Health Tech Bites

Less than 8% of Americans are metabolically healthy... and your budget is absorbing all of it. Dr. Ferro from Betr Health joins Crew Talk to talk about it.

HIMSS 2026 kicks off in Las Vegas today. 25,000 healthcare leaders are on the ground, nearly a third from the C-suite. The big shift this year — AI conversations are moving from "should we" to "we're doing it, now what." Microsoft just turned Dragon Copilot into a clinical AI platform. What started as an ambient documentation tool is now an app store for clinical AI — with partners like Optum, Regard, and Canary Speech building directly inside the workflow. They're also offering a 60% discount to rural hospitals, which is not an accident given everything happening with Medicaid right now. Telehealth got the runway it's been asking for. Federal telehealth approvals extended two years, and hospital-at-home waivers run through 2030. If you've been waiting to make a real infrastructure commitment to virtual care, that hesitation just got removed. Hospitals are already closing units and laying off staff because of the Medicaid cuts — and we're still in the early innings. Maternity wards, community health centers, hospital clinics — the closures are happening this month, not in some future projection. Shelby breaks down what's driving it, what's still coming in 2027, and what healthcare leaders need to do right now before it gets worse.

AI therapy chatbots are everywhere and nobody's really in charge of them. A new Brown University study exposes serious ethical gaps in how general-purpose AI handles mental health conversations and what healthcare leaders need to do before it becomes a patient safety event. Plus Deep Thoughts on why too much sweet ruins the treat.

Special Episode: The ChatGPT Health Study Mount Sinai just published the first independent safety evaluation of ChatGPT Health—the AI tool 40 million people are using daily to decide whether they need emergency care. The findings are sobering: a 52% under-triage rate on true emergencies, anchoring bias that follows when family members minimize symptoms, and suicide crisis safeguards that triggered inversely to actual risk. But the story isn't all bad. An NEJM AI study shows what AI triage looks like when it's designed to support clinical judgment instead of replace it—and the results are genuinely encouraging. We break down what the research says, what's actually working, and what healthcare leaders should do right now. Plus, Deep Thoughts with Shelby on the difference between keeping the peace and making the peace.

Check out Healthcrewhq.com Health Insurers Turn to AI to Cut Billions in Costs — Providers Should Be Paying Attention Squeezed margins are pushing major payers to deploy AI across utilization management and prior auth, raising concerns about rising denials and lack of transparency. Health Systems Go All In on Agentic AI for End-to-End Clinical Workflows The conversation has moved past scribes — systems like Mayo Clinic and Intermountain are investing in AI that handles scheduling, prior auth, care coordination, and follow-up without human intervention. Digital Therapeutics Finally Have a Path to Get Paid New Medicare billing codes and fresh funding signal that app-based treatments are moving from failed pilots to real budget line items for health systems and payers.            

Headline 1: My Experience with Earl 2 Shelby returns after experimenting with OpenClaw (formerly MoltBot), the viral open-source AI agent that autonomously executes tasks on your computer. Despite security researchers calling it a "disaster waiting to happen," he installed it to understand firsthand what autonomous AI actually feels like. His experience provides crucial context for understanding the AI disruption hitting healthcare. Headline 2: Congress Passes Landmark PBM Reform On February 3rd, Congress passed comprehensive PBM reform requiring 100% rebate pass-through to plan clients starting in 2028. The law also bans spread pricing in Medicare Part D and mandates massive transparency requirements. After decades of PBMs operating in a black box, the rebate retention business model is dead. Headline 3: HHS Scraps 340B Rebate Pilot The Department of Health and Human Services abandoned its controversial 340B rebate model after hospitals sued and won. The proposed pilot would have required providers to front full drug costs and wait for rebates—creating massive cash flow problems for safety-net hospitals. While hospitals are relieved, the fight over 340B isn't over.

Headline 1: CMS 2027 Medicare Advantage Rate Shock Triggers $80B Market Wipeout—The Golden Era is Over CMS proposed just 0.09% rate increase for 2027 MA plans versus expected 4-6%, includes aggressive 1.53% cut from eliminating chart-review-only diagnoses, sending CVS, Elevance, and UnitedHealth stocks into freefall on January 27 and forcing health systems to rethink their entire MA strategy. Headline 2: Coalition for Secure AI Releases Security Framework for Model Context Protocol—AI's New Attack Surface Just Got Real Google, Amazon, Microsoft, OpenAI, and NVIDIA's security coalition released an MCP security taxonomy on January 27 as vulnerabilities multiply, MCP servers get exposed in production, and healthcare organizations realize they're deploying AI agents without the governance to contain them. Headline 3: Commure Raises $200M as Autonomous AI Delivers Real Revenue Cycle Results—The Pilot Era is Over While everyone's still talking about AI potential, Commure's autonomous coding is delivering 83% reduction in clinician time at scale across HCA Healthcare and Ob Hospitalist Group, with RCM customers seeing 20% revenue lift—proof that AI agents work when you actually deploy them right.

EPISODE SUMMARY: Headline 1: Amazon Launches Health AI for One Medical—The Clinical AI Race Heats Up Amazon rolled out Health AI integrated directly into One Medical's app, letting patients access records, book appointments, and manage prescriptions through agentic AI—positioning itself against OpenAI and Anthropic in the race to own clinical AI interactions. Headline 2: CMS Finalizes HIPAA Security Rule—72 Hours to Restore or Report Healthcare organizations now have 72 hours to restore ePHI after a cyberattack or report it as a breach, plus new technical safeguards and encryption requirements—forcing health systems to either upgrade their disaster recovery or face mandatory breach reporting. Headline 3: PBM Reform Gets Bipartisan Momentum—The Rebate System Might Actually Change Congress is pushing bipartisan legislation to ban spread pricing, require rebate pass-through, and increase PBM transparency—reforms that could fundamentally reshape how drug pricing works in healthcare if they actually make it through.

Headline 1: The Megadeal Era is Over—M&A Without a "Big Why" is Just Expensive Anxiety Healthcare megadeals collapsed by 60% in 2025, and M&A has shifted from growth strategy to rescue mission—if you can't explain the deal in one sentence, don't do it. Headline 2: Vizient's "New Margin Math"—Old Growth Levers Are Broken, AI is the Last Big Bet Hospitals are saving more lives but losing money doing it, and AI investment is projected to hit $100 billion by 2030—but only if you redesign workflows first, not just buy tools. Headline 3: CareFirst BCBS Sues CMS Over Medicare Advantage Star Ratings—$32 Million Hangs on One Data Point One member's medication adherence data correction dropped CareFirst from 4 stars to 3.5 stars, costing them $32 million in bonus payments and triggering a lawsuit that's part of a growing wave of payer litigation against CMS.

Insurer CEOs grilled on affordability Major payers defend pricing and profits on Capitol Hill as lawmakers shift the blame narrative from providers to insurers, signaling margin pressure that will ripple downstream. OpenEvidence becomes a $12B company A physician-facing AI tool leaps from pilot to infrastructure, forcing health systems and payers to rethink workforce strategy, utilization management, and liability. Congress extends telehealth and hospital-at-home flexibilities Multi-year regulatory certainty unlocks real investment in virtual and acute-at-home models, while setting the stage for tighter audits and compliance scrutiny.

AI poised to legally prescribe medications in select U.S. states by end of 2026 (Multiple Sources) Why it matters: Utah's regulatory sandbox transitions AI from clinical assistant to clinical actor, forcing health systems to scenario-plan workforce strategy, governance frameworks, and competitive positioning before the commodity care automation wave arrives. Digital health IPO momentum builds as startups like Freenome, Ro, Maven Clinic, Virta Health emerge on 2026 IPO watchlists (Industry Reports) Why it matters: The 2026 IPO wave will separate digital health survivors from pretenders—audit your vendor relationships now, because financial fragility in your partners becomes operational risk in your organization. Healthcare data breaches show continued decline in 2025 volume, but sophistication rises (HHS OCR, Fortified Health Security) Why it matters: Fewer breaches but rising sophistication means your security strategy must shift from perimeter defense to continuous detection, third-party governance, and workforce resilience—because the next attack will be faster, smarter, and targeting your vendors, not just you.

AI can flag cognitive decline nearly on par with humans (Fierce Healthcare, Jan 15) Why it matters: AI's near-human accuracy in detecting cognitive decline from notes offers a scalable early-intervention tool, reshaping provider workflows and resource allocation for aging populations. Former AMA president: Without overhaul, U.S. health care system will implode (STAT News, Jan 19) Why it matters: Jesse Ehrenfeld (now at Aidoc) warns of systemic collapse absent major fixes, spotlighting AI as a partial lifeline—pushing leaders to accelerate AI governance and workforce retooling before margins and burnout hit critical. Bariatric surgery beats GLP-1s for type 2 diabetes across income levels, study says (STAT News, Jan 19) Why it matters: Head-to-head evidence favoring durable surgical outcomes over drugs challenges GLP-1 dominance—could shift payer/employer coverage policies toward procedures, impacting obesity chronic-care budgets and provider procedure volumes.

Story 1: Trump releases “Great Healthcare Plan” framework Why it matters: Signals potential shifts in drug pricing, transparency, and subsidy flow. Story 2: Trinity Health cuts 10.5% of rev cycle roles Why it matters: Another sign RCM is being rebuilt around automation and standard work. Story 3: Prior auth reform hits first 2026 deadline Why it matters: Insurers’ pledge moves from press release to execution, and providers should track what actually changes.

OpenEvidence pitches “medical super-intelligence” at JPM26 (STAT News) Why it matters: Clinical decision support is aiming past summaries into reasoning, which raises the upside for workflow quality and the pressure on governance, accountability, and liability. Waystar unveils agentic AI for revenue cycle at JPM26 (Fierce Healthcare) Why it matters: Agentic RCM targets denial prevention and faster cash with fewer manual touches, which will separate operators who modernize revenue cycle from those who stay stuck in queue management. Anthropic launches “Claude for Healthcare” with HIPAA-ready tooling and health-record connectors (Anthropic, Fierce Healthcare) Why it matters: Foundation model vendors are positioning to own the regulated layer with compliant infrastructure and connectors, accelerating adoption for buyers while increasing the need to standardize governance.

Digital Health Funding Reached $14.2B in 2025, with AI Deals Capturing 54% and M&A Volume Up 61% (Rock Health / Fierce Healthcare, Jan 12) Amazon One Medical Pushes Employer-Sponsored Primary Care Memberships (JPM26 coverage and One Medical for Business framing, Jan 12) Hospitals Are Staring Down a Make-or-Break Year (Axios, Jan 13)

Headline 1: OpenAI launches ChatGPT Health with b.well integration for personal health data sync and review Summary: Consumer health questions are moving into an AI interface that can connect to real records, which could reshape how people understand, navigate, and trust care. Headline 2: 67% of physicians report daily AI use in practice Summary: AI is already embedded in clinical work, and the real challenge now is governance, training, and making sure adoption is safe and consistent. Headline 3: Revenue cycle leaders warn AI could accelerate denials unless payers and providers align Summary: Claims, denials, and prior auth are becoming the next AI battleground, and leaders will either use AI to reduce friction or scale it.      

Sanford Health doubles down on its provider-led health plan to counter Medicare Advantage pressures and signals why tighter care plus coverage integration is becoming a real strategy. FDA announces sweeping changes to the oversight of wearables and AI-enabled devices and shifts more of the “is this safe and real” burden from regulators to buyers. OpenAI says 40 million people use ChatGPT daily for healthcare questions and forces the uncomfortable truth that AI is already an unofficial front door, whether healthcare leaders like it or not.

2026 Outlook: Hybrid care companies poised for strong growth (Fierce Healthcare) 21,000 New York nurses to launch strike Jan. 12 (Fierce Healthcare) Tech Compass 2026: AI optimism rises, but people want a “pause button” (Bosch)

STAT: Who will pay for AI in health care? The market has plenty of clinical AI, but reimbursement is not keeping up, so health systems are staring down another “unfunded standard of care” moment. KFF: Policy changes bring renewed focus on high-deductible health plans 2026 plan design is pushing more cost onto consumers, which changes behavior, delays care, and turns affordability into an operational problem. Chief Healthcare Executive: 26 leaders predict AI’s next phase. Leaders are done with pilots and hype. They want enterprise-scale AI that reduces friction, especially inside the EHR, and they know adoption and training will decide who wins.

We will be back Jan 5th. 2026

A special episode on the ACA subsidy cliff and why it’s more than “policy drama.” We break down where things stand right now, what the 2026 reality looks like for premiums and behavior, what people are arguing about, and how to lead through it if you run a plan, health system, or benefits team.

Headline 1 FDA digital health leaders exit amid reorgs, which could slow approvals and reshape how AI devices get reviewed heading into 2026. Headline 2 Employers are seeing big ROI on workplace insurance, but the hidden cost is rising employee friction that quietly hits trust, retention, and delayed care. Headline 3 The ACA subsidy cliff is back on the edge, and if it drops, plans and systems could face fast operational chaos as affordability snaps overnight.

Headline 1: Is healthcare in an AI bubble? CIOs weigh in (Becker’s Hospital Review, Nov 17, 2025) A bunch of CIOs basically say the hype might pop, but the workflow wins are real, measurable, and already changing day-to-day care operations. Headline 2: Growing GLP-1 drug costs squeeze Minnesota employers and health plans (Axios Twin Cities, Dec 15, 2025) GLP-1s are helping people and hammering budgets, forcing employers and plans to build policies that protect both outcomes and affordability without losing trust. Headline 3: Thatch embeds ICHRA health benefits into ADP payroll platform (MobiHealthNews, Dec 15, 2025) This is a “go where people already are” play, turning benefits into something that lives inside payroll workflow instead of a once-a-year fire drill.

Five Ways AI Agents Will Transform Healthcare Operations AI is shifting from suggesting to actually doing the work—from revenue cycle to clinician support—forcing leaders to ask: what are you ready to delegate in 2026? Non-Labor Expenses Are Becoming Hospitals' Biggest Cost Threat The quiet margin squeeze isn’t coming from labor anymore—it’s hiding in thousands of “that’s just how we’ve always done it” non-labor decisions. Bad Debt and Charity Care Up 40% Since 2022 Coverage gaps and Medicaid redeterminations are driving unpaid care higher than ever, turning affordability leaks into a shared crisis for hospitals, plans, and eventually employers.

All 50 states applied for CMS’s $50B Rural Health Transformation Program, awards due Dec 31: A massive bet with a year end clock, where the real question is whether states build the boring foundation that makes change stick, or just dress up a plan with buzzwords. Hospital CIO priorities for 2026 shift from new tools to scale and govern: Big systems are moving from “more AI” to “make it work,” focusing on fewer bets that reduce documentation burden, tighten security, and actually show enterprise impact. Texas AG sues Epic over alleged monopolization and restrictive data practices: Strip away the noise and this is a power fight over data access, switching costs, and what “open” is going to mean in the next era of EHR competition.

Headline 1: Trump Signs Executive Order Blocking State AI Regulations in Healthcare (STAT News, Dec 11, 2025) — A messy state by state AI rulebook may get replaced by one lane, which means your internal governance becomes the real guardrail. Headline 2: HHS Proposes Radical Overhaul to EHR Certification, Slashing 34 Criteria (STAT News, Dec 11, 2025) — If the federal checklist shrinks, this is your chance to stop buying “certified” and start contracting for measurable data flow in real workflows. Headline 3: AARP Study: Tech Use Surges Among Adults 50 Plus, With Smartphone Ownership at 90% and AI Use Rising to 30% (AARP, Dec 2025) — Older adults are already digital, so the market is no longer about adoption, it’s about trust, usability, and follow-through.

In this episode we pull apart Rock Health’s new 2026 innovation map, walk through the six lanes they say actually mattered in 2025, then camp out in the AI lane to ask a simple question: what’s your park, and where do you need to stop pretending you belong?     AI Implementation Toolkit 

Headline 1: 40+ Health Systems Drop Medicare Advantage Contracts for 2026 The MA growth story runs into its first real return line, as hospitals decide they would rather walk away than keep eating losses and fighting denials while seniors try to hang on to the doctors they trust. Headline 2: Harvard Study Finds GLP-1s Have Little Impact on Obesity-Related Cancer Risk The cancer halo around GLP-1s gets a reality check, nudging leaders to treat these drugs as powerful tools for weight and metabolic disease, not a shortcut around building a real prevention strategy. Headline 3: AI Adoption Surges but 95 Percent of Projects Fail on Workflow MIT’s ninety five percent failure stat meets a growing set of real wins, highlighting that the difference is not the model you bought but whether you walk a simple set of STEPS that give clinicians time back instead of homework.

Headline 1: Brown & Brown 2026 Employer Survey Employers hand CFOs a permission slip to make cost control priority number one and quietly move “nice to have” benefits off the table. Headline 2: Lin Health’s 11M Series A and Mayo Partnership Behavior-first chronic pain care tries to prove it can live on real health system and payer rails, not just in the wellness tab. Headline 3: WellSky 2025 Evolution of Care Report Fresh data on sicker patients, messier handoffs, and exhausted staff that shows exactly how overloaded post-acute and home-based care has become.          

In this episode of Health Tech Bites unpacks ACCESS, Medicare’s new chronic care model aimed at paying for what actually happens between visits, not just inside the clinic. The conversation digs into how ACCESS could reshape chronic care from punch-card phone calls to ongoing support woven into Tuesday afternoon life – and what that means for health plans, providers, and digital health vendors. Expect a clear-eyed look at who’s positioned to win, who’s at risk of getting buried in admin, and why this framework might finally force the industry to prove it can help real humans feel better between appointments, not just make dashboards greener.

Story 1: UnitedHealth to wind down most non-Optum revenue cycle contracts by 2026 Story 2: Elevance to roll out $0 primary care copays across its national ASO book in 2026 Story 3: Nvidia launches edge-based “AI doctor” toolkit with pilots at five major health systems      

Today’s Bite Local coalitions are hacking their own benefits, employers are staring down rude 2026 cost projections, and Gen AI scribes just got their first real report card. The real question is not “what is new,” but “who actually gets equipped, encouraged, and empowered by all this.” The Stories • Story 1: SF Chamber Care and the rise of local, chamber-backed coverage models • Story 2: Employers bracing for a 9 percent medical trend and rethinking the entire benefits chassis • Story 3: UCLA’s randomized AI scribe trial, where burnout relief shows up but magic productivity does not

Story 1 (Curative $150M Raise): Curative’s $150M Bet: Zero-Dollar Plans That Could Kill Deductibles Forever Story 2 (Oscar Survey): 53% Will Quit for Better Insurance: The Benefits Exodus No Employer Can Ignore Story 3 (Clinician-First AI): AI That Clinicians Actually Trust: The Burnout Fix Hiding in Plain Workflow

Story 1: Yara AI shut down its own mental-health chatbot after realizing the model worked too powerfully in contexts it couldn’t safely control. Story 2: A surge of holiday health gadgets is creating a massive wave of unregulated health data as consumers build their own personal health stacks faster than the system can protect them. Story 3: Tampa General transformed its call center almost overnight by deploying an AI voice agent named Amy that slashed wait times and abandonment rates.

Today’s Bite: Today healthcare didn’t speed up — it jumped a gear and pretended nothing happened. The Stories: • The White House activates the CMS Health Tech Ecosystem – Real-time patient data just went from “someday” to “start preparing now.” • Cleveland Clinic collapses oncology turnaround times with Google Cloud AI – When results move from days to hours, expectations move with them. • House Rx raises $55M to rewrite specialty pharmacy – AI inside the clinic is coming for the slowest, messiest corner of drug access. Quote of the Bite: “If healthcare keeps speeding up, the organizations built for slowness won’t just struggle — they’ll get exposed.”