The shadow medical groups behind GLP-1 telehealth operations

The Food and Drug Administration is cracking down on companies that market compounded GLP-1 obesity and diabetes medications with misleading claims. The regulator has warned over 70 companies since last year. A new analysis by Katie Palmer suggests at least 30% of these companies are affiliated with just four nationwide medical groups.

These "white label" medical practices have been essential to the rise of telehealth businesses that make it very easy for people to obtain low-cost GLP-1 drugs. But as the FDA cracks down on how compounded drugs are marketed, these businesses may find themselves under the microscope as well. Katie's story explores how the arrangements with white label medical groups work, including interviews with the operators who say they make an effort to vet the telehealth brands they work with.

artifical intelligence

The AI agent invasion

At HIMSS, Epic, Oracle, Amazon, Microsoft, and many other companies have announced new AI agents, or software tools that autonomously complete health care tasks including medial coding, documentation, chart review, scheduling, and more.

But as Casey Ross reports, this rush of new agents comes amid growing concern that automation is being adopted in health care before tech is validated and without sufficient patient input. He looks at two recent studies exploring the topic.

research

Did telehealth expansion help rural populations access mental health treatment?

A new analysis of Medicare claims from 2018 through 2023 shows that mental health providers who most enthusiastically embraced telehealth are not seeing substantially more patients in rural and underserved areas. The findings suggest that while telehealth has seen significant adoption in Medicare since the government insurer expanded coverage during the pandemic, it's not helping reach the places with the most need.

While the study doesn't arrive at explanations, it makes sense that clinicians who are already in high-demand locally would be more likely to serve people in their own communities, said co-author Ateev Mehrotra, a professor at the Brown University School of Public Health. Policies that might help include increasing broadband access and facilitating inter-state licensing for providers.

The research adds to the growing body of literature suggesting that the boom in virtual mental health care is having uneven benefit. A notable analysis of survey data published last year found that in 2021, "individuals who had a higher income, were employed, and were college educated had significantly higher teletherapy use than their counterparts."

The possibility of using technology to expand mental health access in rural communities has been theorized and explored for decades. Making it work is another issue. Back in 2021, I wrote about a successful effort to beam big city psychiatrists and psychologists to remote federally qualified health centers to support primary care providers in treating patients with PTSD and bipolar disorder. Among the takeaways of that story was the complexity of coordinating such an arrangement. It takes more than transmission lines and insurance coverage to carry access to underserved areas.

Health tech news roundup

Omada posted its first profitable quarter. I caught up with CEO Sean Duffy last week about the company's strategy around GLP-1s and AI. Read more here.
A new pre-print details the results of a 100-participant real-world study of AMIE, a diagnostic chatbot Google has been developing for several years. In the study, patients chatted with AMIE before their urgent care appointment with a human clinician. I have not had a chance to fully process the results, but a high-level finding jumps out: One of the diagnoses suggested by AMIE was included in the final diagnosis for a patient in 90% of cases. Google is currently undertaking a randomized study of its experimental clinical AI with Included Health.
Amigo AI, a developer of patient-facing clinical AI agents, raised an $11 million Series A round led by Madrona with participation from Optum Ventures.
Samsung announced it's working with interoperability company B.well to make people's health records readily available on Samsung smartphones.
I have no idea if this is a real problem, but I thought it was interesting: Codoxo, a company that uses tech to help payers identify possible fraud, announced "deepfake detection" to "identify AI-generated or manipulated medical documentation and diagnostic images submitted in support of claims before payment is made." Codoxo most recently raised $35 million led by CVS Health Ventures.
Sword Health began as a company focused on virtual physical therapy but for several years has been working on becoming a company that treats a range of conditions. To that end, the company unsheathed two new products this week: Dawn, a direct-to-consumer AI mental health app, and Pulse, an AI-powered cardiometabolic care offering, including support for GLP-1 medications.
EHR vendor Meditech added ambient listening capabilities to its mobile apps used by clinicians.
Video conferencing service Zoom added new health care-focused features including better integration with Epic.
Revenue management company R1 has a new deal with AI scribe company Heidi Health to capture "the scope and complexity of the work physicians perform and ensuring providers capture the full value of the care they provide."

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