Elevance. FierceHealthcare

Despite all that, what didn’t make UHG employees happy was that Bloomberg News reported from inside sources that employee ‌pay raises this year ‌would be a scant 0% to 2%, ​depending on performance. Moreover, their sources stated that an undisclosed number of employees would be laid off. Yahoo Finance  This shouldn’t be unexpected. Scuttlebutt on TheLayoff.com pinpoints layoffs to hit around 19 March and 30 April. (Mind you, it’s only rumor–yet social media such as this site and Reddit often predict correctly.) But in November-December 2025, layoffs came for dozens of employees in Optum healthcare technology and services marketing, working remotely on the East Coast and in the Midwest.  But never fear–an independent audit has found opportunities for improvements through ’23 action plans’ to be completed 100% by this March. Areas to be improved are policy governance and maintenance and many more. Fast Company

And sometimes, a 24 year run is enough. Last Friday, one of the leading women in healthcare, Heather Cianfrocco, announced her departure from UHG, effective in March. She had been promoted only last April or May (reports differ) to a very top parent company position, EVP of governance, compliance and information security. She had been head of Optum for a year, replaced by Patrick Conway, the CEO of Optum Rx. In 24 years in the UHG universe, Ms. Cianfrocco had held senior positions in UHG’s major divisions including Medicaid, Medicare and clinical strategy. She led Optum Health starting in 2020, moving to CEO of Optum Rx in 2021. Interestingly, she announced her departure via a post on LinkedIn. Notably, she did not say she was retiring. Perhaps a Ladder To Be Determined later?  Healthcare Dive, Becker’s Payer

Perhaps it’s time to start breaking up, selling off, and spinning off. We know what happened to other giant companies on their long and troubled road to failure and breakup. It can be caught in time, if the C-levels wake up.  Should free-falling UnitedHealth Group be broken up? Or break itself up to survive, before it becomes another GE?

Another Chute, but hardly surprising, is that the Coalition for Health AI (CHAI) never delivered on the promise of establishing a nationwide network of AI assurance labs. FierceHealthcare has an unusually long exploration of CHAI’s development, from its showy start in March 2024 (a scant two years ago) to its still showy but confusing present. It documents the now-admitted failure of the AI lab network, now described as a ‘mistake’ by CHAI’s head Brian Anderson, MD, but it is still attempting to define responsible AI and its use in healthcare.

Money is continuing to pour in from well-heeled partners such as health systems and revenue-sharing startups. It has also had a scattering of initiatives. FTA: an ecosystem of AI governance providers, AI model cards and an AI outcomes registry; announced working groups on generative AI, prior authorization, Medicaid work requirements and a faith-based approach to AI alongside the Vatican.  It now seems to be coalescing around a voice for healthcare providers about AI through partnering with the National Association of Community Health Clinics (NACHC) and the Joint Commission.

We briefly covered CHAI at its 2023 start and were skeptical that major player members such as Google wouldn’t use their lobbyist influence on CHAI to get their way on AI in its infancy [TTA 6 Dec 2023]. TTA later noted that two HHS members (at the time), Micky Tripathi and Troy Tazbaz, left the CHAI board despite their non-voting status, discovering they had conflicts of interest [TTA 11 July 2024]. CHAI’s been off our radar till this very long article, which should be reserved for lunch or a longish break. It’s not precisely bite-sized nor linear.

We have one Ladder on tap–KeyCare’s $27.4 million raise. It’s a second Series A (!) that adds to a $27 million Series A raised in 2022, bringing its total raise to $55 million. KeyCare is built on the leading EHR system, Epic, acting as an integrated virtual primary care extension partner for health systems. It is not only a 24/7 virtual care model with clinicians that provide urgent, preventive, chronic, and primary care, but also connects that care back to the patient’s home health system. The Chicago-based company states that it will invest further in AI-enabled technology, expand operational capacity to meet growing demand from health system partners, and continue scaling its platform to improve patient experience and provider efficiency, 

This round was led by HealthX Ventures with participation from previous investors 8VC, LRVHealth, BOLD Capital Partners, and Ikigai Venture Partners. Strategic partners listed are WellSpan Health, Allina Health, University of Chicago Ventures, Edge Ventures, and Exact Sciences. 

Breaking–Oracle Health loses five executives sent there to fix Cerner: report. And what is it telling us?

March 3, 2026 | by | 2 Comments

An interesting follow up on last month’s rampant speculation of an Oracle Health sale. Bloomberg News’ Brody Ford broke the news coursing through Reddit’s Oracle threads last week about the departure of two more Oracle Health executives, SVP Product Management for Clinical and Healthcare AI Suhas Uliyar and EVP of Health and AI Sanga Viswanathan. This follows on three earlier departures at the SVP level: Quais Taraki, general manager of Oracle Health and AI; Ofer Michael, cloud product development; and Max Romanenko, engineering for Oracle Health and AI. The departures of Messrs. Uliyar and Viswanathan have not been publicly disclosed by Oracle; the reporting is from internal sources. Oracle did not comment to Mr. Ford on these departures. Becker’s Hospital/Health IT

What they all had in common, according to Mr. Ford’s report, was that all five were long-time, senior leaders in Oracle’s cloud infrastructure areas, and had specifically been transferred to modernize the 2022 $28 billion bet to “transform healthcare” that was second-place EHR Cerner. Mr. Uliyar in fact had dual positions in Health and in the OCI cloud platform. Messrs. Taraki and Romanenko have since gone to EDB, a database software and AI company.

Mr. Ford’s article goes into greater detail, such as Larry Ellison, Oracle’s 81-year-old (but still quite active) CEO with a passion for longevity research, stating that Oracle had almost completely rewritten Cerner’s software code and had expanded into other hospital systems including accounting and HR. Read his post on LinkedIn. Article for Bloomberg subscribers here. 

Again, it is well known that Oracle purchased the antique EHR that was Cerner in order to sell other Oracle systems into the hospital and large healthcare system market, plus to increase its foothold into the Federal government through the VA and MHS EHR modernization contracts. Our Readers know how that has fared: MHS, with Leidos in a smaller system transitioning from AHLTA, has succeeded, while the far larger VA EHRM, transitioning from VistA, has struggled spectacularly. [TTA 8 Feb latest update]

Oracle’s success with health systems hasn’t been stellar. According to KLAS in a 21 August 2025 premium report (while your Editor was on leave), Oracle Health has lost 57 acute care customers since 2022, including 12 health systems with more than 1,000 beds. Other findings were equally unattractive. In other words, falling behind. From KLAS:

  • Oracle Health has made big promises but has not enhanced the customer experience.
  • Customers report that communication has been lacking and that the vendor partnership has declined.
  • Several large, well-known customers have left Oracle Health.
  • Clinical AI Agent has caught customers’ attention as the first among recently promised enhancement to be delivered.
  • Customers still have lingering questions about Oracle Health’s road map.

Quoted from Becker’s Health IT’s report:

  • About half of those interviewed told KLAS they would not buy the EHR again.
  • Customers cited improvements in code quality and were optimistic about Oracle Health’s Clinical AI Agent, which they say has reduced documentation time and allowed physicians to see more patients each day. Early adopters of the tool described it as a meaningful advance, though broader adoption is still in its early stages.
  • KLAS found mixed reactions to other new and updated products, such as Oracle Health’s revamped EHR and its patient accounting system, RevElate. Some leaders described these efforts as promising, while others expressed skepticism about their ability to address long-standing challenges.

Strictly anecdotal, but when this Editor attended last month’s HealthIMPACT, it was a given that Epic was the hospital system that was the standard, and Oracle Health had fallen away somewhere in the mists. It wasn’t a Hertz and Avis rivalry anymore.

So what does this scatter of tea leaves mean? Returning to Mr. Ford’s article, Oracle expects Oracle Health bookings and revenue to accelerate in 2026, based on a December earnings call.  Mike Sicilia, who is co-CEO, is the face on the calls, but from early 2024, Seema Verma has been general manager and EVP of Oracle Health, reporting to Mr. Sicilia–and has been notably quiet. Remaining in the mix is Oracle Health’s product development head, Oracle veteran TK Anand. One can imagine the pressure on both of them to sell the heck out of the updated EHR and associated systems, especially new ones such as documentation and accounting.

Fun fact: Mr. Ellison, co-founder of Oracle, remains its largest individual shareholder with about 40% of common stock, and his cash flow is dependent on Oracle dividends even though Oracle is ‘torching through cash’ to finance AI datacenters. $1.4 billion was paid in dividends at the end of January. Yahoo Finance

But ditching five senior managers, long time techs with deep knowledge of Oracle cloud and product development, either indicates that their ‘job is done’ — or something else. Why do rumors of layoffs persist when major problems with health systems cluster around communication and partnership? Why when the VA EHRM, which required tremendous fixes, where lack of communication and contacts were repeatedly cited in the VA’s OIG and Federal GAO reports, is about to go into rollout?

Is there a turnaround in the offing for Oracle Health?

Or has Larry Ellison’s focus moved towards AI and building out datacenters for OpenAI, Meta, and Nvidia?

Has Ellison tired of pouring more cash into a second-place EHR?  Has it served its purpose in getting healthcare data? Is Oracle Health, in parts or wholly, being leaned out in preparation for sale or spinoff to finance datacenters?   Stay tuned….

Chutes & Ladders: Amwell’s ’25 loss, ’26 hopes; Teladoc’s flat 2025; Walgreens and Cigna layoffs; telehealth stable at 7%; Humana CenterWell buys MaxHealth clinics; Honest Health raises $140M

February 27, 2026 | by

Chutes first…

Legacy telehealth continues to struggle to find its place–and profitability.

Amwell expects to turn the positive operating cash flow corner in 2026…maybe. American Well closed out its 2025 with total revenue of $249.3 million, about 2% lower than 2024. Subscriptions were $132.4 million (53%) with Amwell Medical Group (AMG) visits earning revenue of $94.3 million. Losses narrowed versus last year with a net loss of $95.0 million versus 2024’s $212.6 million, and adjusted EBITDA of ($39.9 million) versus prior year’s ($134.4 million). Another bit of good news is that 2025 closed without debt and $182 million in cash. Telehealth visits totaled 4.5 million.

Their Q4 2025 revenue took a hit–$55.3 million was down 22.1% versus prior year, attributed to lower revenue from their Defense Health Agency (DHA) contract. It started with partner Leidos in 2023 but was reduced last year in several areas due to DOD budget cutbacks.  Their 2025 EBITDA loss improved to $10.3 million with a net loss $25.2 million.

The narrower losses were attributed to consolidating products such as inpatient tools, a large hardware business. and a virtual psychiatric care offering into a single technology enabled care platform that consolidates virtual care and digital health programs, plus integrates third-party services.

2026 is another year of retrenching. Projections are: revenue in the $195 to $205 million range, about $50 million lower than 2025; AMG visits between 1.32 and 1.37 million, and adjusted EBITDA in the range of between ($24 million) to ($18 million). Amwell also is projecting that operating cash flow will go positive during Q4 2026. Key to this is that the annual DHA contract renews this summer. Amwell release, Healthcare Dive, Yahoo Finance

Teladoc is also struggling to grow in a chaotic market, but like Amwell is paring down and going for the cash flow. Revenue was essentially flat (down 2%) at $2.53 billion in 2025 from $2.57 billion in 2024. 2025 operating free cash flow was also down 2% to $166.9 million. Net loss was reduced to $200 million from last year’s $1 billion with adjusted EBITDA $281.1 million. BetterHelp, their behavioral telehealth unit, fell 9% year over year to $950.4 million in revenue. Teladoc ended the year with $781.1 million in cash and cash equivalents.

The 2026 revenue forecast is also flat in the $2.5 billion range with adjusted EBITDA in the $266 – $308 million range, and still in the loss column with a net loss per share between $1.10 and $0.70, which doesn’t make shareholders or analysts happy. Teladoc is moving from subscription models to to visit-based revenue in integrated care to compensate for enrollment reductions at some client health plans in government programs plus reductions in ACA subsidies. The BetterHelp behavioral health unit is looking at another revenue reduction of up to 7%. Teladoc release, Healthcare Dive

Layoffs continue at Walgreens and Cigna. 

  • Walgreens is laying off 628 employees in Illinois and Texas. These were tracked through WARN notices: 469 positions in Illinois, its home state, by 1 June, plus 159 jobs in Texas because a distribution center is being closed. Walgreens also confirmed to press that it will be closing dozens of stores in 2026. This was expected after last September’s acquisition by Sycamore Partners. And there is more to come. 1,200 stores will be closing over the existing three-year plan, with 500 shutting down in FY 2025. Fast Company, Healthcare Finance News, Healthcare Dive
  • Cigna is cutting 2,000 jobs globally by the end of February. It’s a not insubstantial 3% of its 73,500-person workforce, which is 90% in the US. Affected business units, roles, or geographies are unknown, though no WARN notices have been sent to the Connecticut Department of Labor, where Cigna’s HQ is located. Cigna is well in the black with $6 billion in profits in 2025 and a projected 2026 revenue of $280 billion. Membership stands at 18.1 million, down 5% from 2024, largely due to Cigna’s sale of its Medicare business, including Medicare Advantage and supplements, to Health Care Services Corporation’s (HCSC) HealthSpring unit. Cigna earnings report, Becker’s

What’s up on that ladder?

Telehealth use in primary care has stabilized since 2023 at about 6 to 7%, according to a study by Epic Research. (Yes, that Epic). The study from July 2022 to October 2025 showed the decline from 8% to today’s range. Two other findings were also interesting:

  • Telehealth has consistently remained more common among patients from metropolitan areas compared to those from more rural areas–the opposite of what one would assume.
  • Telehealth use varied substantially by preferred language; many non-English groups had much higher rates than the rates among English-speaking patients. The study tracked patients speaking primarily Chinese, Portuguese, Russian, Persian, and Spanish. Many of their rates are above 10%.

Epic’s data comes from its EHR in health systems representing more than 300 million patient records from 1,800 hospitals and more than 42,000 clinics from 50 US states, Canada, Lebanon, and Saudi Arabia. Healthcare Dive

FAIR Health, which takes a different sample of US commercial insurance claims, has also been steady for the past couple of years. In October and November 2025, telehealth visits accounted for 5% of claims, logically lower because of the methodology. Mental health related diagnoses account for 63% of telehealth visits, with 15.2 % urban and 7.7% rural, which corresponds to Epic’s findings. Primary care does not even register in their tracking.

Humana’s health services operating arm CenterWell acquired MaxHealth. MaxHealth is a West and South Florida-based primary care network  that provides care to 120,000 patients, with 80,000 patients in value-based care programs. The 82 owned and affiliated clinics consist of 54 owned primary care clinics, 4 owned specialty/ancillary clinics, and 24 downstream affiliate clinics. The purchase was from private equity firm Arsenal Capital Partners and the cost was not disclosed. MaxHealth clinics will join CenterWell Senior Primary Care. Release, Healthcare Dive

Honest Health raised $140 million. The unlettered capital raise for this value-based care enablement company was led by NewSpring Healthcare with participation from existing investors and institutional partners, including Rubicon Founders, Oak HC/FT, Welsh, Carson, Anderson & Stowe (WCAS), and Durable Capital Partners. Nashville-based Honest Health is physician-led and its CEO Rob Bessler MD is a physician entrepreneur who previously founded Sound Physicians. The new funds are intended for expansion into new markets, deepening partnerships with health systems, and improving technology-enabled care coordination. Release, Pulse 2.0

Veradigm won’t face SEC enforcement action, cuts 15% of staff, forecasts further retrenching for 2026 growth

February 26, 2026 | by

“Reset, Recover, and Reignite” is their plan forward. Veradigm, the former Allscripts, has since 2022 earned several adjectives, such as ‘tumultuous’, ‘troubled’, ‘problematic’, ‘puzzling’, and even ‘mysterious’. It’s now the fourth year since their failure to provide audited reports for 2022 due to financial software problems, an embarrassment for a software and once-leading health IT company. Then it was the same failures in reporting FY 2023, then 2024, with the final blow a delisting from Nasdaq two years ago on 29 February 2024. Despite being solvent, it couldn’t close a sale to one of three major bidders a year ago. This was topped by an SEC enforcement investigation and a July data breach. It was not until last March that Veradigm provided a 2022 financial report…still unaudited.

Some good news arrived last week. The Securities and Exchange Commission (SEC) informed Veradigm that the investigation, pending since January 2024, has been concluded. The SEC does not intend to recommend an enforcement action based on the available information. Former CEO Richard Poulton and former CFO Leah Jones, both of whom resigned in December 2023, received similar letters, according to the filing. Veradigm SEC Form 8-K. Healthcare Dive

The current CEO, Donald Trigg, who’s remained in place since September, held an update call last week. The highlights of the call were reported in both Healthcare Dive (25 Feb and 19 Feb) and HIStalk on Monday.

  • Veradigm will next release its annual reports for 2023 and 2024 in a Super 10-K, which is a single annual report that includes data that would have been included in overdue previous reports. The plan is to be current on its filings this year and apply to relist on Nasdaq shortly thereafter. Interim CFO Lee Westerfield called this “a major event”.
  • There was no mention of a timetable for filing 2025 results. The preliminary 2025 results show flat revenue and a significant decline in cash due to debt financing and share repurchases: revenue between $584 million and $589 million, down 1% at the mid-point of estimates for the previous year.
  • The company’s overall strategy is to reset its business strategy, recover its market position with independent physician practices, and increase profitable growth. According to CEO Trigg, Veradigm will focus on market impact and growth. CEO Trigg stated on the call that Veradigm was previously run as “a holding company as opposed to an operating company”; presumably, it is now the latter.
  • 15% of the company’s workforce was cut last year.
  • They will discontinue six unnamed low-revenue products.
  • Their Chicago headquarters office will close by mid-2027. It closed three unnamed locations in 2025 and will close two more in 2026. There are two operating hubs: Pune, India, and Raleigh, North Carolina.

To be continued….   TTA’s back file on Veradigm here.