Health Tech Nerds Radio

Kevin O'Leary, Martin Cech
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Where we share our weekly news debriefs and discussions with industry experts. These are lo-fi recordings aimed at giving our readers more opportunities to engage with our analysis and a view into some of the conversations that shape it.

  1. 10h ago

    The Grand Roundup: Q3 earnings from Centene to Lilly, HCA’s ACA-to-uninsured problem, Walmart and AI agents, Alignment’s miss, Medicaid frailty ruling, and more

    Kevin and Martin dig into a busy Q3 earnings week where payers keep winning and providers keep absorbing the affordability squeeze. Centene beat and raised, hit MA breakeven a year early, and barely mentioned ICHRA. Alignment stumbled on a claims platform migration, high-cost cases and a Stars drop in its core California plan. On the hospital side, more of HCA’s ACA members went uninsured than it expected. CHS says commercial patients are pushing hip and knee replacements into next year, and Tenet keeps doubling down on ASCs. Teladoc had a huge week, DaVita’s kidney care business raised guidance again, and Kevin checks the math behind Lilly’s claim that GLP-1 Bridge saves Medicare $20 billion. Next comes Medicaid. A judge blocked CMS’s medical frailty rule less than two months before work requirements start, and Martin explains why 2027 is the hospitals’ problem and 2028 is the payers’. They wrap with AI agents shopping for care through Zocdoc and Walmart’s Better Care Services, a study finding AI recommends roughly three times what physicians do, and what happens when your health agent is free. Links referencedWall Street Journal: “Investors Are Betting a Blue Wave Will Hospitals. Don’t Count on It."Michael Albert Substack: a breakdown of the USC preprintUSC preprint: the $20B Medicare savings from GLP-1 BridgeNEJM AI study: AI care recommendations vs. physician costs For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe

    The Grand Roundup: Q3 earnings from Centene to Lilly, HCA’s ACA-to-uninsured problem, Walmart and AI agents, Alignment’s miss, Medicaid frailty ruling, and more

  2. Oct 27

    The Grand Roundup: Molina’s rate vs. trend math, Elevance’s ASO IDR squeeze, reinventing insurance from scratch, the Bon Secours deal, and more

    Kevin and Martin open with the surprise news that Bon Secours is buying Surgery Partners, plus the Advocate headache of patients linking MyChart to ChatGPT, which sent Epic API calls up 7,000% and left Advocate paying for them. Then it’s Q3 payer earnings. Elevance beat, but mostly on investment gains, and says IDR costs are landing on its ASO book, which means employers are paying them. Molina’s 7% Medicaid rates against roughly 4.5% trend back up the “trough year” story. The guys also ask why Molina is staying in the ACA, and whether D-SNP or C-SNP is the more durable bet. On the employer side, they go through the KFF survey, Oxbridge’s $45M raise for employer episode bundles, and Aon’s  Access Choice marketplace. Along the way they accidentally invent insurance companies from first principles. They also dig into STAT’s reporting on iMPROve Health, an IDR arbitrator whose financials have turned into a hockey stick. To close, they cover Bob Wachter on who AI should serve and the coming “AI death panels” fight, General Medicine’s own medical group and its new Walmart partnership, Daniel Nadler’s drug discovery pitch for OpenEvidence, and Horizon buying Summit for about $1B. Brought to you by Lorikeet is a leading platform health tech companies use to build, test, and deploy AI concierges for patient and provider support. Your patients' AI agents get the same answers and identity checks your patients do. lorikeetcx.ai/healthtech Links referencedLRV Health and CVS paper on the AI agent explosionBecker’s: “Patients linking MyChart to ChatGPT jumped 7,000% at Advocate. Who pays?”Trilliant Health 2026 market trends report For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe

    The Grand Roundup: Molina’s rate vs. trend math, Elevance’s ASO IDR squeeze, reinventing insurance from scratch, the Bon Secours deal, and more

  3. Oct 20

    The Grand Roundup: Q3 earnings special — the C-SNP land grab, Nebraska’s Medicaid warning sign, the big three PBMs hold, AI’s quiet earnings role, and more

    Earnings season is here, and Kevin and Martin preview what they’re listening for in Q3, starting with government programs. They discuss Medicare Advantage plans pruning PPOs in favor of C-SNPs and D-SNPs, the growth outlook for Humana and Alignment, and Clover’s five-star rating heading into AEP. On Medicaid, they cover plans’ view that 2026 is the trough and early disenrollment data from Nebraska’s work requirement rollout. On the commercial side, they get into UnitedHealthcare’s commentary on trend above 11% and No Surprises Act IDR payments as a share of medical spend. They also talk through Omada and Hinge’s selling season, the state of the ACA market, the big three PBMs’ outlook, and state laws separating PBMs from specialty pharmacy. The conversation then turns to hospital operators, covering affordability, delayed elective procedures, and uninsured rates, alongside cash-pay consumer models. The episode closes with value-based care and how AI is showing up on public company earnings calls. Brought to you by Lorikeet is a leading platform health tech companies use to build, test, and deploy AI concierges for patient and provider support. Your patients' AI agents get the same answers and identity checks your patients do. lorikeetcx.ai/healthtech Links referenced STAT report on IDR arbitrator profitability: https://www.statnews.com/2026/10/19/no-surprises-act-billing-arbitration-profits-stat-investigation/ For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe

    The Grand Roundup: Q3 earnings special — the C-SNP land grab, Nebraska’s Medicaid warning sign, the big three PBMs hold, AI’s quiet earnings role, and more

  4. Oct 12

    The Grand Roundup: 2027 Stars winners and losers, Atrium vs. NC State Health Plan, No Surprises Act fix, Megan Fox and D2C consumerism, and more

    Kevin and Martin start with a discussion of the 2027 Stars ratings. The big takeaway: the results were good enough for most plans that Congress won’t feel pressure to fix the program. From there, they cover the fight between Atrium and the NC State Health Plan. That leads into Frank Pallone’s bill to replace No Surprises Act arbitration with an inflation-adjusted QPA, and the real question underneath it: who should pay. They close on consumerism: General Medicine’s $120M raise and TJ Parker’s case that “the agent needs a store,” Megan Fox selling ED meds for Ro, and why brand still beats rational choice in healthcare. Plus quick hits on Option Care, Centene and Marathon, CMS scrutiny of CCM billing, and Utah’s AI sandbox. Brought to you by Lorikeet is a leading platform health tech companies use to build, test, and deploy AI concierges for patient and provider support. lorikeetcx.ai/healthtech Links referenced KFF on the role of healthcare in the midterms: https://www.kff.org/from-drew-altman/a-guide-to-the-role-of-health-in-the-midterms/ CBS News on the No Surprises Act: https://www.cbsnews.com/news/no-surprises-act-medical-bills-arbitration-system-loophole/ NY Times Magazine on health misinformation: https://www.nytimes.com/2026/10/04/magazine/alternative-cancer-clinics-treatment-father.html For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe

    The Grand Roundup: 2027 Stars winners and losers, Atrium vs. NC State Health Plan, No Surprises Act fix, Megan Fox and D2C consumerism, and more

  5. Oct 6

    The Grand Roundup: Devoted's $25B round, Oura's IPO, Cigna Investor Day, the C-SNP gold rush, and more

    Kevin and Martin spend the first half of this week's episode on Devoted Health, which formally announced a $1.18B Series G at a $25B valuation. They get into the NAIC filings showing a 1.1% margin, confirmation that Devoted is profitable at the parent level, the 13 Series F investors who sat this round out, and why 133 new C-SNP plans in the MA landscape file might be the real story. Is the AI-driven admin cost edge durable, or a head start the incumbents eventually close? From there it's Oura pulling its IPO, what that says about the gap between private and public markets, and Martin's bet on a post-midterms window. Then Cigna's Investor Day: Evernorth's specialty engine, Select's growth with small employers, and what that means for the challenger plans renting Cigna's network. They round it out with Grindr buying Freddie, MultiCare launching an MA plan while others exit, Anthropic joining ARPA-H's ADVOCATE, HealthPartners and Essentia merging, and Thoreau's $500M commitment to Ortet. Brought to you byLorikeet is a leading platform health tech companies use to build, test, and deploy AI concierges for patient and provider support. lorikeetcx.ai/healthtech Links referencedBusiness Insider: Devoted Health could be valued at $25 billionhttps://www.businessinsider.com/healthcare-startup-devoted-health-could-be-valued-at-25-billion-2026-8Axios (Dan Primack): Oura delays its IPOhttps://www.axios.com/2026/09/29/oura-ipo-delayed-smart-ring For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe

    The Grand Roundup: Devoted's $25B round, Oura's IPO, Cigna Investor Day, the C-SNP gold rush, and more

  6. Sep 29

    The Grand Roundup: AI agents turn insurance friction into a cost center, Rightway and transparent PBMs, longevity goes to work, Cigna investor day, and more

    Kevin and Martin kick off with the latest Citrini report and its argument that AI agents will turn friction from a profit center into a cost center, with health insurance as exhibit A. Martin doesn't buy the idea that payers unwind, but thinks bots that fight every denial and prior auth mean higher premiums down the road. Kevin brings in the NYT story on SmarterDx and McLaren to ask whether all this coding automation just builds another middleman profit pool. From there it's Rightway's $155M raise at a $1.75B valuation and 45 Fortune 500 clients. If transparent PBMs are winning, why isn't anyone at dinner parties saying their healthcare got better? Martin pulls up Drug Channels data, notes the CAA just made transparency table stakes, and lands on the iron law of insurance: bigger risk pools win, and every innovation gets metabolized. In longevity, Superpower's B2B deal with Sequoia, August's $39 a month membership, Neko's 25,000-person New York waitlist, and PE money flowing into Aligned Modern Health. They close with Heidi Health, Corridor, Basalt, Oura's IPO, and Cigna's investor day. Brought to you by Lorikeet is a leading platform health tech companies use to build, test, and deploy AI concierges for patient and provider support. lorikeetcx.ai/healthtech Links referencedCitrini Research, "Agentic Reality" (Sept. 22, 2026): https://www.citriniresearch.com/p/agentic-realityNew York Times article on Blue Cross Blue Shield Association data about hospitals using AI coding: https://www.nytimes.com/2026/09/24/business/ai-hospitals-insurers-health-care-costs.html For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe

    The Grand Roundup: AI agents turn insurance friction into a cost center, Rightway and transparent PBMs, longevity goes to work, Cigna investor day, and more

  7. Sep 21

    The Grand Roundup: Oscar's Investor Day, Alignment Health's mysterious 35% drop, OpenEvidence's oncology pivot, Walmart's GLP-1 pharmacist pilot, and more

    Kevin and Martin open with a wild AI story: a personal-assistant app is now negotiating discounts with telehealth vendors on users' behalf, opening up some genuinely strange territory around bots negotiating with other bots. From there it's Oscar's Investor Day: Bertolini's pitch that the individual market is a $350 billion opportunity, the ICHRA/Choice and Lucie marketplace ambitions, and whether any of it holds up against a shakier ACA market and skeptical brokers. Then Alignment Health, down 35% this week during CMS's Stars blackout, and OpenEvidence's confusing week — a $250 million raise at a lower valuation than they reportedly turned down over the summer, plus a surprise pivot into drug development. Quick hits close the show: Thatch's $108 million raise, Walmart's new Scan partnership and pharmacist health-coaching pilot, and RCM moves at Waystar and Datavant. Brought to you by Lorikeet is a leading platform health tech companies use to build, test, and deploy AI concierges for patient and provider support. lorikeetcx.ai/healthtech Links referenced Forbes article on OpenEvidence's $250M raise and Memorial Sloan Kettering partnership: https://www.forbes.com/sites/innovationrx/2026/09/16/a-premier-cancer-hospital-makes-its-data-available-to-doctors-nationwide-through-openevidence/ For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe

    The Grand Roundup: Oscar's Investor Day, Alignment Health's mysterious 35% drop, OpenEvidence's oncology pivot, Walmart's GLP-1 pharmacist pilot, and more

  8. Sep 14

    The Grand Roundup: Autonomous clinical AI is here, challenger health plans vs. the incumbents, InnovAge's PACE push, a private markets roundup, and more

    Kevin and Martin open on where autonomous clinical AI actually stands post-ARPA-H awards and the Zeke Emanuel conversation. They then discuss whether employer-sponsored insurance is nearing its end — Julie Yoo’s "Great Health Plan Replacement" thesis, Surest, and the CrowdHealth risk-pool debate Next, they dig into Omada's inaugural investor day: the PBM-as-channel go-to-market strategy and updated margin targets now at 80% gross and 30% adjusted EBITDA. From there, InnovAge's Q4 earnings — the company is planning a growth era following two years spent fixing operational issues in California and Colorado, with CEO Patrick Blair flagging unusually strong federal interest in expanding the PACE model beyond dual eligibles. Private markets stay busy: Fullscript's buyout by L Catterton (with a Thorne/P&G footnote), Thyme Care’s $125M round and new "Thyme Companies" parent entity, Forus’s $150M specialty-pharmacy raise, a senior-living round for Inspiren, and Epsilon Health's radiology raise. Brought to you by Lorikeet is a leading platform health tech companies use to build, test, and deploy AI concierges for patient and provider support. lorikeetcx.ai/healthtech Links referenced Conversation with Zeke Emanuel: https://www.healthtechnerds.com/p/autonomous-ai-and-the-future-of-clinical-care-an-expert-interview-with-ezekiel-emanuel-md-phd Julie Yoo on The Great Health Plan Replacement: https://a16z.com/the-great-health-plan-replacement/ Omada Investor Day presentation: https://investors.omadahealth.com/static-files/fbe637ba-7eba-40d3-8829-761b670be4e7 For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe

    The Grand Roundup: Autonomous clinical AI is here, challenger health plans vs. the incumbents, InnovAge's PACE push, a private markets roundup, and more
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About

Where we share our weekly news debriefs and discussions with industry experts. These are lo-fi recordings aimed at giving our readers more opportunities to engage with our analysis and a view into some of the conversations that shape it.

Information

  • Creator
    Kevin O'Leary, Martin Cech
  • Years Active
    2026
  • Episodes
    103
  • Rating
    Clean
  • Copyright
    © 2026 Kevin O'Leary, Martin Cech
  • Show Website
    Health Tech Nerds Radio

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