2025 healthcare investment off 12% versus 2024, with AI nearly half: Silicon Valley Bank roundup (updated for Scheffel interview))

January 14, 2026 | by | No Comments

Silicon Valley Bank (SVB), now part of First Citizens Bank, is back with a roundup of the prior year in healthcare investment in the US and EU. 2025 was a year of contractions and skewed investments, what they called “barbells, bookends, and have-nots”, with fewer investors hotly chasing profitability and monetization. 

SVB broke ‘healthcare’ into four sectors: Biopharma, Healthtech, Dx (diagnostics)/Tools, and Device. This Editor’s analysis will concentrate on an overall look plus a deeper dive into Healthtech. SVB also broke out an area cutting across all four, emerging from side conversations into the spotlight. It’s an area where many of us have been laboring in for years–Longevity and Healthspan. (Surprise, surprise!)

Highlights:

  • 2025 total healthcare investment in US and EU totaled $46.8 billion, down 12% versus 2024’s $53.2 billion. European investment remained flat. 2025 still exceeded the dreary days of 2023 that dipped sharply to $41.6 billion. (page 12) Yet adjusting for inflation between the two years, 2025 fell below 2023, which would be today $48 billion (Bureau of Labor Statistics using the Consumer Price Index). 
  • Deal numbers fell 7% in 2025 to an estimated 2,517, versus 2024’s 2,704.
  • AI investments across all four sectors was $22 billion–46%. (pages 2, 5)
  • After Biopharma, Healthtech investments stayed relatively strong as the second largest category, growing from 2024’s $13.2 billion to $13.9 billion. (Note: SVB tracks only investment deals above $2 million)
  • Investments resembled a canyon–plenty in Series A, cratering for Series B and Cs (the have-nots), rising for mega-deals around AI, redefined from the traditional $100 million+ to $300 million+. The higher definition reflects the big capital investments required for AI companies. The report calls it a ‘barbell’ shape–and the plates at both ends are heavy.
  • There are fewer deals as investors seek companies with nearer-term scalability, strong fundamentals, defensibility, and strength of execution. Topping it–less money is available for investment from fewer VCs.
  • Healthtech dominated AI unicorns with valuations above $1 billion: Abridge, OpenEvidence, Innovaccer, and Cera. (page 11)
  • Healthtech saw only seven private M&As and three IPOs (Hinge Health and Omada in the US, 66nao Brain Training in China), versus 2024’s 14 and two respectively. (page 24)
  • Healthtech investments fell off in H2 from a decent pace in H1. Both Series A and later stage companies had generous rounds, though getting there is harder than ever. Page 15 presents a roundup of both the Series A and later stage deals.
  • Investor money raised fell to a decade low–$7 billion versus 2024’s $23 billion. Yet many name investors such as Venrock and General Catalyst closed $100 million healthcare funds, continuing the concentration on money following scale, fundamentals, and monetization versus story and potential. (page 7) 

A ‘must read’ is SVB’s discussion of the Longevity and Healthspan sector on pages 18-21. Finally, finally, the market is seeing the huge need and potential of therapies treating age-related conditions from ability to disease, growing 2.3x in 2025. The sector further concentrates into three areas:

  • Geroscience: R&D into the biology of aging to reverse or mitigate changes. Companies: NewLimit, Altos, Cambrian, Rubedo, Aspen Neuroscience
  • Consumer Healthspan: products for users that analyze everyday behaviors to stay healthy longer. Companies: Function, Viome, Oura, Whoop
  • Intrinsic Capacity Healthtech: apps and tools extending functional everyday abilities. Companies: Neuralink, Sword Health, Hinge Health, Science

Based on early indications of investments and deals, 2026 looks brighter, but still continuing AI and consolidation.

A preview of the report is available with registration here. 

Updated 20 Jan: Mobihealthnews interviewed Megan Scheffel, who heads up their healthcare and life sciences practice, outside of JPM last week. She reviewed some of the study findings, such as the ‘barbell’ shape of investment (above). M&As are also reviving, looking “pretty” on the mega/later stage side, but on the smaller side perhaps not the “fantastic outcome” founders and investors wanted, but allowing the technology or founders to live to fight another day. This Q&A was telling:

MHN: Do you see any companies eating up other companies just to bury them?

Scheffel: I don’t know if I would say they’re burying them. I keep saying, like, there’s clearance racks.

For companies, SVB operates on two sides: banking and debt. A strategy, according to Ms. Scheffel, that hasn’t changed since before their near-death experience in 2023. She should know as with them for “a gazillion years” prior to that bad time. “We still really want to help companies, even if they’re not raising $300 million rounds every six months. We still are trying to help find ways to support them and support their causes.”

Her advice to companies to succeed: have good management teams and ideas with a “moat”–innovation, IP, and advantages. For investors, the downturns clear out the dead wood (as this Editor predicted after the 2022-3 shocks). To her, times like now are when good investors can make money from better companies.

 

Editor Donna’s selective roundup: One Medical’s Amazon Rx kiosks, VillageMD sells off Texas, digital health investment’s Q3 boost

October 9, 2025 | by

Amazon keeps trying to integrate healthcare and make One Medical work, using Pharmacy as leverage. Like CVS, Walmart, and Walgreens, Amazon succumbed in 2022 to the Gold Rush of buying up a health clinic network and attempting to integrate primary care delivery into its retail model–after stumbling badly and failing with Amazon Care (2019). While the former have either ditched (Walmart), pivoted (CVS–Oak Street), or spun off their primary care providers (Walgreens–VillageMD/Summit Health), Amazon is testing yet another integration with One Medical, their first being with Amazon Prime.

In its latest tweak, Amazon is delivering limited onsite pharmacy services via a dispensing kiosk to a group of five One Medical offices in the Los Angeles metro. Now Amazon never calls it a test–one has to get about halfway down their release to discover those kiosks won’t be installed till December–but it’s obviously one, with a rollout to other undetermined One Medical offices promised in the sweet bye-and-bye of 2026. The kiosks will dispense common prescription meds in a four-step process: prescription written, sent to Amazon Pharmacy, patient opts for in-office kiosk pickup and payment using their mobile phone to check it out in the Amazon Pharmacy app, and checks it out using a QR code at the kiosk.

Using these five locations (Beverly Hills! West LA!) is an adequate feasibility test, but doesn’t address the piously phrased rationale of 25% of neighborhoods as “pharmacy deserts” and where even in non-desert areas, 51% of patients report delays in filling prescriptions.

The kiosks will be storing basically common Rx meds such as antibiotics, blood pressure medications, and inhalers. 

Where this picture isn’t as revolutionary as my friend Sergei Polevikov maintains in his latest Substack essay (subscription required–and you should; also partially on LinkedIn), it’s another kick in the head for the traditional pharmacy retailers and the PBMs. They are already getting boot impressions by the Hims & Hers virtuals and Big Pharma on GLP-1 and ‘favored nation’ DTC deals. On one side, it reduces friction by making it onsite and easy. But suppose the kiosk doesn’t have my med or it’s out of stock. What do I do once the script is sent and I need to change it? This is also appealing to a younger and/or tech-savvy segment who live on their phone and Amazon apps. Suppose I’m an older patient and apps/QR codes do nothing but confuse me? For Amazon, what about the cost of kiosk installation, cleaning, stocking, monitoring, just like those telehealth kiosks from Forward (CarePods), Higi, and way back HealthSpot Station. They were the future–for five minutes. Apparently there’s also a little regulatory issue of self-dealing referral (hat tip to LinkedIn commenter Ajay Kumar Gupta).  Also Healthcare Dive

VillageMD continues to shrink. The formerly free-standing and co-located Walgreens clinic unit, spun off into a standalone company by Sycamore Partners while I was on medical leave (FierceHealthcare 28 Aug), has sold 32 Texas primary care clinics to Harbor Health, a primary care group and payvider in the Austin area. This adds San Antonio, El Paso, and Dallas as well as more Austin locations. Forbes From a significant almost-national primary and specialty care group, VillageMD is devolving into pieces for sale. One wonders about the extensive Summit Health/CityMD operation, very much tied in with Hackensack Meridian Health that dominates northern New Jersey, and disruption. (Disclosure: my family and I are Summit Health patients)  In other news, Tim Wentworth was replaced as CEO by Mike Motz, from another Sycamore portfolio company. Wentworth remains as director for the time being, undoubtedly working out his retention and various payouts. 

Rock Health breaks the cheerful news that Q3 digital health is an improvement over a dismal 2024 a/k/a 2019. YTD is $9.9 billion, exceeding the $8.4 billion raised through 2024 Q3. Deal size is also trending up: $28.1 million, increasing from $20.4 million in 2024. Where it’s still wobbly is middle-stage investment and anything with a Series letter. Rounds of $100 million plus thrived, with 19 of them accounting for 40% and $3.8 billion of 2025 YTD total funding. I won’t be doing my usual dive into their numbers due to time constraints, but Healthcare Dive summary will do. Rock Health’s Q3 report, usually putting the best foot forward, is weirdly downbeat, calling it ‘signals out of sync’. 

Way out of sync is the continuation of the partial Federal government shutdown, with no mercy on telehealth services and the donkeys doing what donkeys do…refuse to move. 

I’ll be on a short hiatus with no new articles until the week of 27 October.

Will “expensive, complex and inefficient” US healthcare respond to six major demographic, cost, supply trends–and recuperate? Or further sicken?

October 9, 2025 | by

A new and exhaustive report diagnoses the US healthcare patient, pronounces it sick, and the proposed cure involves a “return to first principles”. A new report from researcher Trilliant Health outlines the unsustainability of the current status quo. As of 2023, the US system is the most expensive in the world in absolute terms. It grew from $2.8 trillion in 2012 to $4.9 trillion in 2023 with relatively flat demand and utilization (with 2022 and 2023 skewed because of Covid). In terms of GDP, it was 17.6%, a stunning number that will grow by almost 3 percentage points in the next ten years. The report outlines six trends that are anticipated to affect healthcare, based on data analysis of consumer demand, healthcare supply, and yield–the pricing where they intersect plus regulation and market incentives (e.g. reimbursement). This is a 30,000 foot view of an incredibly detailed report (details below):

  1. Price sensitivity and affordability concerns are reshaping demand. Prices have increased 54.5% from 2009 to 2023, compared to a 45.7% increase in overall consumer prices. Average annual insurer commercial plan premiums are up 85.7% between 2010 and 2024.
  2. Stakeholders are slow to adapt to changing demographic and lifestyle trends. US life 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.
  3. The healthcare delivery system incentivizes specialty care intervention instead of primary care prevention. This is driven by the rise of chronic conditions including “long Covid”, GI diseases, and behavioral health, as well as the low supply of primary care physicians. Retailers and Amazon, after a ‘gold rush’ starting about five years ago, are either exiting, pivoting, or scaling back. Somehow behavioral health volume increased by 43.7% between 2018 and 2024, despite psychiatry not even showing up in their physician specialty analysis. New drug development also is increasingly targeting chronic and rare diseases, with about one-third targeting cancer.
  4. Fraud, waste and abuse are pervasive in U.S. healthcare. To no one’s surprise, rates by CPT codes vary widely and wildly, insurance payers have favored systems, and hospital administration gets more money than direct patient care. Expensive EHRs aren’t delivering on workflow and patient portals. Brokers and PBMs add to cost and complexity.
  5. The transition to alternative care settings and therapies is accelerating. In-patient care innovations tend to start in the hospital and then migrate outward to outpatient settings such as ambulatory surgical care centers. Behavioral health, for instance, has migrated to telehealth. Patients with mental health needs who are well managed and include telehealth tend to have have far more in-patient utilization than unmanaged patients, regardless of utilization level. GLP-1 utilization increased 744.6% between 2018 and 2023, and is increasingly being prescribed and delivered via virtual care providers such as Hims & Hers, Ro, LifeMD, and WW in deals with the pharma companies. Rural health continues to shrink and cut inpatient services.
  6. If the industry cannot deliver value for money and employers will not demand it, the government is prepared to force it. Their effectiveness in this is perhaps a debatable point, since CMS’ value-based care programs such as MSSP and REACH have not really reformed the system, contained costs, nor spread as practices. The profitability of insurers has also deflated. The Trump Administration’s moves with Pfizer on ‘most favored nation’ pricing for Medicaid and direct sales fit here. Coupled with drug manufacturers’ selective desire to bypass PBMs and go direct, there’s a trend here to cut out the middleman.

As to telehealth, once seen as a cost and supply panacea, since 2020 and the pandemic, volume declined by 32.2%, driven by a 52% decrease in non-behavioral care. What remains is behavioral health, 66.9% of visits in 2024. Even that has declined versus prior year from 70.5%. (Slide 84). Another panacea was supposed to be EHRs but they tend to be closed systems, non-interoperable, and another increaser of complexity.

Their conclusion is that healthcare is at a crossroads–no surprise–and that healthcare is now locked into a “doom loop” (Slide 110). Prices increase, the financial strain on patients, providers, payers, and employers increase, patients enter the system sicker, access decreases, and the inefficiency increases geometrically. Their call (Slide 111) is for a return to see what is what is essential and necessary. “At its core, the healthcare system is intended to connect patients with providers for medical care.” Our currently redundant and complex system (see the nightmare that is Slide 8) cannot do that.

The Trilliant Health report is available for download here. Release.

Editor Donna is back. Here’s the catchup.

October 3, 2025 | by

A summer hiatus that’s turning out to be a bit longer than expected. Recuperating from a broken left arm and resuming a mostly “normal life” including some vacation has taken appreciably more time than your Editor thought when last posting in late June. (In fact, where the heck did June go?) Getting back into the issues surrounding healthcare technology and healthcare in general has also taken awhile. So this article will be a mix of ‘this and that’ of tying off some stories that were hot in June. Starting with the current drama…

The US Federal Government shutdown and telehealth. It was uniquely constructed to not affect vital citizen services such as Social Security, Medicare, Medicaid, and even access to our national parks–and to be laid at the feet of one party, not the one in control. Life is going on as the shutdown continues. It may end tomorrow with a congressional resolution (CR) kicking the can down the road for a few weeks, it may end in November with the same.

Most affected from our perspective: Medicare telehealth flexibilities extended from the pandemic now revert to pre-pandemic rules, except for practices under the CMS Medicare Shared Savings Program (MSSP), practices in the end-stage renal disease (ESRD) program, and mental health. Audio-only reimbursement is terminated as is telehealth beyond the rural health program. Health and Human Services (HHS) has furloughed 41% of employees, over 32,000, though the short-term effect is expected to be minimal.

Continuing: programs such as Medicare, Medicaid, OIG’s Health Care Fraud and Abuse-related activities, parts of other agencies such as NIH direct medical, the Indian Health Service (IHS), FDA medical device and drug reviews, emergency preparedness, and other mandatory services. FierceHealthcare, Healthcare Dive   ATA Action is advocating for immediate restoration of Medicare’s telehealth flexibilities, in place since 2020, and the Acute Hospital Care at Home program. One hopes that Senator Schumer and Representative Hakeem Jeffries take note.

Such a deal? Under the shutdown wire, the Administration’s ‘most favored nation’ deal with Pfizer benefits state Medicaid programs and consumers who go on Pfizer’s website and buy drugs direct. In return, Pfizer gets a three-year relief from tariffs on their drugs from the Section 232 probe into the effects of pharmaceutical imports on national security. Details beyond this are scant, but the industry’s lobbying group, PhRMA, has been pressing for allowing drugmakers to sell DTC, bypassing insurers and pharmacy benefit managers (PBM). For commercial and individual insurance, the effect is nil for now. Healthcare Dive unpacks it.

Big deals continue. This week, VC giant General Catalyst, of which this Editor took a very dim view back in February, closed its $515 million acquisition of Summa Health, a non-profit integrated healthcare system based in Akron, Ohio. The acquisition through its HATco subsidiary was announced in January, but had to be boosted by $30 million and meet additional conditions to pass muster with Ohio’s attorney general. How acquiring one regional system advances their goal of “health assurance”, defined as “a more affordable, accessible and proactive system of care”, is To Be Determined. FierceHealthcare

Evolent Health is exiting the ACO business, selling it to competitor Privia Health for $100 million. The sale adds Evolent Care Partners’ more than 120,000 lives in MSSP, as well as commercial programs and Medicare Advantage. Privia now adds more states and their covered lives will total 1.5 million when the sale closes in Q4. The Medicare ACO business continues to contract to a few players; value-based care and Federally subsidized incentives in MSSP and ACO REACH turned not to be all that.  Healthcare Dive

There’s a rundown of other acquisitions and sales rounded up in HISTalk 1 October, indicating a certain liveliness in the market: specialty care coordinator Switchboard acquiring Conduce Health (undisclosed amount), Sunstone Partners taking a majority stake in healthcare cybersecurity/compliance firm Clearwater, AI voice agent developer Assist Health tagging a $76 million Series B round, and others.

In amazement….

  • Veradigm still can’t get itself current with its financial filings and submit itself for Nasdaq relisting as of this week. Revenue is still flat, they repurchased $180 million in convertible notes, and got itself a new CEO, Donald Trigg, in what has been a revolving door position. The last interim CEO ankled in April.  Veradigm release   Insult to injury: a data breach in July (announced to customers 22 September). This affected at least 70,000 patients in Texas and South Carolina, plus customers in California. HIPAA Journal
  • 23andMe was sold back for $305 million to its co-founder and CEO, Anne Wojcicki. She set up an entity, TTAM Research Institute, a non-profit public benefit corporation (PBC), to buy the company for $305 million. Unlike Regeneron’s $256 million bid, Wojcicki’s TTAM is acquiring Lemonaid along with the main Personal Genome Services and Research Services businesses. TTAM is a clever acronym of the spelled-out 23andMe. The Bankruptcy Court of Missouri approved the sale on 7 July and it closed on 14 July, after no further bids from Regeneron. Interestingly, none of the articles mention Wojcicki’s backers. 23andMe release, CNBC, HIPAA Journal.

To this Editor, selling a company back to the CEO who had full financial control over the company but augured a $6 billion valued company into Chapter 11–nosediving after bad investments, a major data breach and turmoil around its data and privacy–is beyond absurdity. I’m surprised that the bankruptcy judge even permitted it given the history, but she legitimately bested Regeneron’s offer by $50 million. It also included the nearly-finished Lemonaid. Supposedly all business is now ongoing. It’s her risk, her money, as noted in our last article on 3 June. And now her responsibility to make a go of it.

And a sad goodbye. Longtime Readers will remember John Boden, one of the pioneers (2001) of healthcare tech care management software for supporting older adults and a national expert in eldercare through his ElderIssues firm. He frequently commented on Steve’s and my articles, along with many insightful and funny emails. He was also a former Marine pilot (VMA-6, Vietnam) who wrote about his experiences in ‘Klondike Playboy’. John “Went West” on 4 December last year after a few years of retirement. Editor Steve discovered this during my hiatus. Our sympathies to his wife, children, extended family, and his VMA-6 shipmates. Legacy obituary

Thank you for your patience! My articles will be ramping up slowly as therapy continues. I’ll also be catching some additional vacation after next week. 

No, this shouldn’t happen to you–an unwanted hiatus for Editor Donna

June 26, 2025 | by

A short note to our Readers:

It’s been quiet in TTA-Land because at the top of June, your Editor fell and broke the upper part of her left arm (humerus, not funny) fairly substantially on what was up to then a very enjoyable trip to Reading, Pennsylvania. It was quite the ‘trip’ and I wouldn’t ‘sling’ it around! Only now is she getting sufficient range of left arm motion while still slung up, enough for her left hand to briefly use a keyboard without screaming (or displacement) and write this overdue note to you. 

Our Editor Emeritus Steve Hards was kind enough to step in and inform you of James Batchelor’s MBE. But our normal cadence of articles will be on pause until at earliest late July, along with our thrice-weekly email Alerts. Much depends on what the orthopedic doctor says next week. For the time being, my brother, also a doctor (psychiatry) is assisting (quite capably) with my ADLs.

Yes, I am now intimately familiar with something called pain management and I hope rehabilitation, soon.

Thank you for your understanding and patience!

Congratulations to James Batchelor MBE

June 15, 2025 | by

Our editors send their hearty congratulations to James Batchelor, the founder of Alertacall, who has been appointed an MBE (Member of the Order of the British Empire) for ‘Services to Technology For Older People’ in King Charles III’s Birthday Honours List 2025.

This prestigious honour, akin to the US Presidential Medal of Freedom, acknowledges an individual’s outstanding achievements and significant, long-term service to the community. He was nominated by people who had observed the considerable social benefit of his work and his extensive support for charities benefiting older people.

His innovative contributions began over 20 years ago when he invented the ‘I am okay’ button, now known as OKEachDay®. It had been inspired by his grandmother Eveline, who refused to use traditional pendant alarms. The technology enables users to press a button on a touchscreen device daily to confirm their well-being. If the button is not pressed, Alertacall’s specially trained team makes contact to check in, helping to bring aid and reduce the number of undiscovered tenant deaths. (The latter is an issue in the UK where many isolated people receive their pension or benefits income and pay their utility bills, etc, through bank automation and so it goes unnoticed that they have not been seen alive.)

The system now incorporates machine learning and AI to detect trend changes that could indicate an imminent issue. Significantly, it has evolved into a range of technologies that improve regular contact with older and vulnerable people, some of whom receive access to these services free of charge.

Alertacall, the company James founded in 2004, has over 110 team members and offices in the Lake District and Cheshire. In collaboration with approximately 60 housing associations provides crucial daily contact services to tens of thousands of people living in public, Section 8, and assisted living housing across the UK. In 2023 Alertacall also received The Queen’s Award for Enterprise in Innovation, a highly esteemed British business award.

Beyond his company, James Batchelor (or James Batchelor MBE, as we should now call him!) tirelessly campaigns to alleviate loneliness and isolation among older people, mentors socially focused entrepreneurs, and supports various charities, including The Silver Line and initiatives that have planted over 25,000 trees in the British Lake District.

James’s work has been of close interest to Telehealth and Telecare Aware since our beginning in 2005 and our first post about Alertacall was in 2006: Alertacall extends safety confirmation service hours.

This just in: Hims acquires Zava, adds 1.3 million European/UK telemed customers

June 4, 2025 | by

Hims & Hers expands to Ireland, France, and Germany, and adds to UK. Announced yesterday, the ambitious strategic acquisition of Zava, a similar online direct to consumer provider of telemedicine remedies for weight loss, ED, asthma, STI testing, and birth control (varying by country), will add over 50%, or 1.3 million customers, to Hims’ US base of 2.4 million. Acquisition costs or staff transitions were not disclosed. It is an all-cash deal financed off their existing balance sheet. It is expected to close, subject to the usual approvals, in the second half of 2025. 

Hims stock peaked on the news yesterday to above $62/share and since has settled down to its previous $52-53 range. They remain the only unqualified SPAC success in healthcare.

Zava has operated in Europe since 2011, preceding Hims by six years. It is a private company, corporately Health Bridge Limited, registered with Companies House in London, and the UK company was formerly known as DrEd. One of their partners is Asda supermarkets in the UK. Their CEO and co-founder David Meinertz lives in Hamburg.

Hims already has a UK presence due to its acquisition of Honest Health in 2021. From the release, apparently the Zava name will transition to Hims & Hers at some point and be accretive to earnings in 2026. This expansion will include access to British, German, and French healthcare providers in local languages. Another positive factor is that pharmaceuticals are generally less expensive in Europe than in the US.

This Editor wonders if an English-language brand name will transition easily to France and Germany, versus the ‘neutral’ Zava. Hims also states that they aren’t through with their international expansion, so their name will continue to be a concern. Developing  CNBC, Fast Company

Some cautions are apparently coming from Wall Street. Reportedly, investor analysts have been consistently shorting the stock on NYSE for months. Both Bank of America and Citi are bearish, with BoA tagging it as an ‘underperform’ with a $28/share target and Citi with $30. (Disclaimer–this is not investment advice). InvestorsObserver

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

June 4, 2025 | by

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 to CNBC, with other sources saying Friday 6 June.

Morgan Stanley, Goldman Sachs & Co., and JP Morgan are acting as lead book-running managers for the proposed offering–a high-level crew for what was in the past a relatively small offering, but times have certainly changed with a dearth of IPOs continuing. 

Omada has raised $528.5 million through 11 rounds since the Ur-Health days of 2011, with a $192 million Series E in 2022 and the last round in 2023 an $80 million debt financing (Crunchbase). Investments came from major VCs such as Andreessen Horowitz, Fidelity, Norwest Venture Partners, Wellington Management, Intermountain, New Enterprise Associates, and Founder Collective. Their repositioning into ‘between-visit care model’ expanding from diabetes into obesity, hypertension, and MSK patients has met with success. With 2,000+ customers and over 679,000 total members enrolled in one or more programs, their 2024 revenue grew 38% from $122.8 million in 2023 to $169.8 million in 2025 , with Q1 2025 by 57% to $55.0 million from Q1 2024’s $35.1 million. Their prospectus revealed that they are closely tied to investor Cigna, with one health plan or PBM accounting for 31% of revenue, then a second health plan or PBM accounted for 29% of its revenue. according to FierceHealthcare. 

Unlike much-larger Hinge Health, Omada isn’t taking a valuation haircut, just a small trim when adjusted for inflation. The market capitalization versus valuation at its last letter raise is essentially flat: $1.1 billion versus $1.02 billion. Omada release, Mobihealthnews, Axios

Centene’s Health Net/Ambetter hit with ‘ghost network’ lawsuit on member fatality. Finding out that your provider isn’t in network is usually an annoyance, though it can be an expensive one. In this case, the consequences were fatal. 36-year-old Ravi Coutinho purchased an Affordable Care Act plan through Ambetter in 2023 and was being treated for mental health and addiction treatment in Phoenix. Both Coutinho and his mother, Barbara Webber, tried to find therapists who contracted with Arizona Ambetter who met Coutinho’s needs. Ambetter failed repeatedly, Coutinho’s condition deteriorated without care, and he was found dead in his apartment in 2023.

Ms. Webber filed a lawsuit last month in Maricopa County. Centene is accused of violating state and federal laws requiring network accuracy and adequacy, as well as negligence and fraud. Keeping provider networks current, especially in ACA plans, has been a known problem for years and under Congressional investigation. Studies from 2023 have indicated that 80% of provider listings contain inaccuracies, with only one-third of provider listings contacted by Senate subcommittee staffers were accurate. This is especially acute in mental health, with a shocking 3 in 4 insured adults who receive mental healthcare experience insurance problems, according to a 2023 survey (KFF). Health plans receive no incentives to keep their network listings current and accurate, though the ACA, state and other Federal laws such as the ‘No Surprises Act’ require plans to keep accurate lists of network providers. This also is not the first roundup on this issue for Centene’s plans. Healthcare Dive, FierceHealthPayer

UHG’s Stephen Hemsley will be seeing a pay cut, compared to his predecessor. UnitedHealth Group’s shareholders on Monday approved a compensation package for their new CEO. Mr. Hemsley will receive a base salary of $1 million per year. For stock options, he will receive only a one-time, $60 million equity award in nonqualified stock options with cliff vesting in three years. There will be no further awards for three years. It’s expected that Mr. Hemsley, 73, who was board chairman, will not remain CEO for the long term in this second round in the top spot. Another task he has is to find a leader who enjoys investor confidence–and who is capable of leading the company through what this Editor considers to be an inevitable change of model, likely a downsizing.

Shareholders are cutting the comp, not quite the 50% that the shares have fallen. This is considerably less than Sir Andrew Witty’s $26.3 million package for 2024, which was top of the pack from 2022 on. That year’s compensation started with a $1.5 million base salary, plus $17.25 million in stock options and $5.75 million in option awards. He also received $1.5 million in non-equity compensation plus ‘other’ of $339,000. Whether he will enjoy all of this based on 2024’s disappointing performance is not disclosed, as he resigned effective 13 May 2025 after Q1 results and a suspended forecast for 2025 were disclosed. Runner-up was Karen Lynch, who departed CVS Health last year but with a comp package of $23.4 million. FierceHealthcare 2 June, 12 May

Short takes:

The Trump Administration has named Thomas Keane, a software engineer and interventional radiologist, as Assistant Secretary for Technology Policy, formerly the Office of the National Coordinator for Health IT (ONC). According to his ASTP bio, Dr. Keane previously served in ASTP and also as a Senior Advisor to the Deputy Secretary of HHS. Among other duties, he was an administrator of the COVID-19 Provider Relief Fund and lead the development of the AHRQ National Nursing Home COVID Action Network. ASTP oversees Federal technology, data and artificial intelligence policy. More changes may be coming as Secretary Robert F. Kennedy Jr. will be reorganizing most areas of HHS. FedScoop, Healthcare Dive

Moving north to Camden, NJ, last March the Cooper Health system detected a data breach dating back to 2024. Personal health information (PHI) was apparently “accessed and acquired” without permission by an unknown actor around 14 May 2024. Abnormal network activity was noticed at the time and their systems were secured. However, the incident review which wrapped in March 2025 confirmed the PHI acquisition and Cooper has since notified the suspected individuals. Information accessed on individuals may include names, dates of birth, Social Security numbers, health insurance information, treatment information, medical record numbers. and medical history information. Mobihealthnews

Net Health acquires Limber Health. Net Health, a provider of specialized EHR software plus diagnostic and predictive analytics, including wound care and rehabilitation, is adding Limber Health’s MSK remote therapeutic monitoring and analytics to its platform. Acquisition cost was not disclosed but from the release at least some of the team will be transferring over to Net Health’s Pittsburgh team. Net Health is a 35-year-old portfolio company of The Carlyle Group, Level Equity, and Silversmith Capital Partners. Limber’s last raise was a $16 million Series A in October 2022 from Glenview Capital Management, Ironwood Ventures, and The Blue Venture Fund. (Crunchbase).  Release

Anne Wojcicki asks 23andMe bankruptcy court to reopen bidding on 12 June with fresh offer (updated with $305M bid)

June 3, 2025 | by

Anne Wojcicki still wants her 23andMe. This time, she is requesting that the auction be reopened for more bids–hers, along with a new backer. The unnamed “Fortune 500 company with a current market capitalization of more than $400bn and $17bn in cash” is interested in participating only with her TTAM Research Institute, described as a “California non-profit public benefit corporation” (PBC).  The 12 June date would allow TTAM plus the unknown backer to offer additional bids, as well as Regeneron, as requested in the filing.

The filing with the US Bankruptcy Court for the Eastern District of Missouri was made this past Saturday, 31 May. No date was revealed for the approval, which would have to be fast.

Regeneron, a $66 billion company, won the three-day auction on 16 May with an all-cash bid of $256 million. It included the Personal Genome Service (PGS) and Total Health and Research Services business lines–but not Lemonaid, which will be shut down. As is usual, it requires final approval by the court, approval under the Hart-Scott-Rodino (HSR) Act, and customary closing conditions. The bankruptcy court was scheduled to hold the approval hearing on 17 June, which would be after any reopened bidding. TTA 21 May

During the 14-16 May auction, TTAM’s formal bid was $150 million. Legal and financial advisers to 23andMe had reservations about the financial resources of TTAM and both the value and liquidity of its portfolio assets. The Wojcicki filing states that the 23andMe advisers had improperly and unfairly capped TTAM’s highest bid to $250 million. TTAM claimed that their bid would have exceeded $280 million.

According to the Financial Times, if the court permits a reopening of bids for 23andMe, Ms. Wojcicki’s bid would compete with any  Regeneron offer, but offer a “last look” to them to top any offer from TTAM along with a $10 million termination fee. FierceBiotech

One wonders where the egos shake out. Regeneron Pharmaceuticals has sound reasons for acquiring 23andMe’s genomic data to add to its developing genomics research. The price, based on our own estimate of over 10.85 million users left providing consent, was generous on a per-user basis. But you really do have to wonder why Anne Wojcicki cannot let go and say ‘enough’. 

This Editor, while not a mindreader nor an attorney, believes that the Missouri court may look upon Ms. Wojcicki’s new filing with a severely jaundiced eye.

  • There was plenty of time for Anne Wojcicki to line up a fully backed bid for 23andMe to best any rival. Buyers were in the pipeline in early April, though not a single bidder rumored in the April ‘early line’ made it anywhere near the finals.
  • 23andMe advisers, who would have access to 23andMe’s board and debtors, would also have access to information about Ms. Wojcicki’s resources. She made multiple lowball bids for 23andMe prior to the bankruptcy, including a bid with New Mountain Capital that disappeared in a week before even being presented to the board. 
  • The court, which could have stopped the bidding process, evidently agreed with the advisers.
  • The court’s purpose is to work through the bankruptcy and make the best out of what is available to satisfy the company’s debtors and a potential buyer.  
  • Finally, there is Anne Wojcicki. She was the CEO from the founding to the bankruptcy, including an astronomical public offering via a SPAC. She was not a CEO in name only, with tight control over management and the board, backed by effective full control over the public company via her special class of shares. Moreover, she has not taken any responsibility for mistakes, including the 2023 coverup of their database hacking that the company blamed upon users reusing passwords. Au contraire.

Considering the above, it’s hard to believe that at this point that Anne Wojcicki and her bid, backed by an undisclosed company, would have any credibility with the court. But let’s see what the court says. We won’t have long to wait.

Updated 5 June: Wojcicki has presented a $305 million bid to the court. Yahoo Finance

Two other views on UnitedHealth Group’s annus horribilis, for your consideration

June 2, 2025 | by

After this Editor’s call for breaking up UnitedHealth Group–two more views, for your consideration (as Rod Serling used to say before we entered ‘The Twilight Zone’).

MedCityNews examines The No Good, Very Bad Year for UnitedHealth. It’s a more, shall we say, measured view, than mine, though we plow many of the same furrows in UHG’s fertile ground. 

Additional points are made by the astute Ari Gottlieb (A2 Strategy, who had the best takes on both Cano and NeueHealth), the critical Robert Pearl, MD (formerly CEO of the Permanente Medical Group and presently a professor at Stanford University School of Medicine and Stanford Graduate School of Business), and Dr. Adam Brown (emergency physician and founder of healthcare advisory firm ABIG Health).

  • Mr. Gottleib focuses on UHG attributing its challenges to Medicare Advantage issues such as increased utilization. Yet other major insurers are stating they anticipated this and it’s trending about how they expected. He believes that UHG will manage their way out of this, much as (smaller, less complex) CVS Health apparently has, which was looking at a breakup in October 2024. But it will take time.
  • Dr. Pearl hits upon a point that I had not thought of, which is that UHG’s strategy was out of an old playbook that doesn’t work today:    “(to) become successful is you increase the medical loss ratio (MLR), by which I mean you lower the value, meaning that you invest less in actual care delivery. He (Witty) does that by a lot of prior authorization {denial}, a tremendous amount of claims denial.” In his view, UHG hasn’t moved beyond that nor is anticipating the future. In this Editor’s view, CFO John Rex’s 13 May statement of UHG’s challenges reinforces this ostrich-head-in-sand approach.
  • Finally, Dr. Brown’s fine point is taken (Editor’s emphasis): “I do believe it’s a bit of a reckoning where United, over the past several years, has been building an empire on Medicare Advantage and on vertical integration. And remember, Medicare Advantage is taxpayer dollars. … I think regulators, politicians — we see it even in a bipartisan manner — and of course patients are asking similar questions: Have we gone too far in vertical integration, and have we handed over too much of healthcare to one single entity?” He also sees them at risk due to scrutiny from the DOJ, FTC, HHS, and Congress, as well as public perception.

Takeaways: other insurers are challenged but UHG, for 40 years the best managed of the lot, is stumbling and falling into a hole of its own shoveling; it hasn’t moved beyond ‘squeezing the rock’ of MLR and reducing care delivery; vertical integration has gone too far; and it’s too much for one company.

A Substacker provides more quantification of the deep hole UHG has dug for itself in its endgame. And it’s damning. Published on 28 April before the Sir Andrew Witty resignation, and not read by this Editor before today, healthcare analyst Jeff Goldsmith on Substack analyzed the sudden end of, as he put it, UHG’s 40-year growth saga, from a primarily financial perspective. The bloom is not only off the rose, but it’s wilting. Some highlights from this Must-Read:

  • “The company is a $400 billion black box. The main United businesses-health insurance, care delivery, pharmacy benefits management and business intelligence/services–are so intertwined with one another that only United CFO John Rex and a few other senior managers actually know from whence United’s earnings actually flow.”
  • Two decades of growth were fueled by United buying other companies out of its astonishing cash flow ($3 billion per month!) 
  • They have literally run out of profitable or near-profitable companies, “accretive transactions”, to buy and add to Optum. They cannot buy other health plans without running into the antitrust buzzsaw. They can’t buy up many more physician groups as over one-third are owned by hospitals–and they are money losers (e.g. they wisely passed on Steward Health’s practices).
  • They sit on a swelling mountain of cash, which is starting to attract the Wrong Kind of Attention.
  • OptumHealth’s margin is shrinking. At seven years ago, a quarter of its present size, its margins were 10%. They are now 25% less. It also bought high-quality practice groups like Kelsey Seybold that had profitable contracts with competitors like state Blues’ Medicare Advantage or their own plans (Kelsey)–which aren’t so profitable anymore.
  • OptumInsight was decimated by hasty acquisitions–Equian, Change Healthcare, and naviHealth. It went from a 28% margin business to 16.5%. (Change Healthcare alone was responsible for a $2.9 billion loss.)
  • Then Change’s ransomwaring and hacking proved that UHG was negligent in running that type of business. As stated before in writing about Change, UHG did not do its due diligence on the only partly digested meal-via-acquisition that Change really was, nor spent the two years before the cyberattack reviewing and hardening Change’s systems. His conclusion–United can’t run that type of business competently. (Too true of ‘black boxes’)

He also returns to the brutality of UHG’s ‘denial machine’ of AI-driven claims and prior authorizations, killing them not only politically but also in a research metric commonly used to rate plans. United has a minus 12 ‘net promoter’ score, which is as bad as it sounds.

It confirms that no one except perhaps (!) at the C-level really had their arms around all of UHG’s businesses. The facts are far more than inconvenient, more like damning. While the tide was lifting all the boats, it was keen and peachy. But when the end hits the fan…will one of the strategy’s architects, Stephen Hemsley, try to save it whole or dismantle it?  Hat tip to Matthew Holt via LinkedIn.

Weekend reading/viewing (for me too): Rural telehealth blackouts and value-based care’s ‘utopia’

May 29, 2025 | by

Your Editor recommends grabbing lunch or a cuppa for these lengthy reads/views:

Flawed Federal Programs Maroon Rural Americans in Telehealth Blackouts. This is mostly about the billions spent in ‘last mile’ programs since the Clinton Administration (!) through the first Trump Administration that were supposed to subsidize better internet connectivity to the un- and poorly connected in US rural areas. This Editor has written about both the FCC Rural Health Program, state programs funded by Covid money, and more pilots going back a decade that never seemed to culminate in success. The programs were makeshift and while some have worked, have left nearly 3 million other rural Americans, young and old, in “dead zones” where even where there is connectivity, there’s not enough bandwidth for telehealth. It focuses on about one-third of West Virginia: 14 counties where high-speed internet deserts overlap with health care provider shortages. Warning, mildly ax-grinding political. Published in the Daily Yonder from KFF Health News.

Value-Based Care: Sluggish Adoption or an Unrealistic Utopia? This panel discussion up on YouTube hosted by Alex Koshykov brings together Sergei Polevikov (AI Health Uncut, see sidebar), Arvind R. Cavale (Clinical Endocrinologist, Diabetes & Endocrinology Consultants of Pennsylvania, LLC), Sally Lewis (Swansea University Professor Value in Health Management), and Mendel Erlenwein (Founder and CEO of CareCo) to discuss what the infamous VBC is really (again) all it’s cracked up to be. It’s supposed to be all about the outcomes, but when was the last time a patient walked in and asked for ‘value’? Having played in the ACO world where the mantra was VBC all the time, like ACOs what it meant went from three supports to four and in the view of whomever you were speaking with. 1 hour 20 minutes.

Short takes: Midi Health’s longevity care for women covered by (some) insurance, NZ government 24/7 telehealth scored by GPs, Auxira tele-cardiology follow-up launches

May 29, 2025 | by

Midi Health broadens mid-life women’s health into longevity–covered by some insurance. Midi Health, which targets women in their middle years (a limiting definition, as this Editor will explain), is pursuing a broader spectrum of services. Their “longevity care” service, dubbed AgeWell, is promoting their ‘whole person’ care. The first step is blood testing and then a virtual visit to review a  personalized care plan involving supplement and medication recommendations, such as hormone therapy. This is an interesting development as it 1) mass markets longevity ‘lite’ and 2) repositions it to be at least partly paid by insurance. Midi is clearly shifting to be more than menopause and about more of the total women’s longevity picture. Axios

Unfortunately, the drawbacks are many to many most interested. There’s no genetic testing. And while some commercial insurers like UnitedHealth, Cigna, HealthNet, and some Blue plans participate, the big omission is Medicare and Medicare-related plans, such as Medicare supplements and Medicare Advantage. The third is marketing that excludes older women. This Editor hates to be Debbie Downer as Midi is trying hard to provide more care plus a continuity of care to women traditionally ignored who are most interested in health and longevity–and believe me, she is, for decades. But it’s very clear that Midi is not interested in women with a few more cycles on the old airframe who are basically healthy, consider themselves still in mid-life, and want to remain so.  All the pictures and testimonials are from women who are 35 (perimenopause) and early menopause (maybe up to 55). Ouch. One can, of course, cash pay for services but it’s very clear that older healthy women in the 60+ age group who are seeking and need services like their offerings aren’t where Midi is at. And that is disappointing.

GPs in New Zealand are warning that the government’s 24/7 telehealth scheme is not all it’s cracked up to be. This Editor hasn’t heard much from NZ (or in Maori, Aotearoa, which seems to be widely used there) of late but this is perhaps an instance of good intentions gone sideways. The chair of NZ’s association of general practitioners, Dr. Buzz Burrell, is cited in Nine to Noon (NZ) 28 May that “to his knowledge, no GP organizations had been consulted over the design of the new telehealth platform, which was concerning.” Dr. Burrell points out that the country has an acute shortage of GPs, estimated at 500-1,000, and further fragment the continuity of GP practice into ‘hit and run’ medicine. An interesting point he made, FTA, was that “research had shown that patients who had the same GP for five years, lived four years longer on average, and had 30 percent fewer referrals to secondary services.” This is a terrific argument for family/primary care.

Background: The NZ Digital Health Association chair is promoting it as it would making it easier for patients to access a doctor and help to avoid “clogging up the hospital system”. NZ is funding a scheme for after hours urgent care but GPs have already said that the NZ$164 million (US$ 98.1 million) funding over the next four years is nowhere near enough–and with the local shortages, who will be staffing the centres? Nine to Noon 19 May  Hat tip to Editor Emeritus Steve, from Roy Lilley’s NHS newsletter today (but I didn’t see it!)

Auxira Health moves out of stealth for ‘white label’ tele-cardiology services. The telehealth startup is centered on cardiology followup as what they term a ‘practice extension’ (clever!) supplementing practices with remote advanced practice providers (APPs) to serve patients in low-acuity visits and handle administrative tasks like inbox messages for physicians. Where it’s different is to match the APPs and services to meet the needs of specific cardiology practices. It was designed out of MedStar Health, funded by the American Heart Association’s Studio Red venture arm, plus Abundant Health Ventures and the investor’s consortium of 17 health systems about a year ago. CEO Inna Plumb was a founding partner at Redesign Health and CEO and co-founder of MedArrive. FierceHealthcare

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

May 29, 2025 | by

Another review/meta-analysis confirms that GLP-1 weight off doesn’t stay off. A University of Oxford systemic review and meta-analysis of 130 full texts, distilled to 11 studies with 6,370 participants, determined the quantity of weight gain after discontinuing GLP-1 RA (receptor agonists) drugs. The gain was approximately 0.8kg (1.8 lbs.) per week for the new, more effective and common GLP-1 drugs semaglutide and tirzepatide, which means that weight loss was regained in approximately 1.5 years (76 weeks+). The meta-study notes that the regain is greater than observed following behavioral weight management programs. The study was done by researchers at the Nuffield Department of Primary Care Health Sciences, University of Oxford and the National Institute of Health Research Oxford Biomedical Research Centre, Oxford. Presented at the 32nd European Congress on Obesity (ECO) 2025 in Malaga, Spain.  Poster PDF here.

Another study from Sacred Heart University (Connecticut) noted last week as a sidebar to our WeightWatchers and Calibrate article also found that the weight regain was proportional to the original weight loss. The regain varied by type of GLP-1 drug, but the study labels it ‘significant’. Obesity Reviews (Wiley) 4 April 2025 

GLP-1 weight loss is not puppies and rainbows as it’s being 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 drugs in future. For the non-obese, it requires continuing weight/lifestyle management and a recognition of the rebound. It’s a good news/bad news scenario for teleprescribers and pharmas: users will require ongoing management and may cycle through another round in a year or two- to lose weight again, but they could also be disappointed and not want to spend the money. Hat tip to the GLP-1 Digest 25 May on Substack.

A “soft robot” that strolls off its 3D printer. We’ve missed our robots. Scientists at the University of Edinburgh developed a new, inexpensive printer that created a palm-sized, 100% soft plastic, walking robot. When connected to a compressed air supply, the robot walks off the 3D Flex Printer (video download here). It’s not much to look at (at left in the picture) but soft plastic robots have great potential for use in areas such as nuclear decommissioning, the biomedical sector and in space. Designs for the printer are public and the printer uses inexpensive off-the-shelf parts that cost less than £400 and don’t require a PhD to put together. University of Edinburgh release

Ambience Healthcare’s ambient AI model now outperforms board-certified physicians in ICD-10 coding accuracy. Ambience’s platform, trained using OpenAI’s Reinforcement Fine-Tuning (RFT) technology, has a 27% relative improvement over physician benchmarks, which means a significant reduction in ICD-10 coding errors. The Ambience system combines scribing patient encounters with identifying the ICD-10 codes to generate a fully informed note that then allows the clinician to review and confirm accurate documentation and coding in real time. Ambience covers codes in over 100 specialties and is in use at 40 health organizations for documentation.  Release

Get A Second Opinion enters the DTC information market on medications. The subscription model at a modest $35/year solves the problem of consumer confusion over medications, interactions, alternatives, and cost. Its two tools are:

  • Discovery Tool: Analyzes a single medication and/or condition against a unique profile, generating a comprehensive report with rankings, supporting data, and average monthly cost—often identifying more effective alternatives with fewer side effects at a lower cost. The annual plan covers up to 10 reports.
  • Planner: Evaluates up to 10 medications treating up to 10 conditions simultaneously, identifying optimal treatment combinations while minimizing side effects and adverse interactions. The annual plan covers up to two reports.

The profile is built using their AI Diagnostician engine, which analyzes age, sex, BMI, medications, pre-existing conditions, and price. It  cross-references each unique profile with FDA data, medical studies, warning labels, and clinical outcomes. Get A Second Opinion also offers a 100% accuracy guarantee. Having all the information in one place is more than reassuring and worth it, especially when prescribed new drugs. Your Editor can say this from first-hand experience–and her brother is a physician! Release

AssistIQ’s surgical supply chain management system raised a Series A of $11.5 million. Funders were Battery Ventures, with participation from existing investor Tamarind Hill. AssistIQ tracks actual supply and implant usage in operating rooms and procedural areas using the AIQ Capture platform that tracks supplies and implants as they are used, eliminating RFID and barcodes, and integrating them into EHR and billing records with 98% accuracy versus half in manual systems. The Montreal-based company had an initial seed raise of C$2.5 million from StandUp Ventures. Its US flagships are design partner Northwell Health (Allscripts transitioning to Epic), Owensboro Health Regional Hospital in Kentucky (Epic), and others in coming months. It is also a partner with CHUM— Centre hospitalier de l’Université de Montréal , the anchor hospital for the University of Montreal. Mobihealthnews, Battery Ventures release, BusinessWire release

Job Posting: Yosi Health seeks Demand Generation Manager and Manager, Data Analytics & Reporting

May 28, 2025 | by

One of our Perspectives contributors, Yosi Health, is seeking candidates for two positions:

Demand Generation Manager

This role combines lead generation with marketing analysis, coordination with sales and marketing, and digital marketing to the B2B buyer customers. It is a full time position, remote/hybrid/in-office NYC.

About Yosi Health:
Yosi Health is a leader in pre-arrival patient intake and engagement solutions, transforming how healthcare practices interact with patients. Our platform streamlines administrative workflows, enhances patient experiences, and drives revenue growth for providers. As we continue expanding, we’re looking for a Demand Generation Manager to accelerate net new lead acquisition, optimize marketing performance, and position Yosi Health to be the segment leader.

About the Role – Is this You?
Yosi Health is looking to add a talented Demand Generation Manager to accelerate our company’s growth. We are looking for someone who wants to be part of a team that is making healthcare smoother and more pleasant for patients of medical practices. We want to bring on an energetic teammate who knows how to turn interested readers/viewers into potential buyers. If you are a demand generation expert who knows how to engage B2B healthcare buyers, that dives into solve problems rather than arranging meetings to study the situation and explores out-of-box ideas, then you may be the person to lead Yosi Health’s demand generation efforts.

For more details and to apply, see their Careers section and the job listing here.

Manager, Data Analytics & Reporting

This position oversees data collection, analysis, reporting and infrastructure maintenance to help gain valuable insights to make business decisions. It is a full-time position, hybrid and based in their NYC office.

About the Role – Is this You?
As Manager of Data Analytics & Reporting, you will play a central role in shaping Yosi Health’s data strategy — helping us unlock the full value of our data to drive growth, improve patient outcomes, and deliver outstanding client value. You’ll lead efforts across analytics, reporting, and insights while working cross-functionally with Sales, Marketing, Product, and Customer Success. You’ll dive into millions of patient records to uncover key trends, create powerful client KPIs, and guide strategic decisions across the company.

For more details and to apply, see their Careers section and the job listing here.

Should free-falling UnitedHealth Group be broken up? Or break itself up to survive, before it becomes another GE? (updated)

May 28, 2025 | by

Breaking up is hard to do. But should be done if UHG wants to survive and thrive.

Our proposition: UnitedHealth Group has become a victim of its own giantism, conflicts, and focus on financials–and its failure will drag down healthcare.

How big? By far, it is the largest US health insurance company based on 2023 enrollments with a 15% market share, 29 million members, and $371.6 billion in revenue. It leads by far Elevance Health (formerly Anthem, 12%), CVS Health/Aetna (12%), Cigna (11%) and Health Care Service Corporation (7%). A more realistic picture of its size is that it is now is the US’ fourth-largest firm by revenues, just behind Walmart, Amazon, and Apple. (Visual Capitalist 17 Dec 2024, based on American Medical Association data). Their growth has been led by acquisition into Optum, their health services division. It houses their owned physician practices as the largest owner of practices in the US with 90,000 physicians, their ACO relationships, data analytics, Change Healthcare, the largest billing and claims management company, home care/hospice, the third largest PBM Optum Rx, a venture investment arm, and much more. Optum is the massive symbol of the integration envisioned by former and current CEO Stephen (Steve) Hemsley. Other health plan companies have health services units, for instance PBMs–CVS has Caremark and Cigna Express Scripts, both larger than OptumRx, and analytics–but not to the vertical and horizontal integration depth and extent of UHG’s continuing search for revenue and profit.

The road this vision took under Mr. Hemsley and later Sir Andrew Witty took diversions along the way that have escalated into a cadence of legal troubles, a near-perfect storm of corporate misery, that have damaged them among customers, shareholders, and regulators. A list of the recent highlights (bold type links are new information; standard type links refer to earlier TTA articles):

  • The contentious two-year-long purchase for an eye-blinking $7.8 billion or $13 billion of Change Healthcare that finally closed in 2022. While opposed by the Department of Justice (DOJ), the District Court disagreed and said it wasn’t anti-competitive or prevented competitive entry. 
  • Change Healthcare was a House That Jack Built that collapsed spectacularly in February 2024 with the ALPH-V/BlackCat ransomware attack. It was evident that Optum didn’t conduct basic due diligence on Change Healthcare’s multiple systems, built up over multiple acquisitions, nor set to work fixing them after the closing, leaving the largest claims/payment system vulnerable. UHG’s response managed to anger patients, providers, and HHS. It took Optum most of 2024 to fix it at a loss of at least $2.3 billion. 
  • DOJ has been investigating certain relationships between the company’s UnitedHealthcare insurance unit and its Optum services unit, specifically around Optum’s ownership of physician groups. This started in March 2024.
  • The $3.3 billion acquisition of Amedisys home health has taken over two years (since June 2023) and has taken multiple rounds of divestitures–and still DOJ is grinding its Paul Bunyan-sized ax against it, filing their suit in Maryland along with four state attorneys general in November 2024.
  • DOJ’s insider trading investigations may have started as early as October 2023. The $300 million Hollywood (Florida) Firefighters Pension Fund filed a class action lawsuit in mid-December 2024 alleging that the sales were made while the Department of Justice (DOJ) was considering an anti-trust action against UHG that would revisit the so-called ‘firewall’ between it and Change Healthcare. Named in the lawsuit were Brian Thompson, head of UnitedHealthcare, Andrew Witty, and Steve Hemsley. (Sir Andrew resigned from UHG’s board effective 20 May, Becker’s and SEC Form 8-K)
  • DOJ is reportedly investigating UHG for criminal Medicare Advantage fraud, according to the WSJ earlier this month, reported in HealthcareFinance.
  • The latest accusation: kickbacks to nursing homes to reduce patient transfers to hospitals and thus costs, based on an investigative report from the UK Guardian reported in FierceHealthcare last week.

The Brian Thompson assassination earlier in December uncapped a boiling volcano of resentment against the health care system that crossed political lines, then focused on UHG itself and its claims treatment. Next it revealed something that UHG undoubtedly didn’t want known–that UHG’s AI-powered claims review system had a 33% rate of claims denial on marketplace plans across 20 states, the second highest in the US (first was BCBS Alabama, a single-state plan) (KFF). This eruption unleashed a tsunami of heartrending social media stories of denied care and approved then denied care by UnitedHealthcare, including one for a patient delivered to a surgeon post-operation.

  • Instead of examining their methods, UH doubled down on featuring ever-so-trendy AI. Revealed recently to the WSJ, half of their 1,000 + AI-powered apps use generative AI and the remainder a more “traditional” form, without explanation of “traditional” according to chief digital and technology officer Sandeep Dadlani, Their software, not necessarily AI-powered but usually rules-based or using algorithms, ‘auto adjudicate’ 90% of UHG claims. And this wasn’t new. UHG was sued in Federal Court as far back as 2023 in using an AI-powered application to evaluate and deny claims.

This is above and beyond the business conditions that have affected every insurer: high utilization costs resulting from accelerated care activity, more (and more expensive) benefit offerings, and higher costs associated with Medicare Advantage beneficiaries, along with a minor reduction in MA benchmark rates.

One healthcare observer’s–and marketer’s–opinion, drawn from her experience not only in healthcare but also outside it.

UHG has pursued profit and growth to justify an immense share price and return to its shareholders. It has become unmoored from its business customers, instead trapped in an ever-widening gyre of increasing its revenue, profit, share price, and dividend every quarter, every year, to satisfy investors. It remains profitable, yet its share price has collapsed from over $600 on 3 December 2024–the day before the Thompson murder–to $378 on 12 May, the day prior to Witty’s resignation, to today’s close of $295. This is despite massive share purchases by Mr. Hemsley and other UHG executives, presumably to demonstrate confidence. Last week, three major investment banks downgraded their recommendations 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 back humans evaluating prior authorizations and claim approvals–and get better tools with a final review by humans. Treat providers in and out of network better.
    • Get back to being the insurer of choice for individuals and groups. Contract for the services you need, not own them and try to manage them too. UHG would not be the first insurer who has faced this–both Molina and Centene have divested all or many of their service businesses.
  • If UHG chooses to be Optum, it needs to focus on their services and how well they integrate. Divorcing Optum from UnitedHealthcare resolves a lot of conflicts around interest but there are still others.
    • Owning and controlling practices creates multiple conflicts and a closed system. The feedback from doctors in Optum-owned practices that this Editor has seen is that they are micro-managed down to the penny, escalating administrative costs and taking focus from patient care. Optum practice locations that this Editor has seen have a ‘bad look’–underused, often repurposed locations.
    • Abandon the Amedisys acquisition and rethink (or spin off) the entire home care business for the same reason as owning practices.
    • Refocus their ACOs from ‘captives’ to management services provisioning that more naturally integrates with Optum services–or get out of the business.
    • Expand analytics into providing the best and most convenient tools for hospital and practice management, which likely will require some acquisitions.
    • Optum Rx is facing its own challenges from new competitors and eroding market share–and simplification can help management focus on it. If Change Healthcare is kept, rework and reform how they process and pay claims across healthcare; harden it against the cyberattack/ransomware that cost the economy and healthcare billions. Optum Ventures and its role should also be examined for conflicts with the main business.

UHG is a company now demonstrating the end stage of integration: too many complex parts, too much administration needed to keep the juggernaut going, too many inherent conflicts, no central theme, too little focus, culminating in failure to customers and shareholders. It has become toxic in reputation to its own members, providers, and to businesses who sign commercial contracts. It’s become a falling knife, a rolling failure such as GE before its breakup or (returning to my airline days) Texas Air Corporation, once the world’s largest airline holding company. Unlike GE or TAC, UHG’s business size and outsized vertical integration choking off alternatives have created multiple situations, such as Change Healthcare’s failure, which can damage the entire healthcare system. It’s time that their new CEO and their C-levels sit down and have a long think about what their future, and the future of their role in being a healthcare leader, should be. Think…smaller.

Update 28 May: The American Hospital Association (AHA) has also provided comments to the Trump Administration, DOJ, and FTC, as part of the administration’s 10:1 deregulation initiative*, addressing payer vertical integration and its effects on providers. Payer control, concentrated among four payers that control half the market (UnitedHealth, Elevance, Aetna, Cigna) , far outstrip those of health systems, and have led to higher premiums and constraints on care. The AHA is demanding review of regulations within the Affordable Care Act (ACA) that permit insurers to circumvent medical loss ratio (MLR) requirements through high-priced practice acquisitions yet enjoy exclusions in the Stark Law (physician self-referral) that health systems cannot. Their comments also included simplification of prior authorization processes and other utilization management practices, and swiped at the increased Premarket Notification process for M&A, something that the new administration is already reviewing. FierceHealthcare published 27 May.

*For every new regulation passed, canning 10 rules, regulations or guidance documents

News roundup 22 May: an inflight ‘save’ and AliveCor’s KardiaMobile, rolling out the VA/Oracle EHR in ‘waves’, Fuze Health formed from LetsGetChecked/Truepill, hacking and ransomware 92% of PHI data breaches

May 23, 2025 | by

Leading our news with a short, heartwarming story.

A passenger on a 29 April KLM flight from Uganda to Amsterdam experienced, three hours in, heart attack symptoms and extreme pain. The Dutch passenger’s luck was that a group of passengers were medical volunteers with Cura from the World, a Oklahoma-based group returning from a medical mission to Uganda. Dr. TJ Trad, the founder/CEO and an invasive cardiologist, created an aid station for the passenger where his legs could be raised and his vitals monitored with the assistance of a nurse. The lucky part was that the team had most of its equipment aboard, including a 12-lead ECG to confirm his cardiac status, plus five medications used for emergency treatment. He was stabilized, but the interesting part was that Dr. Trad used his personal AliveCor KardiaMobile to monitor the patient for arrhythmia, the later and high emergency stage. Dr. Trad was carrying it because a year earlier, he had experienced his own heart attack that canceled out his last medical mission trip and used it to monitor himself. With the patient under monitoring and medications, the KLM flight did not have to divert to Tunisia and it landed at Amsterdam Schiphol three hours later. At the hospital, the Dutch patient was examined over 12 hours and eventually discharged, as he was not diagnosed with a heart attack, stroke or pulmonary embolism, according to the passenger’s wife speaking with CNN. Dr. Trad was able to catch his connecting flight home. From an aviation perspective, it underscores the need for medical training and an emergency kit for monitoring this type of incident. Hat tip to Dave Albert, MD, founder and chief medical officer of AliveCor.

VA now dubbing the rollout of the Oracle Cerner EHR as a ‘wave’ strategy. Dr. Neil Evans, the acting executive program director of VA’s Electronic Health Record Modernization Integration (EHRM) Office elaborated on the ‘wave’ in an interview with GovCIO Media & Research. Each rollout will be clustered in sites that routinely work together and where patients flow for care from one location to another. For instance, the planned 2026 rollout previously announced in December 2024 will be in four Michigan locations: VA Battle Creek Medical Center, VA Detroit Healthcare System, VA Ann Arbor Healthcare System, and VA Saginaw Healthcare System. The nine additional sites in 2026, except for Alaska standing alone, are similarly clustered [TTA 4 April]. The new news? FTA:

  • The White House’s proposed discretionary budget for FY 2026 calls for an increase of nearly $2.2 billion in funding for the EHR program as a “top priority effort.”
  • The proposed budget also plans to streamline much of the agency’s over 1000 IT systems, which it claims are “decades old” and “duplicative.”
  • It pauses procurement of new systems and directs the U.S. Department of Government Efficiency Service (DOGE) to conduct a full review of the agency’s IT systems alongside the VA.
  • Other government agencies are going through the same process: National Oceanic and Atmospheric Administration (NOAA), Defense Department (MHS), and the Coast Guard also are modernizing their EHRs. VA is learning from them as well as the private sector, according to Dr. Evans.

The ‘wave’ needs to work. Veterans Affairs Secretary Doug Collins outlined VA plans at two House appropriations hearings last week on the 2026 and 2027 VA budgets. The total for the EHRM is $3.5 billion in FY 2026 (Federal budgets start in October; the total budget has been dubbed the ‘Big Beautiful Budget’) and is needed for additional rollouts in FY 2027. But given the failures at the six existing implementations and the continuing fixes and patches, in a process that seems like it started in 1900 (actually 2018), one can understand the consternation of Veterans Affairs committee member Rep. Greg Murphy (R-NC): “I’m still dumbfounded at the billions and billions and billions of dollars that have been poured into an EHR that should have never been done in the first place. It’s not a system that should be used for the largest healthcare system in the country.” Healthcare Dive

Fuze Health launches–phase 2 of a merged LetsGetChecked and Truepill ‘arranged marriage’. The merger of the two last October with digital/mail order pharmacy Truepill operating as a subsidiary of at-home diagnostics via testing kits LetsGetChecked was a $525 million deal that we classified as a ‘smush’ when it was announced last August. Both were heavily invested in by Optum and torching  through cash. While $525 million was the purchase value in the headline, only $25 million was in cash and the rest of the financing didn’t add up to the total. The Phase 2 of this entity, Fuze Health, now has a third partner, prescription deliverer Alto, and a new name, Fuze Health. No acquisition amount is mentioned for Alto, which has a total funding of $62.4 million through a June 2021 Series B plus equity crowdfunding (March 2024!) and no financing from Optum (Crunchbase). The only Fuze management mentioned in the release are Alicia Boler Davis, Alto’s CEO, and Paul Greenall, Fuze chief development officer. Their website links back to the four individual companies.

In 2022, LetsGetChecked acquired Veritas Genetics, now prominently featured as part of Fuze. Also in 2022, Truepill fell under DEA scrutiny with a ‘show cause’ action after being a fulfillment pharmacy for Cerebral and Done Health in their Schedule II controlled substance violations. This was settled in November 2023 with multiple requirements including continuing heightened compliance (DEA release). Fuze Health promotes itself as “a technology-powered home health screening, genomics and pharmacy services provider committed to transforming patient experiences and enabling its healthcare partners – including care providers, health plans, employers and life sciences companies – to excel in an outcomes-focused system.” No mention of investors or backing, as is typical in these announcements.  Now go forth and make money. Hat tip to HIStalk 5/23/25 

Hacking and ransomware now constitute 92% of healthcare data breaches. Once upon a time, when this Editor reported on what were then unusual data breaches, the more common causes were insider theft, unauthorized access/disclosure, and improper disposal or loss. They have nearly vanished as the ‘business of breaches’ has settled down and internal security has approved. A cross-sectional study published as a research letter in JAMA Network surveyed breaches from 2009 to 2024 using HHS’s Office of Civil Rights (HHS-OCR) reporting. Of 566 incidents in 2024, 457 were “IT incidents” and 61 were tagged as ransomware, totaling 92%. Despite the massive Change Healthcare breach, ransomware breaches fell to 11%.  Considering patient records, there were 170 million breached in 2024 and hacking/IT incidents accounted for 91% of the total. Of 732 million records affected from 2010 to 2024, hacking or IT incidents and ransomware (considered as a subset) accounted for 88% (643 million) and 39% (285 million) of incidents. Since 2020, ransomware has affected more than half of all patients annually, reaching 69% in 2024–again, the effect of Change Healthcare. Also Healthcare Dive