Personalized Rehab Solution: Supporting Patients With Work Responsibilities Presented by Tranquil Shores

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Featured Story   Which Health Plans Rank Highest In Digital Experience? The skinny Cigna Healthcare leads the way in digital experience among commercial health plans, while UPMC Health Plan ranks highest among Medicare Advantage plans, according to a new report from JD Power. The numbers The U.S. Healthcare Digital Experience study, published on Tuesday, is based on evaluations from 7,687 members of the 17 largest MA plans and 16 largest commercial plans. It measures satisfaction across five factors: visual appeal, navigation, information/content, speed and telehealth. Among commercial plans, Cigna Healthcare achieved a score of 684 points on a 1,000-point scale, while Premera Blue Cross came in second with 682 points and UnitedHealthcare ranked third with 672 points. Horizon Blue Cross Blue Shield of New Jersey ranked last with 605 points. For Medicare Advantage, UPMC Health Plan received a score of 676 points, followed by Healthfirst with 671 points. Devoted Health and UnitedHealthcare tied for third with 665 points. Cigna Healthcare, while highest among commercial plans, ranked last among MA with 604 points. — By Marissa Plescia Sponsored   Personalized Rehab Solution: Supporting Patients With Work Responsibilities Presented by Tranquil Shores Balancing recovery with professional obligations can feel overwhelming. For many clients seeking rehabilitation, stepping away from work entirely is simply not an option. Learn More Top Stories   Luminai Snags $38M The moolah San Francisco-based Luminai snagged $38 million in Series B funding, bringing its fundraising total to $60 million since its founding in 2020. The round was led by Peak XV Partners, with participation from General Catalyst, Y Combinator and Define Ventures. The tech Luminai’s AI platform first turns messy healthcare inputs like faxes, PDFs and handwritten notes into structured data by identifying relevant clinical information and filtering out irrelevant material. It then uses a knowledge graph and AI agents to apply each health system’s specific rules and institutional judgment to route, match and execute administrative workflows — involving humans only when necessary. “Every health system has its own unique processes and policies,” said Luminai CEO Kesava Kirupa Dinakaran. “Luminai encodes that operational logic into versioned, auditable infrastructure, rather than relying on ‘tribal knowledge’ that lives in people's heads.” Cleveland Clinic collab The company is currently partnered with Cleveland Clinic, which is using the platform to automate complex administrative workflows, starting with referral management. Referrals are just the first of many use cases, according to Dinakaran. He said the partnership is designed to expand across “high-volume, operationally intensive workflows” in the administrative realm. — By Katie Adams Digging Deeper Into Degrader Drugs for Cancer The news Gilead Sciences exercised its option to license a protein-degrading cancer drug from partner Kymera Therapeutics, triggering a $45 million payment to the biotech. Meanwhile, Roche began a new partnership with C4 Therapeutics focused on developing a related type of therapy called a degrader antibody drug conjugate (DAC). Roche is paying C4 $20 million up front. The drugs Protein degraders work by leveraging a cellular system for disposing of old or damaged proteins as a way to eliminate disease-causing proteins. The preclinical Kymera drug going to Gilead addresses CDK2, a cancer-driving protein that is expressed by breast cancers and other solid tumors. Roche and C4 will develop DACs for two undisclosed targets, and possibly a third. Why this matters There are many cancer drugs available and in development that work by inhibiting disease-driving proteins. But such drugs can also hit related proteins that aren’t involved with cancer, sparking side effects. Protein degraders are intended to eliminate disease-causing proteins and leave other proteins alone. This approach could reduce side effects and may also improve efficacy. Soundbite “Our new collaboration leverages C4T’s ability to design highly catalytic and selective degraders, as well as degrader payloads for DACs, alongside Roche’s extensive experience developing ADCs with specific binding,” C4 President and CEO Andrew Hirsch said. “Together, these capabilities build a powerful new modality that can offer transformative medicines for patients.” —By Frank Vinluan  AI-Driven Precision Care is the Fix for Our Health System’s Failures The problem After a rushed exam and ensuring that coding and reimbursement criteria are properly matched, the PCP orders a few screening tests and writes a specialist referral. The problem? They know the patient may wait weeks or even months to see the specialist while their condition likely progresses, unmanaged. Moments like these are failure points – not of the physician, but of the system – that happen every day across the country. Bridging the PCP to specialist gap One of AI’s most powerful roles in primary care is bridging the gaps between PCPs and specialists that often result in lost time and disparities in care, according to research.An intelligent clinical assistant can surface relevant data from a patient’s chart, highlight data-based clues to the differential diagnosis, and propose initial evidence-based treatment steps tailored to that individual patient. It’s like having a panel of specialists in the PCP’s pocket, ready to weigh in instantly. Saving primary care AI assistants working at this high level are necessary to save primary care, a field that I’m pained to say is collapsing under its own weight. Navigating a system fraught with failure points, physicians feel rushed. They witness unmanaged conditions and preventable complications on a daily basis. Rampant burnout is the result. Replacing a physician costs as much as $1 million, according to the American Medical Association. Deploying AI-driven assistants to improve PCPs’ workflows – from better care orchestration to more precise coding – is good for caregiving and healthcare’s bottom line. — By MedCity Influencer John Frownfelter  Video   Video: Why This ER Physician Is Embracing GenAI Not all doctors like when patients Google medical questions or use ChatGPT and other AI tools to learn about healthcare. But this ER doctor feels it's better to have empowered patients. Listen to Ania Bilski, VP of clinical AI at OpenEvidence, give her take.

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The Quiet Battle for the Front Door of Healthcare This is not a debate about care models or physician preferences. It is a contest over who will control the referral pathways and the revenue streams that originate at the front door of healthcare.

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