...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,... Continue Reading
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Perspectives: Telehealth as Infrastructure–Building a Financially and Clinically Sustainable Virtual Channel
...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... Continue Reading
Some more Ladders, tall and short: telepsych Grow Therapy’s $150M Series D, UnityAI’s $8.5M Series A; Health Recovery Solutions buys Rimidi
...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... Continue Reading
Chutes & Ladders: UnitedHealth’s sideways ’26, longtime exec Cianfrocco departs; CHAI’s concept failure and future; KeyCare’s $27M Series A
...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,... Continue Reading
Rock Health’s sunnier 2025: up 35% due to AI, but a tale of ‘have and have nots’
...now at a post-F financing. There is zero here about bankruptcies and reorganizations. No reference to the utter implosion of 23andMe and its shocking sale back to founder/CEO Anne Wojcicki. The impact of ACCESS and ELEVATE. There is also a good graphic analysis of two CMS models that may support digital health more comprehensively than previous value-based care models such as ACO shared savings. The first CMMI model, ACCESS, will be debuting in July and is a 10 year voluntary payment model for Original Medicare outcomes in chronic care management. It reduces barriers for digital health to profitably work with... Continue Reading
Chutes & Ladders this week: Carbon Health’s Ch. 11; Centene’s 2-way beat, TrumpRx.com debuts; Doc.com files for $24M Nasdaq listing, $55M for Alaffia Health, big Series Ds for Midi Health and ElevenLabs
...consistency and depth are needed, chronic care management becomes all about risk management. Not care. Beckers, FierceHealthcare, ElevenFlo Between a Chute and a Ladder… Centene’s horrible 2025 closed with a Q4 net loss of $1.1 billion, but a better forecast for 2026. The Q4 compared to a net profit of $283 million in FY 2024. A major factor was that the health benefits ratio (HBR) of 94.3% for Q4 2025 was sharply up from 89.6% in Q4 2024, as well as expenses relating to rising No Surprises Act billing disputes. The ladder was that the revenue topline of $49.7 billion,... Continue Reading
Will “expensive, complex and inefficient” US healthcare respond to six major demographic, cost, supply trends–and recuperate? Or further sicken?
...expectancy is flat, and the average person is living 12.5 years in poor health. This is compared to residents of the 38 OECD countries, who on average live four to eight years longer and in better health. Avoidable mortality rates per 100,000 are over 100 points higher. Chronic disease mortality among those aged 18-44 increased by 6.4% in the past six years, led by chronic liver diseases. US population is also shifting to the ‘sunbelt’ stages, fleeing California and New York State. The healthcare delivery system incentivizes specialty care intervention instead of primary care prevention. This is driven by the... Continue Reading
Need to knows: Omada’s $158M IPO at flat valuation, AZ lawsuit on Centene plan’s ‘ghost network’ fatality, UHG shareholders OK reduced package for CEO Hemsley, new ASTP/HIT-ONC leader, NJ’s Cooper Health patient data breach, Net Health buys Limber Health
Omada Health nears a dip in the chilly IPO waters. Chronic care manager Omada Health started last week to road-show its long-anticipated public offering to interested investors. It’s been a long time in the making, with their first IPO S-1 filing back in October 2024. Their 9 May SEC Form S-1 registration and preliminary prospectus, updated 29 May in their S-1/A, now reveals the extent of the offering–7.9 million shares. With an initial offering price of $18-$20/share, that is a raise of $142.2 to $158 million for OMDA (Nasdaq Global Market). The IPO may take place later this week, according... Continue Reading
News roundup: GLP-1 weight regain real, soft robots walk off 3D printer, Ambience’s AI coding beats doctors by 27%, Get a Second Opinion debuts, $11.5M for AssistIQ
...marketed right now. First, 30% of users quit in four weeks and 42% by 12 weeks due to side effects like nausea, constipation, vomiting, and worse. BCBS study, GLP-1 Digest 4 Apr The flip side is that over half make it past the three-month bar. But it is not ‘one and done’, and right now expectations are not being managed well, especially by the teleprescribers advertising on TV and radio. For the clinically obese, to maintain their hard-won goal weight and health benefits, it will require management as a chronic disease, continuing weight/lifestyle management, and perhaps another round of the... Continue Reading
Should free-falling UnitedHealth Group be broken up? Or break itself up to survive, before it becomes another GE? (updated)
...on UHG. It’s time to sell off businesses and refocus on either being an insurer or being a healthcare services company. Not both. If UHG chooses to be an insurer, refocus on a service mission, not the shareholders. Respect their members (and commercial businesses) who pay the premiums. Focus on member health, first preventative, then managing chronic care. Stop treating patients and providers as always trying to game the system or grift them. People depend on insurance at the time of need, when they are sick, and treatment is complicated. Make it easier for both members and their providers. Bring... Continue Reading
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