The goal of the new non profit Ten Ten Ten founded by TJ Tedesco & Bhargav Raman is to take America from being the most expensive health system in the world with the 48th best outcomes to the top Ten in outcomes, at 10% of GDP in Ten years. Are they crazy? Is there any hope of doing this? I spent a long time in conversation with them suggesting that they probably are, but it was a great conversation to hear why they are doing this and how they think we might do this–Matthew Holt
2026: A Year for Reimagining Healthcare’s Safety Net
By JEFF BRANDES
To say healthcare’s safety net experienced tectonic shifts in 2025 would be an understatement. The rapid introduction of multiple and massive policy shifts left many healthcare leaders reeling with more questions than answers.
As the industry turns the corner into 2026 and the dust begins to settle, it’s time for stakeholders to respond by leveraging all resources and tools available. Current industry shifts will necessitate structural and process changes that ensure the best health outcomes for all communities.
Foundational to any strategy is a recognition that AI and automation have found their place in countering administrative burden in healthcare, and mainstream use of these tools will help speed the industry’s race to greater value. Care teams that previously spent hours reviewing documentation, identifying risk-adjustment opportunities and organizing population-level insights can now claw back the time needed to get ahead of care gaps.
In 2026, healthcare leaders must acknowledge that new realities are here to stay and will require reimagining how the industry delivers optimal care for vulnerable populations. Safety net organizations that have not invested in automation for managing routine tasks will get left behind in the new world of managing population health. By leaning into the following three strategies, stakeholders can realize the promise of value-based collaboration.
Keeping Medicaid Patients Connected to Care
Sweeping changes to Medicaid eligibility, financing, and administrative requirements will have far-reaching impacts on coverage. Current workflows that address these challenges are complex and overwhelming for many resource-strapped safety net providers—not to mention patients and families.
On the Medicaid front, infrastructures that lean into unified data and integrated workflows can help providers become more proactive in identifying those at risk of losing coverage. Specifically, tools that pair eligibility data with clinical and social risk insights can guide outreach prioritization and patient assistance. In addition, providers can use automation to build multilingual renewal campaigns that personalize patient interactions such that vulnerable populations understand their healthcare options.
Safety net providers are already seeing success with the right strategy. For example, the California Primary Care Association (CPCA) leveraged automation and analytics to mobilize outreach and support Medi-Cal renewals and new enrollments across 38 counites. From January 2024 to June 2025, the initiative reached more than 1.3 million people, achieving more than 159,000 Medi-Cal enrollments and re-enrollments.
Continue reading…Carta Healthcare – AI for Registry Creation
It’s not well known but there’s a lot of people in hospitals who spend a lot of time creating patient registries for quality programs, CMS reporting, clinical trials and lots more. It requires extremely detailed abstraction of patient data from patient records and comparisons with registry demands. Wouldn’t it be clever if an AI system could read the chart and help the people doing that work (usually very expensive nurses) do it quicker? That’s the premise behind Carta Healthcare. Greg Miller and Jared Crapo from Carta demoed the system for me and told me about the market for it–Matthew Holt
Will HHS Enhance or Stall the Promise of Artificial Intelligence for Healthcare?
By STEVEN ZECOLA
In its Strategy for Artificial Intelligence (V.3), the Department of Health and Human Services (“HHS”) acknowledges that: “For too long, our Department has been bogged down by bureaucracy and busy work.” HHS promises that it will accelerate artificial intelligence (“AI”) innovation, including “accelerating drug and biologic approvals at the FDA.”
History shows that well-intended but cumulative regulatory intervention – more so than scientific complexity – is the primary deterrent to rapid technological progress. If AI is subject to the typical pattern of regulatory creep, its potential to accelerate drug discovery and development will be significantly reduced. To avoid this outcome, HHS should develop a plan that is premised on a zero-based regulatory approach. That is, each new technology such as AI should start with a clean slate and only the minimum requirements deemed necessary to show effectiveness and safety should be applied in the approval process for that technology.
The Pace of Innovation
Medical innovation has lagged the pace in the other sectors of the economy. As Dr. Scott Podolsky of Harvard Medical School observed: “Medicine in 2020 is much closer to medicine in 1970 than medicine in 1970 was to medicine in 1920.” Podolsky points to breakthroughs such as antibiotics, antihypertensives, antidepressants, antipsychotics, and steroids that have not been met with same impact as innovations in the later 50 years.
Two explanations have been offered for this phenomenon: 1) the inherent complexity of biological processes; and 2) the regulatory approval process.
As a benchmark for comparison to the following case studies, the development of 4G communications spanned less than a decade, with discussions starting around 2001, technical specifications being released in 2004, and the first commercial networks launching in 2009.
Regulatory Intervention in New Technologies
- The Human Genome (Great Science Leads to Regulatory Paralysis)
The Human Genome Project (HGP) ran from 1990 to 2003, and has been lauded as one of the world’s greatest scientific achievements. The project identified the specific location of genes and DNA, creating a “roadmap” of the human genetic code and facilitating the identification of disease-related genes.
The HGP focused on balancing rapid scientific progress with ethical safeguards. Oversight was primarily managed through internal ethical programs and international data-sharing agreements rather than a single overarching legislative or regulatory body.
Under this structure, the HGP beat its target date by two years. That is to say that the complexity of the problem did not cause any delays, and progress was not impeded by the standard drug-approval bottleneck.
However, once the genetic roadmap was handed off for drug discovery and development, progress slowed dramatically.
Continue reading…Primary care, Concierge Care & AI – How to fix health care
At last week’s HITLAB January 2026 Symposium, Matthew Holt gave a talk about what’s wrong with primary care, how concierge care for all can fix it, and how the most advanced primary care telehealth groups are using AI now.
A $2,000 Voucher and 600 Patients: The Math Behind Fixing Care
When I was at HLTH last October Bradley Bostic invited me on his BoomBostic Health podcast. I was in the mood for ranting about the health care system and promoting my desire for getting everyone concierge level primary care. Bradley was very generous in giving me a mike and a lot of rope. I am embedding the youtube version and if you want just audio it’s here. (I was also losing my voice so there’s a cleaned up transcript below)–Matthew Holt
Bradley:
Well, hello and welcome back to another episode of Boombostic Health in the Wild here at HLTH 2025 in Las Vegas. I’m thrilled to have Matthew Holt with me, who is the leader at The Health Care blog, a blog I follow, and I appreciate you being here, Matthew.
Matthew
Bradley, thank you very much. I count my readers, you know, on about two hands, so I want to keep you in good health. I have a little joke. We used to have a podcast that actually wasn’t that well-followed called the THCB gang and one of my colleagues on THCB gang was at a conference and a guy in the row behind him said “oh I recognize your voice, my father used to listen to the podcast but then he died.” When my colleague told me the story I said, we don’t have enough listeners and subscribers to lose them like that – we’ve got to keep them alive in order to keep the podcast going!
Bradley
Well, Boombostic Health was really born out of my pension for building companies in the health tech world and investing in companies. When we first started this. I wasn’t sure if anybody would listen to it. My mom passed away from cancer 25 years ago. So, I knew she wouldn’t be listening to it unfortunately. But that was a big thing that inspired me to get into healthcare. And lo and behold, there is a really interested audience out there that wants to know how innovation is transforming our broken health care system. And clearly with your background with Health 2.0 and The Health Care Blog, this is an area that you’re focused on. And I think you said you have two easy steps. Oh no, two steps, not necessarily easy to fix healthcare.
Matthew
So the preamble to this is I’ve been doing this for a long time. I came to America in 1989.
Continue reading…Jim Gallic shows off Wondr Health
Jim Gallic is Chief Growth Officer at Wondr Health, a company specializing in creating the behavior change required for weight loss. He was a satisfied client who lost a ton of weight (see that before and after photo on the right!) and changed his eating habits completely using Wondr (no drugs involved!). Later in life he joined the company. I spoke to him and got a tour of the experience. A great demo about how Wondr works, and about how GLP1s are altering the conversation. Jim’s stance is that the behavior change works first to create a readiness program for the medication, and then the weight might stay off when the medication ends. Matthew Holt
Even When Healthcare Has a Clear Price Tag, Are We Getting What We Pay For?
By OWEN TRIPP
Move over, GLP-1s. This year the healthcare spotlight is on alternative plan design. Alternative health plans offer cost transparency and a consumer-friendly shopping experience. But can the capabilities under the hood deliver on quality and value? Though it may not sound buzzworthy, it has the potential to trigger a seismic shift in the commercial insurance market.
After years of disappointing returns and unmet promises from traditional insurance models, innovators and big-name insurers themselves are doubling down on alternative plans aimed at reducing healthcare costs through preferred care pathways with transparent pricing. Though these plans come in many flavors, common features include tiered networks, variable copays, care steerage, and an emphasis on primary and virtual care — often packaged in a digital-first (and AI-powered) “shopping” experience.
Alternative plans seem like a win-win. For consumers struggling with surprise bills and medical debt, replacing confusing deductibles and coinsurance with predictable copays offers much-needed peace of mind. For employers facing the highest increase in healthcare costs in 15 years, getting their workforce on a trusted path to quality feels like a sure bet.
There’s a catch, though: Alternative plans won’t help much if they lead people to the same old, fragmented healthcare experience. Innovative cost-sharing and a slick front-end experience must be backed by high-quality clinical care, dynamic population health management, and personalized engagement that represent a significant upgrade from what’s been delivered to date.
Otherwise, signing up for an alternative plan will be a lot like buying a shiny new smartphone, only to discover that its operating system only supports a handful of outdated apps.
Alternative plans: what must be under the hood?
While cost transparency and a streamlined shopping experience offer immediate benefits to consumers, it’s the deeper capabilities and levers under the hood of alternative plans that will drive long-term value and create an alternative model worth embracing.
1. A primary care-led integrated care model
Most insurer-led alternative plans are built on top of existing care delivery networks (and existing provider contracts), often leading people to well-worn pathways and settings, including those that have produced status-quo outcomes for people and minimal cost improvement for employers.
Alternative plans need to create new dynamics around primary care, removing access barriers, creating flexibility and incentives, and repositioning expectations for provider interactions. Simply doing more of the same is inadequate. A true primary care-led plan is one that creates new channels and opportunities, dedicates time for immersive one-to-one discovery, and empowers physicians to lead people to quality across the network based on individual needs — supported by data, technology, and system-wide connections.
Continue reading…Brick by Brick by (Smart) Brick
By KIM BELLARD
I’m an innovation junkie, the further out there the better, but every so often it’s good to be reminded that just because a company has been around for a while, innovation is still possible.
Two examples: LEGO® and Kodak.
Let’s start with LEGO. If you are around any small children – and perhaps not even all that small – you probably have seen them playing with Legos. Legos have been around, in various incarnations, for longer than I’ve been alive, and that’s saying something. Most adults watching kids assemble their Legos probably have two reactions: “gosh, I wish they’d make them even more complicated” (note to the oblivious reader – that was sarcastic), and “well, at least they’re not on their screens.”
So I bet a lot of us have a slightly surprised reaction to Lego’s announcement Monday Jan 6th to CES 2026: LEGO SMART Play™.
The key innovation is the SMART Brick, which “is packed with technologies that bring play to life including sensors, accelerometers, light sensing and a sound sensor as well as a miniature speaker driven by an onboard synthesiser, and much more, in addition to easy wireless charging.” All that is powered by a custom chip, which is smaller than one of the studs on a LEGO brick.
The LEGO Group states: “Without any setup, SMART Bricks are magically ‘aware’ of each other’s positions and orientations in 3D space, thanks to a novel, high-accuracy, magnetic positioning system. They can also communicate via a self-organizing network that adapts to play. Advanced onboard systems let SMART Bricks comprehend and interact with each other, as well as the fans building with them.” “Magic” in this context meaning Bluetooth.
Nerdist calls it “the most exciting innovation in screenless play ever,”
Continue reading…The Dimensions of Artificial Intelligence in the Healthcare Industry
By STEVEN ZECOLA
On December 19th, the Department of Health and Human Services (“HHS”) issued a Request for Information seeking to harness artificial intelligence (“AI”) to deflate health care costs and make America healthy again.
As described herein, AI can be used in many dimensions to help lower healthcare costs and improve care. However, to achieve significant breakthroughs with AI, HHS will need to completely revamp the regulatory approach to drug discovery and development.
Dimension #1. Incorporation of AI into Drug Discovery
The biggest benefit to the healthcare industry’s performance from AI is achievable from drug discovery. Accounting for the costs of failures, the average FDA drug approval costs society almost $3 billion and takes decades to reach the market from its inception in the lab.
In contrast, AI identifies potential treatments much faster than traditional methods by processing vast amounts of biological data, uncovering hidden causal relationships, and generating new actionable insights.
AI is particularly promising for complex, multifactorial conditions – such as neurodegenerative diseases, autism spectrum disorders, and multiple chronic illnesses – where conventional reductionist approaches have failed.
In the short-run, HHS should direct its grants toward AI-generated basic research, with a particular emphasis on the hard-to-solve illnesses. At the same time, the FDA should be putting into place a new approval system for AI-initiated programs to enable breakthrough treatments in a compressed timetable.
Dimension #2. Incorporation of AI into the Drug Development Process
Simply relying on AI for drug discovery, while subjecting its advances to the current approval process would undermine the use of the technology.
Rather, improvements from AI can already be had in fulfilling the exhaustive regulatory documentation requirements, which today add up to as much as 30% of the cost of compliance.
Continue reading…
