Category: Health Tech

Beyond Generative AI

Mar 23, 2026

By BENJAMIN EASTON

Healthcare’s administrative burden is not a documentation problem. It is a workflow problem. Healthcare’s next leap depends on agentic systems that can actually do the work

Over the past year, healthcare organizations have widely adopted generative AI for an array of documentation-related activities such as drafting appeal letters, producing patient-friendly summaries, and even assisting with administrative writing. While these tools have improved how information is created, healthcare’s administrative bottlenecks (e.g., prior authorizations, benefit verification, denial management, clinical trial enrollment), are not caused by a lack of text. They are caused by fragmented systems, manual tracking, payer variability, and workflow handoffs that require continuous monitoring and intervention.

If generative AI helps write the email, agentic systems send it, track it, escalate it, reconcile the response, and close the loop.

That distinction is healthcare’s next inflection point.

From Content Generation to Workflow Execution

An agentic system is not just a chatbot layered onto healthcare workflows. It is a coordinated set of AI-driven agents designed to:

Pull structured and unstructured data from EHRs, payer portals, labs, and internal systems
Apply payer-specific policy logic
Validate documentation requirements
Submit transactions through the appropriate channel
Monitor status changes
Trigger follow-up actions
Escalate exceptions to humans
Log every action for audit and compliance

Behind the scenes, these systems rely on rule engines, structured clinical mappings, secure API integrations, and event-driven automation frameworks. They continuously re-evaluate state changes (e.g., a new lab result, a status update from a payer portal, or a missing documentation flag) and dynamically adjust next steps.

This is not robotic process automation replaying keystrokes. It is intelligent orchestration across disconnected systems.

Preeti Bhargava, Arintra

Mar 20, 2026

Preeti Bhargava is CTO of Arintra. She is the living embodiment of my crack that the smartest people in the world spent the 2010s convincing people to click on ads and now spend their time figuring out how to bill payers more for providers doing the same work. Arintra is in the RCM business. It uses AI to read the medical chart and automatically generate claims using fewer human coders, and generating up to a 5% revenue uplift for one customer, Mercy Health. Of course those paying those claims may have noticed, so we had a chat about the emerging AI RCM arms race–Matthew Holt

Jesse Shoplock, Inbox Health

Mar 16, 2026

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

Mar 13, 2026

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

Mar 11, 2026

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

Mar 6, 2026

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

Mar 3, 2026

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

Mar 2, 2026

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?”

Feb 24, 2026

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.

Can We Ride the GenAI Wave Without Getting Subsumed by It?

Feb 19, 2026

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.