Ian Shakil is the Chief Strategy Officer of Commure, the AI platform being used by HCA, Tenet and others. He came to Commure via its acquisition of Ambient AI vendor Augmedix, and there are a lot other other new acquisitions within Commure (Athelas, PatientKeeper, Memora Health, Rx Health etc). We dived in not only about what Commure does but the big question of how does a client like HCA or Tenet decide what Commure does, vs what Meditech does, vs what Google does vs what they do internally. We also (sorta) looked into the various criticisms (basically all from Sergei Polevikov!) of what Commure and its main funder General Catalyst are up to and what is happening at Summa Health the hospital in Ohio that GC bought. He also says the good experience from AI will come to help patients this year, and I’ll be holding him to that!–Matthew Holt
Function Health has a 23andMe problem
By DEEKSHA HEGDE
I had an itch to draw parallels between the two. The structural facts kept lining up in ways I couldn’t dismiss, and by the end, I stopped trying.
Function’s product is an app: you pay $365 a year, go to a Quest Diagnostics location, get 160+ biomarkers tested twice a year, and receive clinician-written notes interpreting your results. The lab testing is fully outsourced. Function is the layer on top: panel design, member experience, clinician note generation, longitudinal tracking.
Function Health raised $298 million at a $2.5 billion valuation in November 2025. At 25x revenue, the market clearly isn’t buying a lab reseller. It’s buying the data flywheel: longitudinal biomarker histories that compound in clinical value over time, aggregated across hundreds of thousands of members into a dataset that health plans, pharma companies, and AI developers can’t build any other way. A member with four years of data can’t switch to a cheaper competitor without losing the trend. The unit economics work if the interpretation layer scales without proportionally scaling headcount, which is what the Medical Intelligence Lab, their generative AI model launched in November 2025, is built to do. Function is also building toward a B2B enterprise channel, positioning the product as a way to keep employees “healthy, focused, and ready to perform.”
It satisfies a burning need for specific personas: the worried well, the health optimizers, the people who saw their loved ones get diagnosed a little too late, the people who aren’t waiting for a diagnosis before they start paying attention. These are people the rest of the industry has mostly left alone. I wrote earlier this year, in a piece on Hinge Health, about the prevention paradox: the employer ROI model is structurally blind to the member who benefits most from early intervention. Function skips the employer ROI story entirely, charges the member directly, and doesn’t try to prove a CFO case it can’t make. Yet.
Continue reading…Jason Prestinario, Particle Health
Jason Prestinario is CEO of Particle Health. The company is best known for its current lawsuit against Epic, but behind that there is a real company delivering a set of products as on ramp for clients wanting to access health data. Particle was cut off from access to Carequality & Epic a couple of years back but is now both delivering services to its customers and separately suing Epic for being an abusive monopoly regarding its payer platform. I had written about this a couple of years ago but I used this chance to catch up with Jason, to see what the sate of play was. He explained that Carequality said that Particle was right in the original dispute, and why they were right and Epic was wrong. The court case continues. But it’s interesting to hear from someone in the middle of the new disputes about data. — Matthew Holt
Mario Danek, QNovia
Mario Danek is CEO of QNovia, a behavior change platform focusing on smoking cessation product. Essentially the problem with smoking cessation nicotine products is that they don’t deliver the “hit” of a cigarette as quickly as a cigarette or a vape. Mario’s new vape-like product delivers a nicotine replacement therapy (think like Nicorette gum) just as quickly as the form factor it’s replacing. He is hoping that the device/drug/and forthcoming mental health support will be the engine to reduce the current smoking rate from the stubborn level it’s got stuck at. He told me about its likely time to commercialization–Matthew Holt
Beyond Generative AI
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.
Continue reading…Preeti Bhargava, Arintra
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
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
