TTA’s It’s June: Anthropic’s pending IPO, the AI Hype Curve, Oracle Health for sale, Schoenberg’s move to Amazon, Mass. sues UnitedHealthcare, Signos/H1 raises, more!

June 4, 2026 | by | No Comments

Thursday 4 June 2026

This Editor is closing and sending out Alerts a little early this week as off to an event. Most significant this week is Anthropic’s confidential, unpriced IPO filing on top of a $65B raise, a sure mark of Peak AI and the next stages of the Gartner Hype Curve. The other is an analysis of the potential market for a sell-off of Oracle Health’s EHR and what that entails–oddly coinciding with Roy Schoenberg’s move to Amazon Health. More about raises, UHG’s senior MassCare plans accused of fraud, and new Teladoc business. From last week–our Must Reads about the societal impact and the divinity of AI.

Enjoy your week and weekend!

Please feel free to comment on the articles and pass along this Alert. Let me know if this is worth it to you! Also check out my personal page on Substack.

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

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

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

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

Last Week’s Headlines

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

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

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

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

 

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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.

The $10 billion Walgreens take-private deal with Sycamore: what you need to know

March 11, 2025 | by | 1 Comment

Gimlet EyeWalgreens was too big to fail entirely–but made too many mistakes and remained in too many dying segments. The Gimlet Eye credits Walgreens for making a good deal with private equity firm Sycamore Partners before the wheels came off completely, as has happened to all too many retail-based enterprises.

The deal:

  • The equity value will be $10 billion: $11.45 per share in cash that represents a roughly 8% premium to the stock’s closing price on Thursday ($10.63). Of course, with a deal on the table, shares are up today (10 March) and closed at $11.30.
  • There is an up to $3 bonus per share to shareholders when the VillageMD holdings, including CityMD and Summit Medical, are sold, termed “Divested Asset Proceed Right” or “DAP Right”. This assumes that VillageMD will be sold.
  • How Walgreens is positioning it in their release is a total value of $23.7 billion, which would include net debt, capital leases, present value of opioid liability and Everly settlement, less fair value of all equity investments. (Slightly confusing?)
  • Closing is anticipated as Q4 2025, subject to the usual shareholder approvals (minus WBA chair and 10% owner Stefano Pessina as well as shareholders affiliated with Sycamore Partners) and regulatory approvals–a Federal and state-by-state process. Once closed, Walgreens will be private.
  • Stefano Pessina will hold a share in the company. No other transitions are mentioned at this time.
  • Headquarters will remain in Chicago.

Last week’s (and prior) reports of the three-part carveup of WBA’s assets have, so far, not been confirmed. 

Our Readers have been tracking the multiple and cumulative mistakes that Walgreens has made, including:

  • Maintaining an expensive retail footprint…then doubling down on it in 2020 by integrating into their retail footprint a co-located primary care group practice, VillageMD. Then Walgreens backed VillageMD in buying Summit Medical and CityMD. This Editor estimated, based on public information, that Walgreens sank north of $10 billion into VillageMD since their initial investment of $1 billion in 2020 [TTA 22 Feb 2024]. WBA wrote down in their Q2 2024 $5.8 billion of the investment.
    • Retail context: They not only bought Duane Reade in 2010, but also they bought 1,932 Rite Aid stores in March 2018 for $4.38 billion. 
  • It got caught in the Theranos fraud, investing $140 million but able to claw back about $44 million before the collapse.
  • Pulling a fast one on PWN/Everly Health on their Covid testing contract that just cost them $595 million [TTA 26 Feb]
  • Improper dispensing of opioids and other unlawful prescriptions that violated the Controlled Substances Act (CSA). Since Walgreens then sought reimbursement from Federal healthcare programs, they violated the False Claims Act (FCA). This has now resulted in a Department of Justice civil lawsuit filed in the Northern District of Illinois [TTA 24 Jan]. This could be billions in penalties that someone has to pay.
  • Pharmacist labor actions affected Walgreens’ already unsteady pharmacy operation.

One mistake of omission that industry opiners have pointed to was not buying a pharmacy benefit management (PBM) company, although that could be a dodged bullet as PBMs are now under Federal attack.

Too many habits have changed along with their economics. Prior to 2020, only a seer could have truly forecast that retail pharmacies could be displaced as they were by Amazon Pharmacy (which used to be a small player called PillPack), nor CostPlus, Walmart, and the teleprescribers such as Ro and Hims. The pandemic got retail customers accustomed to using online shopping and home delivery for even the smallest of items like toothpaste. Multiple small HBA (health and beauty aids) brands are profitably and directly sold on YouTube and elsewhere. Another nail in retail–shoplifting and related crime drained profit. For shoppers, stores became threatening, not comfortable, places to spend a little time browsing, going in for milk or cough syrup and walking out with cards, printer ink, candy, shampoo, and ice cream. Another change that few mention is how major supermarkets have also added pharmacies along with expanding aisles of vitamins and major brand HBA, at competitive prices.

Unlike CVS, Walgreens stores tend to be (at least locally to this Editor, meaning NY and NJ), barnlike, oddly organized, hard to browse, and harshly lighted locations with a few registers concentrated in a cattle chute design. CVS is generally (not always) easier to browse and slightly better organized especially at checkout with self-check and register options, as is their pharmacy experience. CVS also benefits from having insurer ties and Minute Clinics in many locations.

What’s ahead for Walgreens? Right now, it has 12,500 retail pharmacy locations across the US, Europe and Latin America with 310,000 employees. Neither Walgreens nor Sycamore is talking, which is reasonable, but the Gimlet Eye can make certain educated guesses. Certainly by 2026 there will be major changes in their retail footprint. Their 5,000 scheduled store closures may look miniature compared to what is coming, with the smallest volume or least well located stores going first and likely what is left of Duane Reade closed. Staff will be cut accordingly and one can anticipate difficulties on their pharmacy side which has already seen some unrest in staffing and management. As earlier noted [TTA 4 Mar], expect sell offs or spinoffs of other assets such as CareCentrix, Shields Health Solutions, the 6% left of their Cencora shares, Boots No. 7 beauty, and Boots in the UK.  

It’s hard to be assured that in a year or two, there will be many local Walgreens (or Boots) to run into for a prescription or Band-Aids, given the generally unsuccessful track record of retail PE and the trends noted above. Sycamore Partners in that area is well regarded, especially in how they turned around Staples, Talbots, and others. But given the rabbits-pulled-out-of-hats in how Sycamore put together their funding and debt financing for Walgreens, and the economics of the private equity model of profitability and ROI in covering management fees, debt service, and asset selloffs–it will be an interesting time for those of us who are healthcare observers. CNBC, MedCityNews, Yahoo Finance (CNN)

More on Sycamore’s 83% debt level in financing the Walgreens deal, and what that could mean, here.

The Theranos Story, ch. 46: “F for Fake.” SEC’s fraud charges force Elizabeth Holmes out (finally).

March 15, 2018 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/11/jacobs-well-texas-woe1.jpg” thumb_width=”150″ /]Our New Year’s 2018 prediction (after December’s $100 million loan from Fortress Investment Group): “Ms. Holmes will be removed and replaced, then the company will be reorganized and/or renamed.”

Fortress did not have to wait long or get their hands dirty. Today, the Securities and Exchange Commission (SEC) charged both founder and now former CEO Elizabeth Holmes and past CEO/president Ramesh ‘Sunny’ Balwani with securities fraud. While Mr. Balwani will fight the charges, Ms. Holmes escaped trading her black turtleneck for an orange jumpsuit by agreeing to pay a penalty of $500,000 to the SEC, give back 18.9 million shares to the company, give up her uniquely Silicon Valley perk of super-voting equity rights, and is now barred from serving as a public company director or officer for 10 years. From the Theranos release: “As part of the settlement, neither the Company nor Ms. Holmes admitted or denied any wrongdoing.”

This penalty may seem puny in the light of other securities fraud cases, but it appears that Ms. Holmes took little salary out of the company, with most of her long-gone billions in presently worthless remaining stock. 

The exact meaning of fraud, as determined by the SEC in cases like these, is not casual. We can say that we never believed the Edison or miniLabs would work despite the press hype. We can observe that patients and doctors were misled in test results, resulting in major human cost (our Ch. 22).  The fraud here is directly tied to representations made to investors that enabled Theranos’ massive funding, in multiple rounds, of over $700 million between 2013 to 2015. These misleading representations included demonstrations, reports on the functioning of its analyzers, inflating its relationships such as with the DOD, and its regulatory status with the FDA.

It also does not matter that all the funds were privately raised. The SEC in its statement firmly stated that it will treat private equity as it does public when it comes to investments (pay attention, health tech companies): (more…)

Tunstall secures additional £20 million from Charterhouse: implications?

October 6, 2014 | by

Breaking News  Tunstall Healthcare Group quietly announced on 25 September an additional investment of £20 million from its private equity owner, Charterhouse Capital Partners. Our readers know from our May and July articles the business challenges Tunstall has faced. We have particularly focused on–as have Bloomberg in May, this Editor and our Founder/EIC Emeritus Steve Hards over the years–on the heavy burden of Tunstall’s debt service, multiple management changes on both sides of the Atlantic, and a decided ‘failure to launch’ in the US market.

Readers of the Sunday Times woke up to this headline and lede (what news writers use to introduce the topic and entice you to read on):

Headline: £20m to steady ship at Tunstall

Lede: CHARTERHOUSE Capital Partners, one of the City’s oldest and most secretive private equity firms, has been forced to provide a multimillion-pound lifeline to another of its investments. A fortnight ago, Charterhouse ploughed £20m into Tunstall, a healthcare technology company that makes equipment to monitor the elderly and sick at home.

Insider Media Limited (business news review) had a more measured take in its ‘Yorkshire News’ section:

Headline: BACKERS PUMP £20M INTO HEALTHCARE FIRM (more…)