Chutes, and chutes: Microsoft’s $3B Oracle cloud leasing deal goes sideways, Defense Health Agency to replace Leidos as system integrator for MHS’ EHR, Centene offering voluntary buyouts to most employees

June 19, 2026 | by | No Comments

While SpaceX has debuted to well over a $2.3 trillion (that’s with a T) market cap, it seems that even giant companies are still facing expensive headwinds.

The Microsoft-Oracle cloud deal has gone sideways, if not entirely off. Microsoft’s goal was to lease space on Oracle Cloud Infrastructure (OCI) to expand its capacity and to move some of its workloads there. Microsoft Azure would be prioritized for customers. The problem was that Oracle’s public cloud infrastructure does not have the Federal Risk and Authorization Management Program (FedRAMP) security framework that Microsoft needed for some of these workloads, and Oracle was not willing to add it. OCI does have a FedRAMP framework for its Federal Government work. A source for the Business Insider article said that it was potentially worth up to $3 billion. BI’s source within Oracle said that adding FedRAMP to the public OCI would be a “massive engineering lift”.

To Reuters and to Business Insider, an Oracle spokesperson swiftly responded that the report was “inaccurate” but did not specify the inaccuracies, and that the two companies continue to have “a  tremendously collaborative and fruitful partnership.”–a statement which can be read as a non-denial.

It highlights a shortage of computing capacity in cloud services, where Microsoft and other companies are scratching for more data center bandwidth, and turning to competitors to lease. Microsoft already leases capacity from Amazon for its GitHub code development business and is searching for more. Amazon and Google’s public clouds have FedRAMP and seem like logical alternatives if they have spare capacity. Google alone signed a $920 million per month deal with SpaceX for AI compute capacity that extends from October 2026 to June 2029. SpaceX also has a similar deal with Anthropic.

Oracle could certainly have used the cash flow.

The Defense Health Agency (DHA) will be transitioning away from Leidos as the lead systems integrator for the Military Health System (MHS) EHR and related systems by July 2027.  MHS GENESIS originated from the 2015 EHR contract award to the Leidos Partnership for Defense Health, with Cerner (now Oracle Health) for the EHR and Accenture as members. Leidos served as the lead systems integrator to onboard all the parts of the entire MHS GENESIS system, which grew to include Henry Schein for dental records, Philips North America for tele-critical care, Amwell for telehealth, and Solventum Health Information Systems (formerly 3M) for clinical documentation and coding.

Now that it is fully implemented, DHA will take over the integration role, transitioning Philips and Amwell away from Leidos by the end of this July, Oracle Health by November, and both Schein and Solventum by July 2027. Reasons cited on DHA’s SAM.gov notice were “reduced cost transparency, duplicative layers of management and administration, limited government visibility into pricing structures, and constraints on the government’s ability to directly manage performance and enforce service level agreements.”

While Leidos issued an emollient statement that they hoped to remain working with the DHA, this definitive and apparently drastic move indicates DHA unhappiness with the structure and a desire to directly establish relationships with the vendors as sole-source contractors. Unhappily for Leidos, it has affected its market value and how analysts view its future position in the Federal health IT market. Washington Technology (PDF of article), Yahoo Finance  Hat tip to a Reader who wishes to remain anonymous

Major health insurer Centene is offering voluntary buyouts to most employees through a Voluntary Separation Plan (VSP). The insurer currently employs 61,000 people across multiple plans. It is both the largest state Medicaid (12.4 million members) and Affordable Care Act (ACA, 3.5 million members) marketplace provider. But its memberships in both are shrinking. As of March, Medicaid membership was down 4% and ACA membership was down a stunning 54% (2 million members). The latter drop is puzzling, since insurers have exited or cut back on their ACA Marketplace plans, notably Aetna for this year and Cigna after this year.

ACA plans are offered on a state, then county-availability level. 2026 is the first time since 2018 that the average number of insurers participating in the ACA marketplaces has dropped, according to KFF cited in MedCity News. The ACA premium tax credit subsidies expired at the end of 2025, effectively causing premiums to double for nearly everyone. Many members dropped out of exchanges; those who remained were sicker (higher risk) and in lower-level plans that cost less in premiums. Centene also expects that its ACA membership will fall by another 40% by the end of 2026, per their company statement at a Barclays conference in March. CNBC

While Centene has grown membership in other plans, such as employer-sponsored plans and Medicare prescription drug plans (PDP), its total membership has decreased.  Centene currently has almost 26.3 million at-risk members, down from 27.9 million in the prior year, a 6% decline. Yet revenue is projected to remain relatively flat, with a forecast of about $189.5 billion at the midpoint of 2026, a decline of roughly 3% from 2025. Share price has recovered from last year’s nadir by over 50%

According to (paywalled) Bloomberg News (quoted in Insurance Business), “a [Centene] spokesperson did not specify how far Centene intends to shrink its headcount, but said layoffs could follow if the company fails to reach its target through voluntary departures.” In her message to staff last Monday, CEO Sarah London wrote, “When our membership shifts, we need to shift our organization accordingly.” To Healthcare Dive, a spokesperson said that “Centene is positioning the company to lead the future of healthcare — working to deliver a simpler and better experience for our members and partners while meeting the realities of today’s healthcare environment.” 

Now what could that mean? That “shift” in London’s terms requires a repositioning and further reorganizations. Those have not been disclosed or even hinted at–yet.  Certainly, that will be a subject at Centene’s Q2 earnings call in July for investors and shareholders.

In this Editor’s view, rarely does shrinking to profitability work except as an interim strategy to stem losses. Because health plans operate on an annual basis, and enrollment periods start up in the fall, it’s likely that changes won’t be disclosed until then, though internal reorganizations will start to happen. It is hard to operate plans on a ‘bare bones’ basis for long, the nature of the health plan ‘beast’. Lack of service and low customer satisfaction affect vital quality ratings such as STAR (CMS) and HEDIS (NCQA), which influence both CMS payments and plan buyers.

This leads to other alternatives that may be open to Centene. The company could be acquired, broken up, or the larger plans spun off.

  • A full sale presents regulatory and Federal antitrust problems to any plan, and would take a long time for approval both at the state and Federal level. Perhaps longer than Centene can afford.
  • Payers aren’t attractive to private equity except on a hit-and-run basis. Politan Capital, since its major moves to reorganize Centene in 2022-23 after accumulating $900 million in shares, is now down to $70 million.
  • What might be faster: selling off individual or groups of plans to a smaller company such as Molina, or to larger Cigna (once rumored as an acquirer, now divesting whole lines of business), Elevance, or Humana. Centene has always been a ‘family of brands’ such as Wellcare and HealthNet, and the Centene ‘brand’ is nonexistent.

It cannot be emphasized enough that Federal antitrust and the states present significant regulatory barriers on all these alternatives. The plans are what is left to sell. Centene has already sold off most, if not all, of its non-plan management services, such as Magellan and the Collaborative Health Systems ACO/MSO, to generate cash after the Politan Capital-led reorganization.

Another factor: at the state and Federal levels, since ACA, Medicaid. and Medicare Advantage plans are funded and approved by them, eventually the layoffs will attract attention and questions by CMS and state departments of banking and insurance (DOBIs). The VSP may be a way to get around them.

Details for the VSP, eligibility as a % of the workforce, and acceptance goal numbers have not been publicly disclosed. Employee posting sites such as The Layoff and on Reddit indicate that the ‘bonus’ for signing the agreement is an additional four weeks on a package based on your tenure by service years and grade level, plus paid-for COBRA and outplacement. The consensus in the comments is that the information provided to eligible employees is somewhat vague. The word “estimated” is used in terms of the buyout. In addition, ‘eligibility’ apparently does not guarantee that the applicant will be accepted for the VSP (an exit date mentioned is 1 September) nor that an involuntary layoff for a lesser package will take place before then. Recent hires with tenure under two years apparently are not eligible. Opt-out date is 2 July. Unsurprisingly, a third-party administrator has by reports been brought in for this. For employees, another consideration is that accepting a voluntary separation means that in many states, it is treated as ‘quitting’ and you are ineligible for unemployment payment. Most on these boards believe that involuntary layoffs will happen anyway.

It is certainly a difficult decision to make for most people. Best wishes from this Editor to everyone. The impact on healthcare is not going to be subtle, which is why this is discussed at length. (Disclosure: this Editor was briefly a Centene employee after the company she worked for, WellCare Health Plans, was bought by Centene. She is a holder of Centene stock converted from her prior company. The above is strictly her opinion and protected speech, and should not be used as investment advice.)

Tuesday 23 June–UKTelehealthcare webinar/virtual event: Keeping People at Home, Supported by Technology

June 18, 2026 | by | No Comments

Long-time TTA partner UKTelehealthcare is presenting a free and open to all two-hour Zoom webinar/event next Tuesday. It is focused on the role telecare in multiple forms takes in the UK to support residents in their homes to reduce pressure on acute care.

Presenters are from UKTelehealthcare (Gerry Allmark and Ross Barrie, the organization’s new CEO), Tunstall, TakingCare, Kuradocs, Kyndi, Mole Valley Life, and Legrand. The Tuesday 23 June event will be from 10 am to 12 noon BST (UTC+1). Agenda and registration are here on the Events page. When you register, you may also submit a question for the panel.

From the event: 

One of the most significant shifts underway in healthcare right now is the move towards supporting people to stay at home for longer, using technology to deliver the right care, at the right time, without the need for a hospital bed.

This webinar will bring together leading thinkers and practitioners to explore how digital tools and remote monitoring are helping to prevent unnecessary admissions, support earlier discharge, and reduce the pressure building on our acute services.

The session will examine:

    • What is working on the ground across the UK
    • The technologies enabling people to be safely managed in their own homes
    • The care pathways being adapted to make this possible
    • The role of clinical and non-clinical teams in delivering these services
    • The real-world impact on patients and the wider healthcare system

Perspectives: Virtual Care, AI, and the Future of Autism Therapy

June 17, 2026 | by | No Comments

TTA has an open invitation to industry leaders to contribute to our Perspectives non-promotional opinion and thought leadership area. Today’s topic concerns how technology can increase access to outcomes-based behavioral health care for underserved families, improving the progress and effectiveness of care for those children with autism. Our author, Jeff Beck, LCSW, is the co-founder and CEO of AnswersNow, which provides virtual support based on applied behavior analysis (ABA) therapy. Mr. Beck spent the first 15 years of his career working directly with children in low-income and rural communities.

Recent reporting in The New York Times is just the latest to detail allegations of fraud, abuse, and excessive billing across parts of the autism therapy industry. But this story was especially troubling because of the stories of the children and families caught in the middle. It’s a reminder that the challenges in autism therapy today are human ones with real and urgent consequences. 

At the center of these issues is healthcare’s longstanding fee-for-service reimbursement system, which incentivizes autism providers to bill for therapy hours rather than patient progress. Now, the ongoing surge in autism diagnoses and the continued scarcity of highly trained clinicians have created an even greater opportunity for those same providers to ramp up their billings and lock children into extended cycles of therapy without producing meaningful improvement.

The encouraging news is that technology is changing that calculus.

For years, healthcare leaders have talked about shifting from fee-for-service reimbursement toward outcomes-based care. In autism therapy, that means aligning families, providers, and payers around a holistic goal to help children make progress faster and more efficiently. The challenge has been how to measure outcomes, scale care, and manage costs.

Today, virtual care and artificial intelligence are making all three increasingly achievable.

Virtual Care Solves More Than Access

Telehealth is often described as a convenience. However, in autism therapy, virtual care is creating entirely new ways to deliver higher-quality care.

  1. Virtual care expands access. Traditional autism therapy relies heavily on centralized clinics, forcing families to travel long distances and organize their schedules around available appointments. In many communities, waitlists stretch for months or even more than a year. Virtual therapy removes geography as a barrier and allows families to receive support directly from home.
  2. Virtual care helps solve a workforce problem. The shortage of Board-Certified Behavior Analysts (BCBAs), our industry’s most highly trained therapists, is unlikely to disappear anytime soon. Virtual care allows a BCBA in one location to support families hundreds of miles away, dramatically expanding access without requiring a corresponding increase in the workforce. It also means that, rather than spending large portions of their day supervising less-trained staff, BCBAs can work more directly with children and caregivers. More one-on-one interaction can lead to more personalized care and stronger therapeutic relationships. It also has the added benefit of boosting clinician retention rates. 
  3. Virtual care can improve the therapy experience itself. Children often learn best in environments where they feel comfortable and secure. Sessions conducted in the home allow therapists to work within real-world routines and challenges rather than simulated clinical settings. And for some children, interacting through a screen can even feel more natural and familiar.

AI Makes Better Care More Scalable

AI can be a force multiplier, improving both the efficiency and availability of BCBAs. But it can also be deployed to enhance the therapy experience itself and measure progress over time. 

  1. AI enables more personalized therapy. Historically, creating individualized materials and activities required substantial clinician time. AI can now help therapists generate customized content aligned to a child’s interests, developmental goals, and learning style in real time. That allows clinicians to adapt more quickly and keep sessions engaging and relevant for faster progress by kids.
  2. AI helps reduce administrative burden. Highly trained clinicians routinely spend hours each week documenting sessions, reviewing records, writing notes, and developing care plans. These activities are necessary, but they reduce the time available for direct patient care. AI can take on many of these tasks, returning meaningful time to clinicians. 
  3. AI can improve how providers measure and manage outcomes. It can help identify patterns earlier, track progress more consistently, and support more informed treatment planning. Just as importantly, it generates the data needed to evaluate whether children are actually improving rather than simply accumulating therapy hours.

Of course, security and compliance are non-negotiable in this space, especially given the strict regulations health systems and payers face. The default industry standard should include a “compliance toggle” that allows enterprise partners and families to completely disable AI tools whenever their internal security protocols require it.

Building the Next Generation of Autism Care

Autism therapy is entering a period of necessary scrutiny, and bad actors should be held accountable. But the larger opportunity is to build something better.

  • Providers should view virtual care and AI as more than operational tools. Together, they make it possible to deliver higher-quality care with greater efficiency, personalization, and transparency.
  • More importantly, they create the foundation for a different model of care, one where success is measured by a child’s progress rather than the number of hours billed.

That shift will take time. But providers using technology to expand access, strengthen outcomes, and improve accountability will help define what better autism care looks like for the next generation of children and families.

News roundup: VSee refocuses business, transitions CEO; legacy PERS connectivity problems; South Korea’s AI ‘Talking Buddy’, expands telemedicine to foreign patients; Novellia’s $18M Series A

June 12, 2026 | by | No Comments

Veteran telemedicine robotics company VSee separates from its Labs subsidiary, moves to a single CEO.  Best known for its acute care telemedicine robots, most recently debuting at HIMSS an AI autonomous robot that navigates by LiDAR [TTA 12 Mar], VSee is now featuring on its website not only the iDoc telehealth platform but also multiple enterprise healthcare tools, such as for revenue cycle management, analytics, staffing optimization, remote monitoring, patient engagement, and more. Its latest move: sell off the VSee Labs subsidiary to now former co-CEO Milton Chen for the return of his ownership in the company–7% of their outstanding stock or 2,870,069 shares, plus making good on any remaining liabilities. At today’s Nasdaq Capital Markets valuation of $0.156, the purchase price was approximately $447,731. The rationale given in the press release was that it eliminated “a non-core and operationally distracting division”, a “strategic reset”, and that the retirement of shares enhanced shareholder value. With Mr. Chen’s departure, Dr. Imoigele Aisiku is now sole CEO and board chairman. VSee shares reached their $17/share peak on 27 May 2024 and fell precipitously from there. Release

Traditional PERS alert units are still a feature of senior housing and private homes. The problem is that many of these older systems, built for wireless 3G systems, don’t work so well anymore. Because wireless companies such as AT&T and Verizon shut down 3G services four years ago, these legacy PERS devices may appear functional but fail to connect to monitoring centers. Another issue is rural cell networks and landlines. The latter are being withdrawn in many areas to internet service, or moving from copper to fiber. Providers need to test their devices on the local 4G LTE cell networks for their customers in those areas to ensure that they work. PERS Insider, Saving Advice

Also noted in PERS Insider is South Korea’s “Talking Buddy”. It is a conversational AI chatbot service developed by Naver Cloud that places wellness calls to seniors. It can remind the client of the usual, such as eating, sleeping, hydration, and medications, but it also can be programmed for post-operative follow up. It can have reasonably interactive chats and in one case, identified a senior in distress, contacting a social worker. It was developed from a fever checker in the pandemic period. In the original New York Times/Japan Times article is a profile of Rowan’s SuperBrain, a tablet-based program designed by neuropsychiatrists that prompts users with early cognitive impairment through a series of brain exercises designed to stimulate memory and association. South Korea is facing a ‘tsunami’ of dementia patients, with an estimated 2 million expected by 2044. The disease carries stigma, especially among highly self-reliant Korean seniors who fear dependence.

South Korea is also expanding telehealth to foreign patients who visit the country for medical procedures. Korea is becoming a desirable destination for medical tourism, with about 2 million annual visitors. The Medical Overseas Expansion Act was amended to include telehealth services for these short-stay patients. These include remote pre-visit consultations and follow-up care at clinic or hospital-level medical institutions, continuous observations, counseling, education, diagnosis, and prescriptions. Healthcare IT News

Novellia garners $18 million Series A. The funding round for the New York-based company was led by Spark Capital with participation from Khosla Ventures, Acrew Capital, Bling Capital, and TMV, bringing Novellia’s total funding to $28 million. Their platform is targeted to patients with serious or chronic conditions, helping them to pull all their data from various health providers, add information, digitize paper records, and overall control their health history. Novellia most recently introduced a mobile app platform. The fresh funding will be used to scale Novellia’s AI-powered technology, adding emerging therapeutic areas such as GLP-1 and cardiometabolic, and the opportunity to share their information with medical researchers. This last feature is another revenue stream for Novellia, which then shares anonymized insights to pharma companies and diagnostics firms for R&D. Release, Mobihealthnews, MedCityNews

VA’s EHR goes live with four more centers; GAO criticizes VA, MHS on EHR cybersecurity collaboration

June 12, 2026 | by | No Comments

VA stays on schedule with four more EHR go-lives. On 6 June, right on schedule, the Oracle EHR went live at four more VA Medical Centers in Ohio and Kentucky: Cincinnati VA Medical Center, Chillicothe VA Medical Center, Dayton VA Medical Center, and the Cincinnati VA Medical Center-Fort Thomas. All are in VISN 10 (VISN=region). This second wave of 2026 transitions, according to the VA release, more than 107,000 veteran patients and 7,200 VA clinicians and staff. The next wave of three more VAMCs will roll out in August with a final two in October.

Interestingly, the VA release also scores the previous Biden Administration on holding up the EHR implementation for two years, starting after the well-publicized disastrous implementations of 2020-2023. Our Readers and this Editor remember that Congress, led by a Republican House and the Veterans committees (the House approves budgets), basically forced VA to end the deployments [TTA 26 April 2023] and renegotiate the next five years of the Oracle contract to contain performance metrics and requirements [TTA 18 May 2023]. At least some of the reforms noted in the release started under that previous administration, but the second Trump Administration starting in 2025 should be credited with accelerating what many of us observers considered a ‘dead in the water’ repair and rollout. The biggest change is the standardization of the system across the VAMCs; the previous deployments allowed for too much customization by facility, something Oracle wasn’t exactly equipped to handle with the legacy Cerner system.  Federal News Network

There’s also an enjoyable, locally made YouTube video of the go-live at the Dayton VAMC. It focuses on the IT team and how they are helping the clinical staff, including the first new patient entered into the EHR. Complete with an opening group prayer service and dancing–how can they lose? YouTube video, 3 minutes. 

What’s not going so well is VA-Department of War (DoW formerly DoD) cooperation on EHR cybersecurity issues. A new Government Accountability Office (GAO) report discusses how the Federal Electronic Health Record Modernization office (FEHRM) that is responsible for oversight and direction on joint functions is not adhering to “leading practices” in several areas. The Oracle EHR is not only used at the VA but also in a different version covers the Military Health System (MHS),  the US Coast Guard, and the National Oceanic and Atmospheric Administration (NOAA). The DoW has the primary responsibility for ensuring cybersecurity of the EHR systems. Where the agency fell short was in defining common goals, outcomes, and performance metrics, as well as communicating progress on EHR cybersecurity and privacy.

FTR:

GAO is making one recommendation to DOD and one to VA to direct the FEHRM to define common goals, outcomes, and associated performance measures, and monitor, assess, and communicate progress on collaboration efforts toward ensuring the cybersecurity and privacy of the federal enclave. DOD disagreed with our report and VA neither agreed nor disagreed with the recommendations. GAO maintains its recommendations are valid, as discussed in this report.

The GAO is required by the Further Consolidated Appropriations Act of 2024 to conduct performance audits; this one covers June 2024 to June 2026. GAO summary with links to full report, Healthcare IT News

UK News: Health Bill 2026 modernization will abolish NHS England, introduce Single Patient Record, save 20K A&E visits and £20M; IPO launches Knowledge Asset Management Hub

June 11, 2026 | by | No Comments

The UK Government proposes a far-reaching bill to modernize the NHS. The Health Bill proposed to Parliament has passed its second reading before the House of Commons and is now in committee. The sponsoring department is the Department of Health and Social Care (DHSC) and applies to England and Wales only. 

The bombshell part frontloaded in the Health Act 2026 (full 200 pages here) is the abolition of NHS England. The intent is to “put power and resources in the hands of frontline NHS organisations by abolishing NHS England and stripping back national bureaucracy”. The organization’s responsibilities would be devolved by the Secretary of State to any one or more of the following, largely at more local levels: 

  • the Secretary of State
  • an integrated care board (ICB)
  • a company formed under section 223 of the National Health Service Act 2006
  • a Special Health Authority
  • an NHS trust
  • an NHS foundation trust
  • a Local Health Board
  • any other public body

Local ICBs would be more numerous and gain more powers, but have more direction from and control by central government, via the DHSC.

The second bombshell is the Single Patient Record (SPR). The SPR would require all GPs, including private providers, and hospitals to share data on patients so that information that is now fragmented can be seen anywhere in England. This would redirect the information to the right doctors, nurses and specialists to securely see a patient’s full medical history. The Government claims this can go through as early as 2024 for maternity and frailty care.

The SPR is the means to create savings at the A&E and GP level. DHSC estimates that the combination of SPRs with virtual care would reduce A&E visits for frail patients by about 10,000 a year plus reduce another 10,000 visits due to fewer misdiagnoses. Other estimated annual savings would be for doctors’ hours–500,000–and 6,000 fewer hospital admissions, totaling £20 million. Patients would also have greater access to their health data including who may access it. It would join up community services with an audit trail to track anyone who accesses the record.

What’s disputed is controlling the data and supervising its security. At present, GPs are the data controllers for their patients’ records. They are permitted to share them with third parties for research purposes.  This would change to the DHSC. The British Medical Association (BMA) opposes this; their GP committee has warned that any move to take control of data away from GPs would damage trust and risk confidentiality.

Other parts of the bill reinforce NHS’ virtual hospital model through the NHS app. NHS Online is scheduled to launch in 2027 for planned specialist care. It’s estimated to provide the equivalent of up to 8.5 million appointments and assessments in its first three years. The other is that there is a “Duty to Promote Innovation” (section 6) by the Secretary of State, including payments and prizes. 

Effects on patient health and safety include the abolition of the independent patient advocate, Healthwatch, with its duties transferred to the ICBs and local councils. The Health Services Safety Investigations Body (HSSIB) will merge into the Care Quality Commission (CQC) regulator.

Effects on other sectors from the PinsentMasons analysis:

  • On private healthcare and outsourced providers, more power will go to the ICBs and the DHSC.  The DHSC will have increased governance control through “the power to be able to cap day-to-day spending limits on NHS Trusts, appoint foundation trust boards, issue directions to ICBs regardless of performance, and may shift care provision between public and private sectors depending on whether or not doing so is in the interest of the NHS.”
  • For life sciences and medtech, the focus on innovation is a major plus. The minus is that there will be more layers and structure to pass through.
  • For health tech and data companies, the interoperability demands and innovation requirements are solid pluses. There will be “clear opportunities in platform, cloud and infrastructure provision, along with integrating AI and analytics systems for operations in clinical and administrative sectors.” Concerns are data governance and management.
  • For social care and adjacent services, this reinforces the trend towards tighter integration. This will include “closer alignment with NHS commissioning structures, opportunities to participate more formally in integrated care pathways, and (sic) having to navigate increased and more centralised regulatory oversight.”

Implementation would be expected to start this year and extend over the next decade. Additional information from the NHS: press release, collection page for the Health Bill, Impact Assessment Summary. The Guardian

The Intellectual Property Office (IPO) launches the Knowledge Asset Management Hub (KAM). The KAM Hub’s purpose is to assist universities and other research organizations in identifying and commercializing their innovations, IP, and other knowledge assets. It was announced at the Knowledge Exchange UK Conference 2026 in Newport, Wales, by IPO Chief Executive Adam Williams. The Hub’s assistance spans four component areas: institutional IP strategy guidance, project-level IP risk and opportunity tools, patent data analysis and IP due diligence resources, and the Knowledge Asset Management Toolkit. UK.gov:  IPO release, KAM Hub document list

Chutes & Ladders: MA sues UHG on Medicaid fraud, Teladoc joins Walmart’s Better Care Services, raises for Signos and H1

June 3, 2026 | by | No Comments

It’s another chute for UnitedHealth Group, which hardly needs another. On Friday 29 May, the Massachusetts attorney general sued UnitedHealthcare Community Plans of Massachusetts for misrepresenting and manipulating the health records of members in the MassHealth Senior Care Options (SCO) plans. The objective was to gain higher payments from the Commonwealth of Massachusetts. The fraudulent amount in question is about $100 million. The lawsuit was filed in Suffolk Superior Court.

UnitedHealthcare is the largest provider of SCO plans in Massachusetts. SCO is a state Medicaid program that covers members 65 or older who live in designated areas of the state. Based on a mandatory in-home clinical assessment to determine their health status, covered members are assigned a level of care based on health conditions, with Level 1 being the least serious, Level 2 having behavioral health or substance use disorders, and Level 3 having the most serious health conditions. The levels have correspondingly escalating levels of payment to the plan.

The Commonwealth is stating that members were classified by UnitedHealthcare to Level 2 despite no other diagnosis or treatment. Other patients were assigned to Level 3 through improper assessments. Moreover, United allegedly knew that beginning in 2018 and continuing into 2019, members were improperly assigned to Level 3. United never disclosed the error nor repaid the higher payments resulting from the assignment. 

From the Office of the Attorney General release, “The AGO alleges that these were intentional failures, the result of a ‘growth at all costs’ strategy employed by United that incentivized and encouraged its field nurses to code MassHealth members as sicker or less able than they were.” UnitedHealthcare responded that the fraud allegations and the lawsuit are “meritless” and that “[The complaint] doesn’t accurately describe our Senior Care Options program, which helps seniors with complex care meet their individual health needs.”  MedCityNews, Healthcare Dive  

A nice ladder for Teladoc is the addition of their telehealth services to Walmart’s digital health offerings. Walmart’s Better Care Services will add Teladoc’s telehealth services in virtual urgent care for common conditions, dermatology, and nutrition for their customers. Payment can be either cash pay at $89/visit or through insurance. Prescriptions, if needed, can be sent to a pharmacy, including Walmart’s, which has same-day delivery  in as fast as an hour available in many locations. Walmart added Teladoc’s BetterHelp mental health services in January. Teladoc release, MedCityNews, Healthcare Dive

And funding ladders continue, indicating some freeing up of investment cash for companies that have gone through a few (or more than a few) rounds.

Glucose monitoring system Signos raised a $20 million round. The investment is from GV (Google Ventures), Dexcom, and Blue Cross Blue Shield of Alabama. Funding to date including this round is $57 million.  Signos is also a partner with Dexcom through their direct-to-consumer continuous glucose monitoring website, Stelo.com. Signos’ app for tracking glucose for weight management is FDA-cleared and includes insights into how behavior, lifestyle, sleep, and stress affect weight. It can also detect low and high glucose levels. Membership is $127/month including two sensors a month on the six-month plan. Mobihealthnews, Yahoo Finance

Healthcare provider data and directory company H1 raised $40 million, led by CVS Health Ventures. Across ten lettered and unlettered rounds, funding to date is $233.9 million. It has developed an AI-powered platform for identifying and engaging the right doctor across life sciences, payers, providers, and patients.  The H1 Doctor Graph platform is a structured representation of physician identity, expertise, relationships, and behavioral signals that identifies and engages the right doctors for critical workflows across pharma, health plan, health system, and technology companies. CVS Health and H1 have collaborated on several projects, including an AI model that improved the accuracy of their health care provider directory. Release, Mobihealthnews

Breaking: Anthropic files confidential S-1 with SEC for IPO, less than one week after $65B raise. But is this Peak AI?

June 2, 2026 | by | No Comments

It’s raining mega-IPOs. One week after Oura’s filing a confidential S-1 with the Securities and Exchange Commission for its IPO, massively bigger Anthropic, the developer of Claude AI, has done the same. As with Oura, neither share price nor number of shares has been disclosed in this preliminary filing. Anthropic release

The S-1 filing comes on top of their 28 May announcement of a $65 billion Series H funding led by Altimeter Capital, Dragoneer, Greenoaks, and Sequoia Capital. The valuation of $965 billion makes Anthropic the most valuable AI company on Planet Earth and perhaps the entire Solar System, surpassing OpenAI by about $113 billion. Anthropic’s valuation in February was $380 billion with their Series G raise, so the Series H valuation multiplied that by a stunning 2.5 times+ in three months. The new funds will be used for AI research, expanding its computing power for Claude, and scaling its products and partnerships.  CNBC, Mobihealthnews, Anthropic release

Anthropic’s over-the-top valuation was boosted by its projected annual revenue run of $50 billion, tipping into profitability this quarter, beating its own growth metrics regularly, and introducing new Claude products such as Claude Opus 4.8 and Claude Mythos Preview with advanced cybersecurity available to a limited group of companies. Anthropic in January rolled out Claude for Healthcare for providers and consumers. Claude pulled in front in corporate sales, ahead of OpenAI, as of April, and last month inked a new partnership with Bristol Myers Squibb to implement Claude throughout the company.

But are we at Peak AI? Axios, never one to shy away from Cold Buckets of Water when it makes for a good lede, has been trumpeting for the past week that companies are suddenly shying away from their “discovery” of soaring AI costs. Suddenly, ballooning IT costs, uncertain productivity gains, and a strange combination of employee overuse and sudden skepticism are causes for concern. An AI consultant told Axios that employees blew through half a billion dollars in a single month because they didn’t put usage limits on Claude licenses. Then the CEO of an AI software company, CloudBees, admitted that companies are using workforce cuts to offset their soaring AI costs. This has to be one of the worst-kept secrets in corporate America. Even a casual peruser of LinkedIn would have known this a year ago.

Corporate adoption in Axios‘ view is running into four expensive headwinds such as:

  • Using AI to automate disliked tasks rather than prioritizing revenue-generating tasks–which is understandable without guidance and pressure on time.
  • Using AI for trivial tasks such as checking the weather (well, no one said they couldn’t)
  • Leadership is clueless on what AI tools work and are throwing licenses at the employee wall to see what sticks.
  • Reluctance to give AI models proprietary information, which makes the AI tool less effective. (Not feeding AI models proprietary information to prevent it from becoming public in LLM models is, one would believe, an understandable concern.)

Even OpenAI’s Sam Altman commented when Anthropic’s Series H was announced that corporate costs are the most valid concern to date.

Unless there is a massive enterprise pullback in AI spend, though, look to Anthropic floating that IPO no later than the fall, even if corporate AI spend pulls back. It’s to be expected. The Gartner Hype Curve is fully in gear and the momentum from Inflated Expectations to the Trough of Disillusionment will continue, until it is processed and moves on to the Slope of Enlightenment.

Selling Oracle Health’s EHR–what are the potential buyers, their odds, and price?

June 2, 2026 | by | 5 Comments

The speculation is now “official”, since it is by a London investment banking firm, but it confirms this Editor’s earlier view: Oracle, to become an “AI Infrastructure Landlord” (in their apt term), has to sell off what was Cerner and the EHR operation. 

That train is now approaching, though realistically, no one knows when it is due and at what station.

The need: Oracle must reduce the extent of its “liquidity and capital expenditure crisis” in order to stay in the AI Game. Layoffs of 30,000 staff, or 18% of their global employees, is not enough. A fresh financing of $16 billion from the PIMCO bond fund and others cannot relieve the financial stress created by a previous estimated $72 to $100 billion in previous debt load and payments, so significant that banks refused to lend to still-profitable Oracle. And the AI transformation itself is high risk. Oracle owes OpenAI alone $553 billion in remaining performance obligations, and it has obligations to Meta as well. Add to this the long “taffy pull”–the years-long process of building, chip expenditure, then making a data center operational and generating cash. [TTA 14 May, 7 May, and prior; also Ed Zitron’s article for a much longer take.] Take all of them together, and they are polite words for “rock and a hard place” or a Very Dark Corner.

The London investment banking firm Nelson Advisors has taken a deep yet remarkably easy-to-digest analysis on a potential sale. Highlights are below. The paper is one long web page, not a deck of 50 pages. It is well worth your reading time.

Background: Cerner was bought four years ago in the go-go days of June 2022 for $28 billion. Cerner had an aging EHR and a deteriorating market share. Recently it’s plummeted to a 27% market share versus Epic’s 48% in large health systems. Oracle’s interest was not only in health, but also the health data Cerner contained. The plans were to update the software based EHR to a cloud-native data platform as the linchpin of Healthcare Transformation (Ed. note), except that integration proved to be slow and far more expensive than estimated.

Oracle also inherited from Cerner two huge and impossible to escape Federal obligations: the Military Health System EHR and the Veterans Health Administration EHR Modernization, two separate but mandatorily interoperable systems. MHS was the first implemented and is now  completed, but remains an obligation. The VA EHRM, as TTA has chronicled, started rolling out in 2020 and by 2023 was halted after five implementations Due to Disaster. It resumed in April 2026. The VA and Congressional process for funding now has tight guardrails in place on continuance.  

Who will buy the Oracle/Cerner EHR operation is the question. For how much isn’t as clear. Selling Oracle Cerner “represents the most significant “lump sum” of liquidity available. In the Nelson analogy, Oracle took the Cerner cow, milked it of data to feed its data into its LLMs, and no longer wants knackered ol’ Bessie even rejuvenated by the cloud. (In this Editor’s view, Oracle knows it is fighting a losing battle against Epic, which does privately pretty much what it wants and plans to stay that way.)

The obvious group of potential buyers are ‘hyperscalers’ who view health data as the Next Frontier. They already have feet in this healthcare pond. They also meet approved FedRAMP High security requirements for the VA and MHS contracts. Equally, they all have drawbacks.

Microsoft seems the most logical. It already has a huge footprint and expertise within health systems, courtesy of ambient scribe Nuance/DAX Copilot and cloud computing platform Azure.

  • Conflict #1: Epic is a major Azure customer. Would Microsoft be willing to lose this business in a high-stakes move?
  • Conflict #2: FTC would likely challenge the acquisition based on this huge existing footprint.

Amazon is also engaged in healthcare, but not with health systems. It has Amazon Health Services comprising Pharmacy, One Medical, and DTC telehealth services. (Editor’s note: not mentioned by Nelson is that Amazon Health has a new leader, Dr. Roy Schoenberg, with experience in Federal contracts via Amwell for the Defense Health Agency and MHS. This broke late last week.)

  • Conflict: Amazon Web Services is an established vendor in other areas of health systems, and acquiring an EHR could be seen as too much under one roof.
  • Problem: no experience with EHRs (same as Oracle) nor highly regulated health systems. The scale of the MHS/VA implementation and academic hospitals would be a steep learning curve with little existing precedent or credibility in Amazon-World.

Google certainly has the size and resources, and could position the EHR to rival both Microsoft and Epic. 

  • Conflict #1: Cultural. Google moves fast and healthcare slowly.
  • Conflict #2: Lacks the enterprise sales and support needed to service health systems. It doesn’t have a service culture.
  • Editor’s note: Google has tried and failed to be a healthcare giant at least twice. It doesn’t seem to fit.

Nelson also looked at two outliers, UnitedHealth Group/Optum and the hospital groups HCA or CommonSpirit Health. Both would be vertical integrators. Hospital groups do not have the margin nor borrowing power to make the move. UHG and their Optum operation face cash crunches and ongoing Federal scrutiny. (Had this been a few years ago under a different management, this would have been on strategy for UHG.)

Another outlier from the international space is SAP. Their aim would be global expansion into the Middle East and Europe with another asset their enterprise resource planning (ERP) expertise. Their problem? Lack of experience in the highly regulated US environment. In the Nelson view, the US Government could be the make/break for any deal.

The final destination for this ‘hard to sell’ asset? Private equity. And more than one involved. Nelson looked at five PE players in the healthcare space: Thoma Bravo, Francisco Partners, Bain Capital, Blackstone, and New Mountain Capital. (All are familiar PEs to Readers.) Even with their considerable individual assets, it would likely take a consortium to buy Oracle Health in a $20 to $25 billion deal. Nelson rates this as the most likely scenario as long as a consortium could be formed and it can be seen as a turnaround. The drawbacks are a governance structure and the real lack of an exit strategy. (PEs always need exit strategies to keep the funders happy. They are not in it to buy and keep.) The lower price could be made palatable to Oracle if they retained the Oracle Cloud Infrastructure (OCI) network and the Oracle Autonomous Database revenue streams.

The other partner in this consortium scenario? The Federal Government. It’s a high priority to secure the EHR for both the MHS and VA. Congress is already concerned.

Place your bets!  Hat tip to a Reader who wishes to remain anonymous.

Breaking: Roy Schoenberg moving to Amazon to lead Health Services; Neil Lindsay to depart

May 29, 2026 | by

Roy Schoenberg, MD MPH, the co-founder of Amwell and a past CEO, is moving effective 1 July to head up Amazon Health Services. He is replacing Neil Lindsay, who is a 15-year Amazon veteran and was senior vice president since 2021.

Dr. Schoenberg, whom with physician brother Ido co-founded American Well in Boston in 2006, can be considered one of the pioneers of telehealth. Notably, he had become less active in the now Amwell starting in June 2024 when he stepped down as president/CEO, moving to executive vice chairman. His LinkedIn profile has this board role ending this month with the announcement. He is also listed as the founder as of September 2025 of Aileen.ai, a personal health companion targeted to the senior market, and with various board positions that continue. He announced his appointment on a LinkedIn post yesterday.

From reports, Mr. Lindsay led the search for his successor. Lindsay oversaw a restructuring of AHS into six divisions last June, leading to several executive departures. One Medical’s integration and marketing has remained a struggle since 2022 and Amazon Care was discontinued in 2023. The scope of the reorganization and the status of the parts will be a considerable challenge for the good doctor.

Amazon Health Services comprise primary care (One Medical), pharmacy services (Amazon Pharmacy), and telehealth services (Direct Message Care and Video Care). All are tightly integrated with Amazon Prime. (As an Amazon shopper who has studiously avoided the expense of Prime, that has been a drawback.) CNBC, Healthcare IT News

Must Reads on AI: its societal and economic effects, and why its developers see it as replacing God

May 29, 2026 | by

Two Substack Must Reads for the weekend. Both are open and do not require subscription. Grab the cuppa and take a walk in the park after to consider them.

The “Messy Middle” by Molly Kinder in “Kinder Futures”
Why the years between today and post-AGI abundance will be the hardest political and economic problem of our generation, and why we can’t skip past them

This is the longer of the two essays that presents two realities: Reality 1 of today where AI is increasingly everywhere, but the societal effects have yet to be felt, and Reality 3 where it has been absorbed and we are in the bright sunlit uplands of abundance. The mess is in Reality 2, which she posits as year, perhaps decades, of societal upheaval and what we are already seeing–the near-destruction of the professional  ‘cognitive classes’. Yes, people like you and me as creative thought, ability, and specifically cognitive ability, become commodities. This cognitive displacement will affect governments, as the vast middle that pays most taxes suddenly finds income cut in half or more, forced into early retirement, and dependent on government for support. The essential jobs as determined during the Covid pandemic will be the least affected, but still affected because their income trajectory despite need has been declining and that won’t change. The trades survive because their practitioners are scarce for now. The effects on the middle and upper middle classes internationally will be brutal in her scenarios. Ms. Kinder does arrive at conclusions re the political backlash rearranging the current state (we are in it now) and a managed transition that you may not necessarily agree with. See the comments at the end.

The Tech Bros Want to Build God by George Shay in “Common Sense”

Why Pope Leo XIV May Be Right to Worry About Artificial Intelligence—But Not for the Reason You Think

Pope Leo’s first encyclical tackled AI and began, in the introduction, “Humanity, created by God in all its grandeur, is today facing a pivotal choice: either to construct a new Tower of Babel or to build the city in which God and humanity dwell together.” Further, “We must, then, avoid the “Babel syndrome,” namely the idolatry of profit that sacrifices the weak, a uniformity that neutralizes differences, and the pretense that a single language — even a digital one — can translate everything, including the mystery of the person, into data and performance. The risk of dehumanization — of building a future that excludes God and reduces the other to a means — is an ancient and ever-new temptation that today takes on a technical guise.” Like most encyclicals, it is written in exceedingly dense, very Catholic language (disclosure, your Editor is Roman Catholic). 

Mr. Shay’s take is considerably less dense and moves from a different philosophical ground. All too many of the ‘tech bros’, especially at a high level, speak of technology in almost religious terms. AI has become their highest expression of faith. They rejected traditional faith while young and redirected that impulse, that exists in nearly every human save the sociopaths, into technology. To the observant, that is nothing new–witness the well-known lives of Steve Jobs and Bill Gates. Instead, in the search for meaning, their salvation is technology.

FTA: “Instead of God creating man in His image, we now hear man preparing to create a machine in his own image.

Some of the rhetoric coming out of Silicon Valley is astonishingly explicit. Researchers and entrepreneurs casually discuss creating “machine gods” or engineering a “new species” superior to humanity. And importantly, they are not speaking metaphorically. They mean it quite literally.”

The ultimate question is ‘why’–and there is no AI that can answer that, despite how the visionaries position AI “in terms that resemble divinity”. 

Your Editor expressed two comments that are solely her observations. The first: “Perhaps those most enthusiastic about AI are those most frightened of the existence of God behind life, faith in that God, ethics beyond their own wants and needs, consideration of their fellow man, and their own mortality. Is it no mistake that most of those leaders in technology resemble flawed and strange little boys, even when they are 70? That is an unsettling thought.” The second is lengthy and saved for your reading of the article.

Short takes: Garner Health’s $100M Series E; Veradigm files financial reports for ’23/’24, moved to net loss; Rovex debuts autonomous in-hospital transport robot

May 29, 2026 | by

A relatively quiet week woke up at the end.

Garner Health’s doctor finder app now has another $100 million to back it. The Series E was led by Index Ventures with participation from existing investors including Kleiner Perkins, Redpoint, Thrive, Sequoia, Founders Fund, and Kaiser Permanente Ventures. The round brings Garner’s valuation to $2.74 billion. It’s a far cry from the 5x Series E typical raises of a few years ago, but fairly healthy in the current slow recovery of lettered raises and more conservative fundings. Previous funding was $219 million through a 2024 Series D. Garner’s apps (Assistant and Research Agent) are targeted to employers and benefit managers as a service to connect employees with high-performing in-network physicians, based on clinical performance data and claims information, and to save on total healthcare spend. The company claims that they serve over 700 companies. The app is still available to individuals as a free download. Release 

Veradigm finally files its financial reports for 2023 and 2024, and they’re not cheering. This took the form of a ‘Super 10-K’, a comprehensive annual report that covers two fiscal years, as promised on Veradigm’s investor call last February. 

2023 to 2024 results weren’t cheering for the shareholders, as revenue dropped 5% 2024 compared to 2023, continuing their multi-year decline.  The company in 2024 swung to a net loss, a change of $341 million due to impairments and other costs. Adjusted EBITDA was affected by 29%.  

  • Revenue of $594 million in 2024 compared to revenue of $626 million in 2023, which includes $19 million of non-recurring revenue in 2023 from settlements.
  • Net Loss in 2024 was $292 million compared to Net Income of $49 million in 2023. The net loss in 2024 reflects an impairment of goodwill and other assets as well as the impact from transaction and other costs.
  • Adjusted EBITDA of $94 million in 2024 compared to Adjusted EBITDA of $132 million in 2023.

Veradigm has three main market segments: provider, payer, and life science. It is adjusting its software and implementations to incorporate AI, which was briefly discussed on their earnings summary call 26 May. The transcript and audio is on Seeking Alpha.

According to Veradigm’s release, they will file their 2025 Form 10-K before year-end 2026. Revenue is estimated to be in a range between $584 million and $589 million, flat from 2024. Nothing definite was stated about their 2026 filings with the SEC, which will be required before they can file for relisting on Nasdaq or on any exchange. From the release, “The Company remains focused on getting current and staying current with its SEC filing obligations and subsequently relisting its common stock on a national exchange. As of May 12, 2026, the Company had 109.0 million shares of common stock and 13.3 million of unvested restricted stock units outstanding.”

Veradigm also has a new CFO, Christian Greyenbuhl, replacing interim CFO Lee Westerfield, who came for six months and stayed for two years. He will remain in a ‘strategic advisory role’ until March 2027, a standard workout period. Mr. Greyenbuhl was formerly CFO of Ministry Brands, which provides over 90,000 faith-based organizations and private sector businesses, SaaS payments and background screening solutions. Previously, Christian was a longtime finance and operating executive at ADP. 

It’s now the fourth year of make-up reporting since 2022. Veradigm’s their failure to provide audited reports due to financial software problems has been an embarrassment for a software and once-leading health IT company. In 2025, 15% of staff were cut, three facilities closed, and will exit at least two more as well as their present Chicago HQ by 2027. Our February article also provides a capsule of Veradigm’s recent troubled history and our back file as the situation for the former Allscripts developed.

And to wind up with something that could really help in hospitals in moving patients from point A to B…Rovex has developed a robotic transporter for in-hospital patients. The transporter, Rovi, is the world’s first autonomous transport robot that can transport any hospital stretcher yet maintain contact with the care team. It is being piloted without patients at BayCare Health System’s Morton Plant Hospital. The pilot is designed to evaluate workflows, transport patterns, staff burden effects, and operational opportunities within the hospital environment. Later phases will support potential in-hospital robotic stretcher movement. Those of us with hospital experience either in the clinical setting or as patients know how speed of transfer affects the entire clinical workflow and care. BayCare is the largest not-for-profit academic health care system in West Central Florida. Rovex is a two year old company, still in seed funding of $2.27 million (Pitchbook) and headquartered in Gainesville, Florida.  BayCare release, Interesting Engineering

Post-holiday news roundup: Oracle Health acute care EHR market share crumbles to 20%–what that means; retail real estate downsizer marketing Walgreens leases; Oura files for US IPO, Swoop buys NimbleRx

May 27, 2026 | by

Epic dominates, Oracle Health evaporates. The 2026 KLAS report on acute care hospital EHR market share as of end of 2025 is not a cheerful earful for Oracle Health.  From a reader comment published on HIStalk 5/27/26, Epic’s market share now tops 56.9% of hospital beds. Trailing far behind is Oracle with 20.4% and niche player Meditech with 12.5%. What’s more disturbing are the trends.

From KLAS’ brief unpaywalled summary:

  • The number of hospitals impacted by EHR purchase decisions dropped 40% compared to 2024 and nearly 50% compared to 2023.
  • Acute care EHR purchase energy declined significantly in 2025, driven by several converging factors. Ongoing questions around government policy contributed to hesitation, and at the same time, many health systems redirected investment toward technologies with more immediate financial returns, such as AI and other solutions designed to improve operational efficiency.
  • Additionally, while Oracle Health has continued to lose market share, many Oracle Health customers have been deferring action as they await greater clarity on the vendor’s evolving direction.

In this stagnant picture, the commenter ‘Spinout’, who clearly has report access, adds that:

  • Epic continued to take customers away from Oracle Health, adding 77 hospitals with 19,000 beds in 2025 while Oracle Health lost 56 hospitals with 15,000 beds. (This is absolute confirmation of what this Editor has heard from industry people–that Oracle is now an also-ran EHR.)
  • Oracle Health customer satisfaction continues to go down. One-third of its customers say Oracle isn’t in their long-term plans while another one-third say they might want to leave or would if they could. That leaves the company’s AI-powered EHR as a make-or-break product. (When you can’t hold 2/3 of your customers, you’re in big trouble. And an AI-powered EHR? With a shortage of AI data center capacity, TTA 14 May, welcome to downtime)
  • Third-place vendor Meditech continues to increase customer retention as its legacy clients increasingly choose Expanse instead of a new vendor.

What this may mean. It’s becoming all too easy, too logical, to make the case that Oracle Health has turned into a losing proposition, one that Larry Ellison can no longer afford even if he owns 40% of the company. One senses a pile of dirt, a hole, and a shovel. Mr. Ellison also needs money, which makes it even more likely that Oracle Health is spun off or sold for cash. 

From this Editor’s earlier article about the 30,000+ Oracle layoffs (10,000 in the US, with 539 employees laid off effective 26 May-1 June in Kansas City, Cerner’s former HQ and presumably where most EHR staff remained): 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?

Yet Oracle cannot simply close the division and turn off the systems. In addition to hospitals and health systems, let’s not forget that the VA is back to sprinting towards an implementation schedule ending in 2031. The EHR Modernization has 13 VA locations to cutover this calendar year, with 26 new sites in 2027 and 28 in 2028. Oracle will literally jeopardize every Federal contract they have if they botch VA EHRM. In short–Oracle Health is one of several bottomless pits Oracle faces.

Walgreens’ leases on the market–see A&G Real Estate Partners. One of the outcomes of Walgreens’ reorganization is a drastic downsizing of its retail footprint. Both city and suburban/rural locations have been affected, to the distress of many communities. Of note is the organization that the New Walgreens has chosen in this process is A&G Real Estate Partners, which specializes in companies exiting their retail locations due to Chapter 11 bankruptcies, such as Saks Global, Party City, over 1,000 Rite Aid leases, and Bed Bath and Beyond. A&G is marketing a mix of 78 Walgreens store leases and owned properties nationwide, per their presence at the ICSC retail real estate confab in Las Vegas. Sycamore Partners, the new owner, has deep experience in retail, so that their choice of real estate marketer is not surprising. One can expect that number to increase as the three-year plan has 1,200 closures and Walgreens, in layoffs announced earlier this year, reiterated that they were closing dozens of locations this year [TTA 27 Feb]. FTA, “A&G expects the same kinds of retailers that were interested in the Rite Aid stores to be interested in Walgreens, as well as possibly specialty grocery chains and healthcare providers, according to (principal) Joe McKeska.” A&G principals at ICSC met with these retailers as well as lenders and investors. CoStar

On to cheerier news

Oura has confidentially filed an S-1 with the Securities and Exchange Commission (SEC) for an IPO. The Finland-based smart ring developer did not state pricing nor number of shares in the preliminary filing.

Pre-IPO, Oura is on a roll as well, with up to 5.5 million devices sold, $1 billion in revenue, and 1,200 health partners. Their investments have been substantial. Oura’s most recent jumbo Series E of $900 million in October 2025 topped a Series D of $250 million in 2024, sandwiching a debt financing of $250 million in September 2025. Major investors are Fidelity and Dexcom, the latter announcing a partnership and $75 million investment in November 2024. Oura has also been on an acquisition tear: Doublepoint in March, Sparta Science and Veri in 2024, and Proxy in 2023.  Last October, FDA authorized a trial with Oura users of a new blood pressure feature. It also has partnerships in women’s health and hormone tracking. Most recently, last week Oura announced a partnership with Resmed, giving users access to a sleep assessment and educational resources.  Oura release, Healthcare Dive, Mobihealthnews

Swoop just scooped up NimbleRx. Acquisition cost was not disclosed. Swoop is a data platform for life sciences companies that enables marketing to both patients and healthcare providers, engaging them via targeting, community engagement, AI-powered web solutions, coordinated omnichannel activation, and now prescription fulfillment. NimbleRx streamlines workflows for pharmacy providers and prescription management for both pharmacies and patients, and claims coverage of 16 million patients. Their service will now be known as SwoopRx by Nimble. This is Swoop’s second acquisition in the past year, with MyHealthTeam, an opt-in patient social network for 62 conditions. Release, Mobihealthnews

Holiday weekend roundup: VA asks for ‘cyberspeed’ 25% EHR budget bump, update on EHRM fraud indictment; Commure raises $70M; Innovaccer buys Caduceus, lays off staff; Doximity, OpenEvidence slugfest gets hot

May 22, 2026 | by | 2 Comments

A slower news week preceding the Memorial Day holiday in the US and the UK late May bank holiday.

Federal budgets for 2027 are in the Congressional washing machine, and the cycle is on ‘agitate’. VA Secretary Doug Collins has tagged a 25% increase in the EHR Modernization budget for FY 2027 over what is currently in the 2027 Military Construction and Veterans Affairs Appropriations bill –$4.2 billion versus $3.4 billion, an increase of $840 million. He testified on Wednesday 20 May to the Senate Veterans’ Affairs Committee and Thursday 21 May to the House Appropriations Subcommittee on Military Construction, Veterans Affairs and Related. Apparently, the biggest problem VA has with the much-repaired and now standardized Oracle EHR is that every VA executive director wants it now, not later. An additionally funded EHRM would speed up the cutover for VA facilities to go from ‘dial-up’ to ‘cyberspeed’ internally, in communicating with other VA hospitals, community care, and in record sharing with the military system and civilian health facilities.

Difficulties reported to date (April for four sites in Michigan, VISN 10) are around transferring health records between VA and Department of War facilities. DoW healthcare also uses Oracle, but a different version suited for their needs that has been fully implemented. 

While the House has already passed the bill at the lower budget number and sent it to the Senate, the subcommittee chair John Carter (R-Texas) during the hearing said they’re “not through with the possibility of getting you some more money”. 

VA’s implementation timeline is 19 before the end of this year (13 new and the 2020-24 six), 26 new sites in 2027 and 28 VA Medical Centers in 2028. Even sped up, there are still 90 more to go and the deployment is not expected to be complete till 2031. FedScoop 21 May, 30 April

Update on the fraud indictment of the former EHRM director, John Windom. Surprisingly, there has been little to no mainstream media coverage of the Federal charges against John Windom, who was indicted on 25 March in the Federal District Court for the District of Columbia. The three counts related to accepting cash and gifts from vendors plus failure to report them could bring a maximum of 35 years. This article on conservative news website PJ Media is the most recent (re)telling of the tale and links to nearly all the same sources this Editor included in our 3 April article. It is more colorful than our reporting but brings up an important point I overlooked: where, oh where, are the indictments of some of the vendors who doled out cash, gifts, and maybe more, and in return got prime and sub-contracts. He knew, they knew to keep quiet–‘loose lips sink ships’. Because any Federal contractor–I worked for two, Viterion Digital Health and Collaborative Health Systems, then part of WellCare Health Plans–receives compliance training on working with their Federal agency counterparts. 

Perhaps there are investigations and indictments to come, as I’ve seen in Federal Medicare fraud cases that peel like an endless onion over years. According to the VA inspector general, Mike Missal, who served from 2016 until January 2025, evidence was being gathered internally back during the Biden administration. This fits the timeline of the US Attorney requesting a grand jury be summoned then sworn in on 30 October 2025. Mr. Missal was fired along with 16 other inspectors general by the incoming Trump administration.

Since Mr. Windom was deeply engaged in the choice of Cerner for the VA EHR in 2017-2018, and in the disastrous implementation of VA Mann-Grandstaff (VISN 20) in October 2020 and four more in 2022, resulting in the rollout’s termination in 2023, Oracle would be unwise to not prepare for a few questions about Cerner’s relationship with Mr. Windom, as I wrote at the time. 

The PJ Media article also references the comprehensive article in the 27 March Spokane Spokesman-Review, which has been on the Cerner/Oracle implementation story since the implementation failure in the region’s Mann-Grandstaff VA facility. Their check of the OEHRM website as of that date confirmed that Mr. Windom was still listed as the deputy director of the Federal Electronic Health Management Office, the joint VA-DOD initiative in the role he assumed in January 2022 after the Mann-Grandstaff problems detonated and the then-Secretary reorganized the department. (Heads did not roll, but they rarely do with SES members). FTA: “The Federal Electronic Health Record Modernization Office did not respond on Thursday (26 March) when asked if Windom remains employed there.” The article by Orion Donovan Smith is a recommended read.

In the funding/M&A department

Healthcare software integrator Commure received a $70 million funding from current investors. Commure’s lead investor is General Catalyst. Commure now has $750 million raised and a $7 billion post-money valuation for its AI infrastructure development. Its subsidiary, Athelas, provides AI-based revenue cycle management and clinical workflow tools. The General Catalyst funding of $200 million plus is an interesting scheme, in that GC fronts the cost of sales and marketing and, in return, receives a share of the revenue from new customers generated by that investment, up to a fixed cap. The new funding will be used for scaling its RCM and practice management platforms, advancing the ‘shared intelligence layer’ beneath Commure’s workflows, and expanding their AI infrastructure into global healthcare markets. Release, Mobihealthnews

Innovaccer acquires CaduceusHealth, a revenue cycle management (RCM) and management services (MSO) provider. Neither transaction cost nor management transitions were disclosed. Well-funded Innovaccer ($675 million through a Series F) has been growing in AI-centric healthcare IT services mainly through acquisition. CaduceusHealth is the fifth in their creating a “comprehensive agentic stack” for health systems and provider groups in their Flow suite. Innovaccer claims to serve over 200 health systems and payers, 95% of community pharmacies, and 80 million patient lives across the US. Release Unfortunately, their growth has been matched by a reduction in staff, with 340 layoffs in the US and India. It is their third layoff in four years as it applies its own AI to automate its own processes. (We are seeing a lot of this across the board, allegedly.) FierceHealthcare

We close with a major Must Read with the OpenEvidence-Doximity battle.

OpenEvidence and Doximity are slugging it out for the same market funding–and a third competitor has just sneaked into the ring. OpenEvidence is the upstart, founded four years ago, and the best valued ($12 billion) yet private healthcare AI company on the planet Earth and is generally thought of as the up-and-coming platform for physician information. Doximity is the mature company, public with a $3.6 billion market cap, proven revenue of $645 million, and (be still my heart) profitable with an EBIDTA margin of 55% and a stunning 49% free cash flow margin. It’s been dubbed ‘LinkedIn for doctors’ but is actually much more with tools for secure telehealth, news, reputation management, and free CME.

They are mutually litigious. Both OpenEvidence (OE) and Doximity tag-team each other in product offerings, use defamation tactics and key staff poaching, and in product development, copycat each other, with Doximity generally leading development and OE following shortly thereafter. Coming up is Doximity’s new product, an in-workflow e-prescribing, prosaically called Doximity Prescribe. Based on the pattern, how long will it be before OE develops a similar product?

Where they make their money is only indirectly from users. Both are supported by a fixed source–pharmaceutical advertising. They both slug it out for physician attention. While doctors love (or hate) both, if they become too similar, the balance will tip. Into this bout steps OpenAI with a new professional product, ChatGPT for Clinicians [TTA 30 April]. Lurking near the ropes is the AI-powered iteration of Wolters Kluwer’s UpToDate peer-reviewed medical content, integrated with Microsoft and Abridge, already in 70% of the largest enterprise health systems because it’s been around forever. OE’s vulnerability may be overpromising in claiming ‘no hallucinations’ of their AI-generated medical content–a claim that is structurally impossible, and results in deficits in completeness, communication quality, and systems-based safety reasoning.

Digging through all of this is the intrepid Sergei Polevikov on his Substack AI Health Uncut. Grab a cuppa and sandwich for this one. For most of the article (Part 1 of 2!), a subscription is required. Consider it money well spent for access to some of the best investigative reporting around with plenty of backup. OpenEvidence Prescribe Coming to Your Doctor’s Office This Month?

Perspectives: AI Hallucinations in Behavioral Health–Why Access Needs Better Infrastructure, Not Better Chatbots

May 21, 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 about the use of AI in the mental health area–how it is uniquely exposed to risk from LLMs and generative AI–and where best to use them. The author, Hari Prasad, is co-founder and CEO of  Yosi Health, a full-service technology ecosystem that connects patients with their providers through the entire care journey before, during and after the visit, modernizing the entire healthcare patient experience. 

One in three U.S. adults has now used an AI chatbot for health information in the past year, according to the most recent KFF tracking poll. Among adolescents and young adults, one in six has turned to a large language model specifically for mental health advice. That second number should stop every behavioral health leader in their tracks, because when those tools get it wrong, the consequences are not a bad product recommendation. They are clinical.

We are not witnessing patients casually Googling symptoms anymore. They are having extended, emotionally charged conversations with generative AI tools about medications, crisis management, and care decisions, often weeks or months before they ever speak to a licensed provider. And the technology they are confiding in has a well-documented failure mode that the industry still has not adequately addressed: the hallucination.

The Problem Is Not That AI Sounds Wrong. It Is That It Sounds Right.

An AI hallucination occurs when a model generates a response that is fluent, confident, and completely fabricated. In most consumer contexts, that is an inconvenience. In behavioral health, it is a patient safety event waiting to happen.

Consider the real scenarios already playing out: a generative AI tool confidently suggesting an incorrect dosage for a mood stabilizer. A chatbot offering therapeutic advice that directly contradicts evidence-based protocols for trauma. A model providing reassurance to a patient in acute crisis when the clinically appropriate response is immediate escalation. These are not hypothetical edge cases. They are the predictable output of systems designed to be helpful and conversational above all else.

What makes this uniquely dangerous is the packaging. These models are engineered to sound empathetic and authoritative simultaneously. A patient in a vulnerable mental state has no reliable way to distinguish a clinical fact from a statistically plausible guess. And once that trust is broken, the damage extends beyond the misinformation itself. A patient who receives hallucinated guidance during a moment of crisis may lose willingness to engage with the legitimate care system at all.

Why Behavioral Health Is Uniquely Exposed

Two structural realities make behavioral health the highest-stakes frontier for AI hallucination risk: subjectivity and scarcity.

First, subjectivity. Unlike a fracture that shows on an X-ray, mental health concerns are communicated through nuance, context, and subtext. Generative AI is exceptional at mimicking tone. It is incapable of the clinical judgment required to understand the weight behind a patient’s words. There is no lab value to cross-reference, no imaging to confirm. The entire diagnostic framework depends on the kind of human interpretive skill that cannot be approximated by next-token prediction.

Second, scarcity. As of late 2025, 137 million Americans live in a Mental Health Professional Shortage Area, and only about 27% of need is being met in those regions. Appointment wait times range from three weeks to six months depending on location and specialty. For the roughly 29.5 million adults with a mental health condition who received no treatment last year, the barrier was not awareness. It was access. When the pathway to a licensed professional is blocked by a three-month wait, an AI chatbot becomes the path of least resistance, not by preference, but by default.

This is the uncomfortable truth the industry must confront: patients are not turning to AI because they trust it more than their providers. They are turning to AI because the system has not given them a better option.

The Fix Is Infrastructure, Not Disclaimers

The standard industry response to AI hallucination risk has been to add disclaimers and guardrails to the models themselves. That approach treats the symptom while ignoring the disease. The reason patients are having clinical conversations with chatbots is that the operational infrastructure of most practices still makes it easier to talk to a machine at 2 AM than to get a timely appointment with a human being.

The real solution is to shift AI’s role from clinical logic to operational logistics. Practices need to deploy technology that removes the administrative barriers driving patients toward unregulated alternatives in the first place. That means rethinking three operational layers.

Deterministic intake over conversational intake. When an LLM “chats” its way through a patient intake, it introduces the same hallucination risk we are trying to eliminate. The alternative is structured, deterministic intake systems that gather discrete clinical data without improvising questions or advice. Symptoms, history, social determinants of health, all captured through validated frameworks and delivered into the EHR as clean, fact-based data. The clinician gets a head start. The patient gets accuracy.

Precision navigation over generic triage. AI’s greatest operational strength is processing complex variables at scale. That capability should be pointed at routing, not counseling. If a patient’s digital intake surfaces indicators of acute risk, the system should not offer a supportive quote. It should trigger immediate escalation to a crisis line or emergency clinician. The technology’s job is to get the right patient to the right level of care at the right time, not to play therapist in the interim.

Intelligent follow-up over passive waiting. The period between appointments is where behavioral health patients are most isolated and most vulnerable. This is where AI can add genuine value, not by providing care, but by acting as a monitoring layer. Structured check-ins, flagging of concerning patterns in patient-reported outcomes, and automated alerts to clinical teams when intervention thresholds are crossed. The AI serves as a tripwire, not a therapist.

From Advice to Access: The Shift That Matters

The practices getting behavioral health engagement right are not the ones deploying the most sophisticated AI interfaces. They are the ones using technology to collapse the administrative distance between a patient’s first expression of need and their first clinical encounter. When scheduling, intake, and insurance verification happen before the patient walks in, the clinical encounter starts on solid ground. That is what patient engagement actually looks like in 2026.

The hallucination problem is not an argument against AI in healthcare. It is an argument for precision about where AI belongs. Every time we deploy AI in the clinical layer without adequate safeguards, we introduce risk. Every time we deploy it in the operational layer to accelerate access, we reduce risk. The distinction is not subtle, and the stakes are too high to keep blurring it.

Behavioral health already has a trust deficit driven by stigma, scarcity, and systemic friction. The last thing this field needs is a technology layer that erodes trust further by giving patients confident answers that turn out to be wrong. The opportunity in front of us is to use AI to rebuild that trust by making the system itself faster, smarter, and more responsive. Not by replacing the clinician, but by making sure the patient actually gets to one.

Related article from TTA

Character.AI sued by Pennsylvania on its chatbots posing as licensed physicians and psychiatrists

 

Perspectives: The Next Phase of Healthcare AI Will Depend on Operational Execution

May 21, 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 on moving AI tools from restricted pilots to full operational use, and what that entails in workflow design. The author, Inger Sivanthi, is the Chief Executive Officer of Droidal, an AI healthcare services company focused on revenue cycle and operational automation. His and the company’s work centers on responsible AI adoption that scales to real world clinical and operational workflows.

For the past few years, healthcare AI has been framed as a story about possibility. Leaders have asked which workflows could be automated, which decisions could be supported, and which longstanding bottlenecks might finally be addressed. Those questions were necessary, because they opened the door to experimentation and helped organizations test where AI might create value.

That phase is ending. The difference between organizations that will move forward and those that stall no longer lies in how many AI tools they pilot. It lies in how well they can embed AI into real workflows, governance structures, and enterprise systems. The next phase of healthcare AI will depend on operational execution, not on how advanced the models are.

Pilots rarely prepare you for real operations

Most pilots run under conditions that real operations never see. The workflow is narrow, the team is small, and someone is watching the numbers closely enough to catch problems before they compound. In that environment, even fragile AI tools can look impressive.

Production is different. Real healthcare operations are full of exceptions, staff changes, and system constraints. Tasks that start with simple data triage or routing quickly spread into clinical, scheduling, and financial workflows. The closer AI gets to patient care, safety, and financial outcomes, the more important the underlying operational design becomes.

A 2023 systematic review on barriers to AI in healthcare, published in PLOS Digital Health via the National Institutes of Health, shows that the main obstacles are not the algorithms themselves, but how they fit into existing workflows and governance structures. The model may work. The operational scaffolding does not.

Success depends on how you design workflows around AI

Healthcare AI becomes valuable only when it fits naturally into the way people already work. That requires more than a technical deployment. It requires clarity on who reviews the output, who handles exceptions, and how decisions are documented when the system is wrong.

When an AI system touches clinical documentation, care coordination, or billing decisions, the downstream consequences land on real people and real timelines. Delays or misrouted tasks can affect patient access, continuity of care, and financial performance. The closer AI gets to those outcomes, the more important it is to have a named person responsible for reviewing what the system produces and catching what it misses.

Connectivity between systems and teams is just as critical as the AI model itself. Point tools that sit outside the surrounding infrastructure often create new handoffs instead of removing work. The strongest operational use cases in healthcare are those that span pre‑service, clinical, and post‑service workflows. AI delivers the most value when it supports the full sequence, not just one isolated task.

Trust depends on how you govern AI in practice

Another reason execution is difficult is that organizations often treat adoption as an afterthought. Staff are expected to absorb new tools while maintaining the same pace, same targets, and same accountability. That usually leads to friction, workarounds, or quiet resistance.

AI changes the shape of work. It shifts who reviews information, who handles exceptions, and how quickly decisions move. People need clarity on those changes and confidence that the system supports them, not that it creates hidden complexity. The closer AI gets to high‑stakes decisions, the more important it is to have clear governance, oversight, and auditability.

The American Medical Association highlights that clear accountability, oversight, and governance are essential for AI to earn trust inside health systems. AI will not win trust through claims or marketing. It will earn trust by performing consistently inside real workflows, especially when pressure is high and staff have no time to compensate for gaps.

Operational execution is where AI succeeds or fails

The organizations that move ahead in healthcare AI will not be the ones running the most pilots. They will be the ones that turn AI into dependable operational infrastructure. That means embedding responsibility, transparency, and integration into the design from the start.

The next phase of healthcare AI will depend on how well organizations manage its operational execution, not on how advanced the models are. Healthcare leaders who treat AI as a workflow‑design problem, not just a technology problem, will be the ones for whom it actually works in practice.