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Happy Tuesday, Hospitalogists! You'll never believe what happened to me at Fields Ranch golf course in Frisco, Texas this weekend. Scroll to the end to find out! Today we're diving into a recap of a VERY eventful June, and I still feel like I barely scratched the surface this month. Any other big stories or trends I missed, let me know! Let's dive in. As always, I appreciate each and every one of you working to make this industry better. Thanks to Turquoise Health and Mission Mobile Medical for sponsoring today's send! |
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THE MONTHLY EXECUTIVE SUMMARY |
The most important news from the month |
Big Beautiful Bill: Unfortunately we have to cover a bit of policy because it's all the rage in 2025. The Senate passed the Big Beautiful Bill yesterday (I know, technically July…sue me), so it'll head back to the House. With the so-called Byrd rule in effect, it's unclear what exactly will get passed (if it does) so we'll check back in once that happens. For now, know that the healthcare changes being discussed include Medicaid cuts (via the provider tax and state directed payments), HSA expansion, ICHRA expansion, Medicaid work requirements, state cost-sharing for above poverty line Medicaid enrollees, immigration eligibility, and plenty more. I find McDermott's blog and timeline analysis to be a great resource to follow along with all the changes to the Very Important Legislation otherwise known as the Big Beautiful Bill that is turning out to be Not So Beautiful or Big for Healthcare. Physician Employment Dynamics: Private practice continues its slide as hospital employment ticks up. Plus, MGMA 2025 survey data released this June, interestingly noting a boost to hospital-employed productivity and compensation in 2025 - outstripping that of private practices, which is the first time this dynamic has ever been recorded. It's interesting to note this happening at the same time that the hospital physician employment subsidy model is said to be breaking. So which is it? Is this a lagging indicator? Either way, look at that huge fluctuation in 2024 - a major jump in employed, and a major reduction in owners: |
Ascension and AmSurg deal: Ascension announced its intention to acquire AmSurg as the winning bidder at a $3.9B purchase price. Ascension, which has been reshaping its portfolio of assets, adds 250 ASCs, a scaled platform with infrastructure and talent to boot, across 34 states. |
CVS and Humana go full consumer: CVS announced a $20B investment over a 10-year time horizon to transform its business operations into more consumer friendly and facing features. Humana echoed similar sentiment while providing updates on its new company slogan as a senior "healthcare services business" and its path back from the depths of Medicare Advantage Tartarus. Relatedly, Humana announced a joint venture with Mercy Health to open up 65+ senior clinics in their overlapping service areas. |
Omada's public debut: Following in the footsteps of its peer Hinge Health, Omada successfully debuted on the public markets in early June but has since seen its stock price slide. Omada serves a similar employer and payor demographic (with some key partnerships with PBMs) and runs cost-saving, high quality chronic disease management programs across areas of high need and spend including hypertension, diabetes, MSK, and of course, obesity. In 2024 it generated $169.8M in revenue with operating losses of ($43.6M), and a promising path toward profitability as seen in the rolling graph below. Plus, Sean Duffy is the man. Omada sits at a $1.4B enterprise value today. Relatedly in the MSK space, Net Health acquired Limber Health in early June. |
Ambient goes agentic: With Abridge, Nabla, and Commure all refreshing their balance sheets with more capital and associated intended uses for said capital, AI scribes are morphing into fully ambient players by moving upstream into RCM and coding functions along with other agentic use cases. |
June Health Tech Fundraising Spotlight |
Sword Health's $40M raise |
UnitedHealth Group promoted Patrick Conway to CEO of Optum Health alongside his same role at OptumRx. Nordic Capital acquired a majority stake in Arcadia, an AI-enabled data analytics. The transaction comes on the heels of Arcadia's acquisition of CareJourney in June 2024. You can read my quick recap on Arcadia's plans and my convo with President & CEO Michael Meucci in my HLTH summary here. Aledade acquired the VBC operations of the Commonwealth Care Alliance in Michigan bringing its total footprint in the state to more than 1,500 physician partners across 180+ practices. Best Buy divested Current Health after purchasing the hospital-at-home player for $400M during the Covid era. Former CEO Chris McGhee will retake the helm while Best Buy restructures its health division after accounting for a $475 million impairment charge, followed by $109 million in restructuring charges related to the segment. That's a lot to unwind and restructure after years of investing serious capital into the hospital at home and at-home care space. More broadly, hospital at home has seen challenges given this development along with the Dispatch-Medically home merger and rumored valuation buzzcut haircut. Decent and Nice announced their intent to merge into a more comprehensive direct primary care platform covering care navigation, chronic disease management, and general primary care services via a network of concierge and direct primary care players for small and medium businesses. The news comes after Decent ran into some major snags with a large insurance partner in 2023, then pivoted into level-funded employer plans involving direct primary care. Some Payment & Policy Updates - Medicare is now expected to go broke 26 years before I reach retirement age as I continue to dutifully pay into it, or in 2033, after officials revised their estimates based on current spending trajectories.
- CMS' proposed rule for home health & hospice will result in a 6.4% reduction in reimbursement to the services segment, decreasing total payments to home health by over $1.1B which will be sure to spur continued consolidation in the industry. CMS continues to crack the whip on home health payment updates,
- $14.6B fraud: The DOJ has charged 300+ people involved in nearly $15B in healthcare fraud and false claims, including a $10B urinary catheter scheme. For reference, all of health tech combined received $10B in funding in 2024. Here's a great report from the Washington Post on inside the largest healthcare fraud bust ever.
- CMS plans to add prior authorization for some Medicare services - WISeR - and use AI to do so. Looks like we're headed down a utilization management path in both traditional Medicare and MA, which will stand to favor MA plans. It'll run for 6 years thru 2031. In a statement, CMS Administrator Dr. Mehmet Oz said the program is designed to protect Medicare beneficiaries from receiving "unnecessary and often costly procedures."
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June 2025 Health Tech (non-exhaustive) Funding Roundup |
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Hospitalogy June 2025 Essays |
My favorite reads & resources from the week |
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Random personal anecdotes and musings from me |
I told you guys I'd have an update for you after my rounds at PGA Omni Frisco (Fields Ranch East & West courses) and oh man do I. We played the east (championship) course first and that course ate my lunch…or more like my ball. I drove the ball decently well that day but unfortunately found the rough by a couple of yards on more than one hole, and the rough was no joke. My approach game was shot to hell playing from the rough for most of the day so I ended with an 84.
As you can see below, my second round went much…MUCH better playing at the west course, with my third or fourth ever eagle on the downhill par 5 6th hole. I flushed a drive, flushed a 3 hybrid downhill down wind to ~ 30 feet, and then drained a right to left breaker for the 3. Probably my best ever eagle, and not one I'll soon forget! |
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Thanks for the read! Miss anything from your company, or something else noteworthy? Let me know by hitting reply. I am only human after all! — Blake |
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