Thoughts on Healthcare Markets & Technology Podcast

Thoughts on Healthcare Markets and Technology

Expert analysis of healthcare & life sciences markets, investment, policy, entrepreneurship, technology and AI — for investors, entrepreneurs, executives, and physicians navigating the business of healthcare and life sciences. www.onhealthcare.tech

  1. Part I: How the Trump Administration and a Cohort of AI Startups Are Building a Regulatory On-Ramp for Autonomous AI Doctors, and Why Working Physicians Think the Genie Is Already Out of the Bottle

    16h ago

    Part I: How the Trump Administration and a Cohort of AI Startups Are Building a Regulatory On-Ramp for Autonomous AI Doctors, and Why Working Physicians Think the Genie Is Already Out of the Bottle

    The administration is building a regulatory pathway for AI systems that diagnose and prescribe with no physician in the loop. Utah already has a pilot running. The Medical Licensing Board asked for an immediate suspension. A Nature Medicine study gave chatbots 1,200 real patient simulations. Correct diagnosis rate: 34%. They were worse than Google at guiding people to the right decision. These same models pass medical licensing exams. The self-driving car comparison is everywhere. But robotaxis are geofenced - Waymo refuses the hard routes. The entrepreneurs are pitching a general-purpose AI that handles everything. That is Level 5 in any weather, which the auto industry spent a decade learning to stop promising. The sleeper risk is the corporate practice of medicine doctrine. Most states bar corporations from practicing medicine. A chatbot owned by a VC-backed company that diagnoses and prescribes is, on its face, a corporation practicing medicine. Nobody running these pilots has a clean answer for who holds the license. Subscribe to www.onhealthcare.tech for free and paid articles, podcasts, and more. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.onhealthcare.tech/subscribe

    14 min
  2. Part I: Mayo Owns the Model, Microsoft Owns the Pipes: What the Mayo Clinic and Microsoft Frontier Healthcare AI Deal Reveals

    2d ago

    Part I: Mayo Owns the Model, Microsoft Owns the Pipes: What the Mayo Clinic and Microsoft Frontier Healthcare AI Deal Reveals

    Mayo Clinic will OWN the frontier healthcare AI model it is building with Microsoft. Microsoft will distribute it through Azure. That ownership split is the entire story. Mayo brings 54M+ de-identified patient records, 5.8B+ images, and years of longitudinal linkage infrastructure. Microsoft brings compute, engineers, and Azure distribution. Neither could do this alone. The benchmark driving the superintelligence language: Microsoft’s MAI-DxO hit 85.5% on 304 hard NEJM cases. Physicians averaged 20%. Catch: physicians were not allowed to look anything up. Not quite the same test. Microsoft already owns Nuance DAX, the ambient scribe in thousands of hospital exam rooms. A Mayo-branded reasoning model plugs into that funnel directly. Models are becoming commodities. Trust is not. Subscribe to www.onhealthcare.tech for free and paid articles, podcasts, and more. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.onhealthcare.tech/subscribe

    9 min
  3. Part I: Inside the Agentic Back Office Race for Specialty Practices: How a YC Company Hit 17x Growth and Seven Figures in ARR by Doing the Fax, Referral, Scheduling, and Collections

    4d ago

    Part I: Inside the Agentic Back Office Race for Specialty Practices: How a YC Company Hit 17x Growth and Seven Figures in ARR by Doing the Fax, Referral, Scheduling, and Collections

    A YC company grew 17x and hit seven figures in ARR in under a year by not selling software. It does the fax, referral, scheduling, and collections work instead. 15-25% of specialty referrals never get scheduled at all. Not lost to competition. Lost to intake paperwork. One client had 4,800 referrals sitting in Epic for 4 months. Payers denied more claims in 2025 than 2024. Up to 65% of denials are never appealed. Not because practices win, but because the appeal costs more than the claim. The comp is Tennr: $101M Series C, $605M valuation, 10M docs/month. Fax-to-$605M in about 15 months tells you how much capital is hunting this exact problem. Subscribe to www.onhealthcare.tech for free and paid articles, podcasts, and more. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.onhealthcare.tech/subscribe

    9 min
  4. Part I: A Solopreneur Business Plan for Building Medicaid Fraud Detection Software Aimed at the Early Intensive Developmental and Behavioral Intervention Autism Scam

    May 31

    Part I: A Solopreneur Business Plan for Building Medicaid Fraud Detection Software Aimed at the Early Intensive Developmental and Behavioral Intervention Autism Scam

    Smart Therapy LLC billed $14M in phantom autism therapy over 5 years. The state had all the data to catch it. Nobody ran the queries. How it worked: teenage relatives billed as clinicians, parents paid $300-$1,500/mo per kid to enroll, forged supervisor sign-offs, billing maximums every single day, transport vendors on the same payroll. EIDBI claims in Minnesota went from $600K in 2018 to $400M by 2025. 14 Medicaid programs flagged high risk. One Optum-run tightening cut ~$165M in spending across those programs in a couple quarters. Every signal was loud and public: billing the cap daily, impossible daily hours per tech, same humans across multiple programs, LLC incorporated and enrolled within weeks. Arithmetic, not AI, catches this. Subscribe to www.onhealthcare.tech for free and paid articles, podcasts, and more. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.onhealthcare.tech/subscribe

    8 min
  5. Part I: One Infusion. A Permanent Gene Edit. A Lifetime of LDL Lowering. The VERVE-102 NEJM Data, the Lilly Acquisition Thesis, and What It Means.

    May 28

    Part I: One Infusion. A Permanent Gene Edit. A Lifetime of LDL Lowering. The VERVE-102 NEJM Data, the Lilly Acquisition Thesis, and What It Means.

    VERVE-102 just published Phase 1b data in NEJM. Single IV infusion. 88% PCSK9 reduction. 62% LDL-C reduction. 18-month durability. No serious adverse events in 35 patients. But the core problem being solved is not efficacy. Statins work. PCSK9 inhibitors work. The problem: roughly half of patients prescribed lipid-lowering therapy stop taking it within a year. Every year. Consistently. Adenine base editing does not cut DNA. It converts a single nucleotide letter in the PCSK9 gene in liver cells. No double-strand break. The target mimics a natural human variant already field-tested by evolution. The 18-month durability signal is the most important data point in the whole dataset - not the peak LDL reduction. For a one-time treatment, everything hinges on whether the effect persists. Subscribe to www.onhealthcare.tech for free and paid articles, podcasts, and more. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.onhealthcare.tech/subscribe

    10 min
  6. Part I: How The Joint Commission & CHAI Are Quietly Building A Parallel FDA For Hospital AI & Why The Governance Infrastructure Layer Will Eat More Of The Health AI Market Than The Models Themselves

    May 26

    Part I: How The Joint Commission & CHAI Are Quietly Building A Parallel FDA For Hospital AI & Why The Governance Infrastructure Layer Will Eat More Of The Health AI Market Than The Models Themselves

    The real hospital AI regulator is not the FDA. It is the Joint Commission, which accredits 80% of US hospitals and controls access to 60% of their revenue. In September 2025 the Joint Commission plus CHAI released AI governance guidance. Once it enters accreditation standards, hospitals operationalize it the same way they operationalize infection control. Mandatory committees, audits, evidence binders. That shifts the AI procurement gate from innovation officers to legal, compliance, and clinical risk. Vendors without documentation mapping to the guidance get filtered before pricing conversations happen. The core insight: every AI deployment is now a governance surface area, not just a tool. Compliance, legal, audit, patient safety, and cybersecurity exposure all live in that surface simultaneously. Subscribe to www.onhealthcare.tech for free and paid articles, podcasts, and more. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.onhealthcare.tech/subscribe

    9 min
  7. Part I: HHS Goes All-In on ChatGPT for State Audits: What the May 2026 Generative AI Fraud Expansion & Feb’s CRUSH RFI Mean for Payment Integrity, Provider Audit Defense & the Health Tech Buy-Side

    May 24

    Part I: HHS Goes All-In on ChatGPT for State Audits: What the May 2026 Generative AI Fraud Expansion & Feb’s CRUSH RFI Mean for Payment Integrity, Provider Audit Defense & the Health Tech Buy-Side

    HHS shipped an LLM workflow for federal audits without an RFP. No vendor circus. No multi-year authorization. That is the actual story from May 21. Single audits from every entity spending over $1M in federal funds sit in the Federal Audit Clearinghouse. Most were never read. HHS is now reading them with ChatGPT and threatening funding cuts for chronic deficiencies. Three months earlier, CMS dropped the CRUSH RFI: provider enrollment reform, lab fraud, DMEPOS moratorium, AI-assisted coding review, and a direct question about using AI in the insurance marketplaces. This is a coordinated policy signal, not a one-off. The Oz line: CMS is padlocking the cookie jar and letting fraudsters starve. Pay and chase is out. Detect and deploy is in. Different vendors, different stack, different unit economics. The $15B payment integrity market just got a major policy tailwind. Subscribe to www.onhealthcare.tech for free and paid articles, podcasts, and more. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.onhealthcare.tech/subscribe

    9 min
  8. Part I: Forus Just Raised $160M at a $1B Valuation to Become the Operational Routing Layer for Specialty Rx & the Real Story Is Why Investors Now Believe Healthcare Orchestration Beats SaaS

    May 22

    Part I: Forus Just Raised $160M at a $1B Valuation to Become the Operational Routing Layer for Specialty Rx & the Real Story Is Why Investors Now Believe Healthcare Orchestration Beats SaaS

    Forus raised $160M at a $1B valuation on ~$50M in annualized revenue. That is a 20x multiple at Series B. Here is why Thrive and General Catalyst wrote that check. Healthcare is a transaction routing economy, not a care delivery industry. Every prior auth, every benefits check, every specialty pharmacy assignment is a transaction. The intermediary stack exists entirely because of that fragmentation. Specialty drugs changed the math. A therapy at $60K-$3M per patient makes every coordination failure expensive. Manufacturers now pay real money for faster time to therapy. The transaction layer became economically valuable for the first time. Forus gives the product free to providers and patients. Revenue comes from biopharma manufacturers downstream. Provider adoption grew 10x year over year for two years, reportedly through word of mouth. That is the structural unlock. Subscribe to www.onhealthcare.tech for free and paid articles, podcasts, and more. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.onhealthcare.tech/subscribe

    11 min
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Expert analysis of healthcare & life sciences markets, investment, policy, entrepreneurship, technology and AI — for investors, entrepreneurs, executives, and physicians navigating the business of healthcare and life sciences. www.onhealthcare.tech

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