Jesse Shoplock is SVP of Business Development at Inbox Health. They are trying to help one of the messiest parts of American health care, figuring out both how much patients owe at the point of care and how to actually help the providers get paid. As of now 70% of patients don’t know what they owe, and in some cases those patients payments are 30% of total revenue and a bug chunk of that isn’t being collected. Jess told me how they are helping practices fix that. (And in the answer to my question Jesse didn’t know, they’ve raised some $55m so far)–Matthew Holt
Ratnakar Lavu, Elevance
Ratnakar Lavu is the Chief Digital Information Officer of Elevance, the holding company of Blue Cross and Blue Shield plans in some 14 states (usually called Anthem Blue Cross). We had a great chat about what the priorities are for Elevance, and Ratnakar’s goal is to use tech to make the member experience simple. They are leaning heavily on AI and chatbots to help members inform themselves, and to help providers speed up approvals for prior auth et al. We also discussed how they work with vendors and how they help them scale.–Matthew Holt
Michael Dalton, Ovatient
Michael Dalton is CEO of Ovatient — it’s a telehealth company built on Epic that comes out of health systems (Medical University of South Carolina and Metro Health, Cleveland, OH). It does the integration and care continuity between its medical group and health systems (a little like KeyCare which also serves health system). I asked him why this is different from other telehealth companies? Those systems wanted something embedded in their own tech stack, that could bill insurance etc. Their clients are using Medicaid, cash, Blue Cross, etc. He told me about the patient experience, how they get to Ovatient and how the company works–Matthew Holt
Lauren Ranalli, Town Square Health
Lauren Ranalli is the VP of Patient & Community Engagement at Town Square Health, a brand new medical group setting itself up for the senior population. There have of course been a lot of attempts to create new primary care medical groups. Town Square has its roots in Oak Street but is adding immediate visits (during primary care visits) with specialists which the believe will close the care loops and provide better care. Their goal is to be efficient on staffing, use AI and then take risk. Personally I’m not sure that’s the best tactic…so Lauren and I had a good chat about their strategy, and how the heck we fix primary care in America–Matthew Holt
Oren Nissim, Brook.ai – Figuring out RPM
Oren Nissim is the CEO of Brook.ai which is making some waves in the remote care space. Their goal is to use remote patient monitoring to help providers reduce readmissions, and help patients stay on their care plans. For example they get more than 80% of their populations into hypertension control within 10 weeks, and reduced CHF readmissions some 90%. Late last year they raised $28m in Series B funding ($40m in so far), and Oren told me about their process and their business at the VIVE conference in Feb 2026–Matthew Holt
Miriam Paramore, RxUtility
In this quickbite interview recorded at the Feb 2026 VIVE conference, I am talking with Miriam Paramore. Miriam is building RxUtility, which is helping consumers access the lowest drug prices at the point of dispensing. That means BOTH bringing in all those manufacturers coupons and getting the lowest cash prices. How does it work? Why is drug pricing such a mess? Miriam tells all!— Matthew Holt
Will AI Solve Immunology’s Debate Over “Self vs. Non-Self?”
By MIKE MAGEE
In 1872, English mathematician and sometimes poet, Augustus de Morgan, wrote this catching rhyme: “Great fleas have little fleas upon their backs to bite ‘em, And little fleas have lesser fleas, and so ad infinitum.”
This truism about competition among species for access to nutrition and reproduction could have come in handy to Napoleon 60 years earlier when he tragically underestimated his enemies will to live. It wasn’t so much the stubborn Russians as it was microbes that were his undoing.
When he launched his invasion with a staggering force of 615,000 men, 200,000 horses, and 1,372 mobile guns, he appeared unstoppable. But on his way to Moscow, (according to Tolstoy’s account of the misadventure in “War and Peace”) he lost 130,000 men to Shigella dysentery. Confronted with harsh weather and a Russian force that refused to engage in defense of Moscow, Napoleon lost 2/3 of his remaining retreating force to Typhus, carried by Rickettsia prowazekki, housed in body lice embedded in his soldiers rancid clothing.
Under more favorable circumstances, the soldiers immune systems would have been their ally. Human bioengineering has evolved side by side with pathogenic microbes determined to chemically out smart their human hosts.
Humans rely on innate and adaptive mechanisms to detect and destroy pathogens. But to do so while sparing their own cells, they must be able to distinguish self from non-self. And they must adapt and remember, producing long-lived immune cells and protein receptors that allow them to “capture” and destroy repeat offenders.
If the system experiences a breakdown in self-tolerance, the protective processes may over-shoot and result in a chronic inflammatory response that destroys healthy tissues and marks the emergence of auto-immune diseases.
One special circumstance where immuno-tolerance is both normal and essential is maternal self-suppression during pregnancy which allows two separate immunologic organisms to survive intimate relations side-by-side.
Continue reading…Can We Ride the GenAI Wave Without Getting Subsumed by It?
By DAVID SHAYWITZ
“There are decades where nothing happens; and there are weeks where decades happen,” said Lenin, probably never. It’s also a remarkably apt characterization of the last year in generative AI (genAI) — the last week in particular — which has seen the AI landscape shift so dramatically that even skeptics are now updating their priors in a more bullish direction.
In September 2025, Anthropic, the AI company behind Claude, released what it described as its most capable model yet, and said it could stay on complex coding tasks for about 30 hours continuously. Reported examples including building a web app from scratch, with some runs described as generating roughly 11,000 lines of code. In January 2026, two Wall Street Journal reporters who said they had no programming background used Claude Code to build and publish a Journal project, and described the capability as “a breakout moment for Anthropic’s coding tool” and for “vibe coding” — the idea of creating software simply by describing it.
Around the same time, OpenClaw went viral as an open-source assistant that runs locally and works through everyday apps like WhatsApp, Telegram, and Slack to execute multi-step tasks. The deeper shift, though, is architectural: the ecosystem is converging on open standards for AI integration. One such standard called MCP — the “USB-C of AI” — is now being downloaded nearly 100 million times a month, suggesting that AI integration has moved from exploratory to operational.
Markets are watching the evolution of AI agents into potentially useful economic actors and reacting accordingly. When Anthropic announced plans to move into high-revenue verticals — including financial services, law, and life sciences — the Journal headline read: “Threat of New AI Tools Wipes $300B Off Software and Data Stocks.”
Economist Tyler Cowen observed that this moment will “go down as some kind of turning point.” Derek Thompson, long concerned about an AI bubble, said his worries “declined significantly” in recent weeks. Heeding Wharton’s Ethan Mollick — “remember, today’s AI is the worst AI you will ever use” — investors and entrepreneurs are busily searching for opportunities to ride this wave.
Some founders are taking their ambition to healthcare and life science, where they see a slew of problems for which (they anticipate) genAI might be the solution, or at least part of it. The approach one AI-driven startup is taking towards primary care offers a glimpse into what such a future might hold (or perhaps what fresh hell awaits us).
Two Visions of Primary Care
There is genuine crisis in primary care. Absurdly overburdened and comically underpaid, primary care physicians have fled the profession in droves — some to concierge practices where (they say) they can provide the quality of care that originally attracted them to medicine, many out of clinical practice entirely. Recruiting new trainees grows harder each year.
What’s being lost is captured with extraordinary power by Dr. Lisa Rosenbaum in her NEJM podcast series on the topic.
Continue reading…Sofia Noori, Nema Health
Nema Health has cracked the code on PTSD and has an amazing study showing that their technique of intensive cognitive processing therapy is over 99% effective in flat out curing it in under a month. CEO psychiatrist Sofia Noori took me through what PTSD is, a full demo of how their solution works, and showed me what the study shows. Sofia is one of the brightest CEOs in mental health (and also a former Health 2.0 intern!), and Nema’s solution is extraordinary.–Matthew Holt
AI replaces me: The Private AI Bubble Meets the Public Digital Health Reality Check
By CLAUDE.AI trying to write like me MATTHEW HOLT
I finally did what I have been wanting to do for a while and had an AI ingest everything I’ve written on The Health Care Blog. Given there’s 20 years of my posts intermingled in hundreds of guest posts, it wasn’t as easy as I’d hoped. But over three days I finally got to about 500 or so articles I’ve written and asked Claude to ingest my style. I then gave it three decent sized prompts which I’d previously used on linkedin or in a Slack message and it spat out this—Everything below is AI with no edit and no re-prompting. And it is about 60% of my tone and maybe 75% of my opinion. Pretty amazing–Matthew Holt
The Private AI Bubble Meets the Public Digital Health Reality Check
So Garner Health just raised $118 million at a $1.35 billion valuation, and Talkiatry pulled in $210 million. Meanwhile, you could buy both Talkspace (market cap ~$640 million) and BetterHelp—Teladoc’s entire mental health division that once did over a billion in revenue—for under a billion dollars combined given Teladoc’s current market cap of $953 million.
Something doesn’t add up here, and it’s not the math.
We’re watching a fascinating divergence between what private market investors think digital health companies are worth and what public market investors are actually willing to pay for them. And stuck in the middle is the latest gold rush: AI-powered revenue cycle management.
Let’s start with Garner. I like what they’re trying to do—using massive claims datasets to steer people to higher-quality doctors with financial incentives. It’s clever. But 12% in cost savings in the first year? The Health Rosetta crowd claims they can get their members far better results. The direct primary care groups working with employers are reporting bigger numbers without needing a $1.35 billion valuation to do it. And they don’t have a medical group like Included Health backing them up.
So why the massive valuation? Because “AI-powered” and “big data” and “320 million patient records” sound really good in a pitch deck. Never mind that the actual demonstrated savings are less impressive than what consultants have been delivering for a decade.
Then there’s Talkiatry, which just raised $210 million—on top of their previous $130 million Series C. Good for them, they’ve built something real: 800+ employed psychiatrists delivering actual care with decent outcomes data. But here’s what I can’t figure out: why is every mainstream mental health company still raising hundreds of millions in private markets when literally nobody has gotten out?
Talkspace trades at a $640 million market cap. Teladoc owns BetterHelp, which peaked at over $1 billion in revenue and is now in the dumpster, dragging down Teladoc’s market cap to under $1 billion total. Where’s the Lyra IPO? The Brightline exit? The Spring Health or Headspace liquidity event? They don’t exist.
The public markets are basically screaming: “We don’t believe digital health companies are worth what VCs think they’re worth.” And yet the private money keeps flowing.
Now let’s talk about where the really stupid money is going: RCM AI. We’ve got Anterior raising $64 million total to help payers process prior authorizations faster, and an entire ecosystem of companies raising massive rounds to help providers fight those denials. As I’ve written elsewhere, we’ve gone from the smartest people in the world getting consumers to click on ads to half of them trying to squeeze 5% more revenue out of payers for providers, while the other half are building AI to help payers stop them.
This is the dumbest arms race in healthcare technology. We’re automating the negotiation over the crumbs instead of fixing the system that creates the waste in the first place. But VCs love it because there’s a clear value proposition: “We’ll get you an extra $X million in reimbursements” or “We’ll save you $Y million in denied claims.” Never mind that we’re spending billions to build technology that makes a fundamentally broken payment system slightly more efficient at being broken.
Meanwhile, back in the public markets, actual digital health companies with actual revenue and actual customers are trading at valuations that suggest investors think they’re going to zero. Teladoc’s market cap is $953 million. They did $2.53 billion in revenue last year. That’s a 0.37x price-to-sales ratio. BetterHelp alone was doing over a billion before the bottom fell out.
The divergence is getting absurd. Private companies with unproven business models and uncertain paths to profitability are raising at sky-high valuations. Public companies with real revenue, real customers, and real operations are trading like they’re distressed assets.
So what’s happening here? A few things:
First, private market investors are betting on potential while public market investors are pricing in reality. Potential sounds better in a conference room than on an earnings call.
Second, we’re in an AI bubble. Slap “AI-powered” on anything healthcare-related and suddenly you can raise at multiples that make no sense. Doesn’t matter if the AI is actually doing something useful or just glorified automation of existing processes.
Third, the exit window for digital health has been effectively closed for years. The SPAC boom and bust taught us that taking half-baked digital health companies public ends badly. So private companies keep raising private money because that’s the only money available, creating a massive valuation disconnect.
Fourth, and this is the one nobody wants to talk about: a lot of these companies might not be worth what VCs are paying for them. The mental health companies keep raising because they can, not because they’ve proven a path to sustainable profitability. The RCM companies are raising on the promise of extracting value from a broken system rather than fixing it.
Here’s my prediction: We’re going to see a reckoning. Either these private valuations are going to come down to meet public market reality, or we’re going to see a wave of down rounds and shutdowns. The public markets aren’t wrong about digital health—they’re appropriately skeptical of companies that haven’t proven they can make money at scale.
And the AI RCM gold rush? That’s going to end when someone realizes we’re spending billions to automate arguing over money instead of spending billions to reduce the total cost of care. Because at the end of the day, every dollar these companies “save” or “recover” is a dollar that shouldn’t have been in dispute in the first place.
The smartest investors should be looking at the public market valuations and asking: if actual digital health companies with real revenue can’t get respect from public investors, why are we valuing private companies like they’re going to be worth 10x more when they finally try to exit?
Unless, of course, nobody’s planning on exits anymore. In which case, we’re not building companies—we’re building very expensive science projects funded by LPs who apparently have infinite patience and capital to burn.
I’ve been covering this industry long enough to know how this movie ends. And spoiler alert: it’s not with a bunch of unicorn IPOs.
Claude is a clever chatbot made by Anthropic. Matthew Holt hopes it replaces him soon
