🏥 May Recap
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Happy Tuesday, Hospitalogists! Today I’m sharing news and trends over the month of May. I also wanted to continue to promote my upcoming event for hospital and health system folks!
These are just a few of the health systems that will be in the room this November at the official Hospitalogy AI Retreat. We’re covering travel. We’re establishing Chatham House Rules. And we’re going to talk about the things that matter most in healthcare right now…distilling the noise and gaining a true understanding of what health system 2.0 looks like. If you're a C-suite or VP-level executive at a hospital or health system, apply here! (And if you’re interested in speaking or have a topic in mind, reply to this email. I am developing the entire agenda myself with meticulous thoughtfulness). 
Now let’s dive in. Was this email forwarded to you? Sponsored by Cedar Uninsured patient responsibility is up 54% in three years. Two-thirds of the growth is in one cohort. Hospitalogy News Recap: May 2026Download the full recap of all stories here. Return of the Mega IPO: OpenAI, Anthropic, and SpaceX all announced IPOs signaling investor appetite to stomach massive valuations at hyper scaling companies. In health tech and wearables land, Oura confidentially filed to go public as well likely at a $12B+ valuation. Similar to Whoop, Oura made a slew of announcements alongside the release of its latest smart ring with more health oriented offerings. Slimmer rings, new health insights, blood pressure, and more…it’s an exciting time to be thinking about the growing prevalence of wearables alongside traditional healthcare offerings. Hospital M&A Unfreezes: After 2025 logged the fewest hospital deals in 15 years. the dam cracked in a single month. Sutter–Allina went definitive at $26B, the biggest hospital deal of 2026 so far. Atrium "combined" with WakeMed, Sanford finally cracked the Twin Cities via North Memorial after two failed Fairview runs. UPMC took CommonSpirit's Trinity Health in Ohio as CommonSpirit sheds what doesn't fit its turnaround. Quorum Health quietly nuked its for-profit, PE-backed identity to go nonprofit under Healthside Partners, and Ascension's $3B AmSurg deal is still sitting in regulatory limbo. So while deal flow is unfreezing, regulatory pressures around hospital-centric M&A is not. One perhaps under the radar vertical deal was HCA’s acquisition of The College of Health Care Professions as the for-profit operator continues to scratch and claw for ways to reduce labor pressure, introducing new labor pipelines for its hospitals (Galen College of Nursing). On the broader M&A front, my expectation is for M&A to thaw up further - deal momentum will continue headed into 2H 26. Public vs. Private AI Price Differentials: Which price is right, Hospitalogy fam? On one hand, public markets are hammering AI transitions. Doximity got beheaded (-28%) once the Street noticed AI compute eating its network margin, and Health Catalyst dropped 20% with a significant portion of revenue admitted at risk during its AI pivot. Meanwhile, in quite literally the same month, Forus (the rebranded Tandem) raised $160M at a $1B valuation from Thrive and General Catalyst, OpenEvidence (a close peer to Doximity) reportedly hit 650K doctors and 27M April searches (last raising at a $12B private illiquid valuation while Doximity’ TEV is under $4B…). In general capital seems to be concentrating in mature AI platforms while early stage is getting squeezed.
Bot Wars Continue and AI Platforms Benefit: Assort Health launched Activate, and Carlyle stood up its Knack/EqualizeRCM consolidating play. Plus Senate Democrats are already circling CMS' WISeR AI prior-auth pilot, so the politics of automating utilization management will only continue to heat up from here. Notable Litigation: AG Andrea Joy Campbell's suit alleges UnitedHealthcare upcoded MassHealth Senior Care Options members for at least $100M, one of the first to take the MA upcoding playbook and apply it to duals — a far thornier and larger pool. Pair it with Clover's win in Georgia, where a judge tossed 20 Stars measures and ordered a ~$120M recalculation, and two branches of government are now re-pricing the risk-adjustment and quality-bonus machinery the entire MA P&L rests on. State Directed payment reform: The proposed Medicaid state-directed payment rule (capping SDPs at 100% of Medicare in expansion states, 110% in non-expansion) is functionally a $775B clawback Medicare’s $50/month GLP-1 is de-facto Part D Expansion: CMS confirmed the $50/month price (May 5) for Wegovy, Zepbound, and Foundayo starting July 1, with net price to manufacturers at $245. Do that math: CMS eats roughly $195/month per beneficiary across a pool KFF pegged at ~14M overweight/obese Medicare beneficiaries. Even at 5% uptake, that's $1.6B annually. Bridge runs through December 2027, then hands off to BALANCE. This coverage announcement is the largest expansion of Medicare drug coverage since Part D in 2006. Lilly's Q1 - $20B in revenue in a single quarter, with Mounjaro/Zepbound at 65% of the total. Watch employer behavior next: 67% currently cover GLP-1s, and ~10% are likely to drop coverage in 2027. Two payment rails are forming in real time, cash-pay-via-Medicare for seniors and DTC-cash for the working-age population. Oh, and don’t forget about the peptide gray market. Fraud, Waste, and Abuse = major crackdown: Look at one month of happenings here: CMS’ new fraud prevention initiative, new reports targeting overpayments like in acute strokes, No Surprises Act IDR reform, Makary out at FDA (seems like a revolving door these days), a six-month nationwide enrollment moratorium on hospice and home health, a $1.3B freeze on California Medicaid, a finalized 2027 ACA Exchange rule narrowing enrollment windows, work requirements looming…then at the state level you have CON repeal in Tennessee (and more to come), rural health transformation dollars flowing. PE’s resparked interest in post-acute care and exit windows are reopening: Regulatory capture, M&A consolidation, and aging demographics all provided windfalls for one capital structure so far in Q2 (private, levered, integrated). Enhabit closed its $1.1B Kinderhook take-private the exact week CMS announced a six-month enrollment moratorium for new hospice and home health agencies — which hands a short term advantage to scaled existing operators like Addus, Chemed, BrightSpring, and now-private Enhabit. Add General Atlantic closing its $3B Team Services deal along with Select Medical going private, and PE is rolling up post-acute assets across the board. On the public side, GMR Solutions (KKR's ambulance roll-up) cleared an IPO at $3.35B and raised $479M. Payvidors under pressure: Providence Health Plan is winding down most operations for 2027, Becker's reported systems broadly scaling back payvider ambitions, ACA deductibles spiked 37% per KFF as subsidies expired, and Berkshire exited UnitedHealth entirely. Meanwhile, the Milliman Medical Index hit $37,824 for a family of four, an 8% jump and the largest non-COVID increase in a decade. Physician employment dynamics and CPoM: Perimeter around physician aggregation is tightening on three fronts at once. A Health Affairs paper on PE related primary-care acquisitions (225 practices, 2016-22) found services billed +30% and patients seen +11%, driven by APP scaling and lab/AWV mining. Pair it with Nebraska banning healthcare staffing noncompetes, California's AG scrutinizing the Aspen Dental MSO model, the PeaceHealth emergency staffing debacle (and the first real test of Oregon’s stringent corporate practice of medicine law) and the House E&C subcommittee mulling Medicare physician pay reform…there’s a ton happening around these specific dynamics. Download the full 219-item list here. Sponsored by Abridge Abridge has been one of the more quietly impressive builds in clinical AI: ambient documentation that actually works at scale, built by a physician. On June 11, CEO and Founder Dr. Shiv Rao is taking the stage for Abridge's first-ever Keynote to announce what they've been working toward: a reimagined healthcare experience that puts the clinical conversation at the center of the care ecosystem. Worth tuning in. ON YOUR RADAR
*This read is brought to you by one of my brand partners who help make this newsletter possible! That’s all for this Tuesday. I would love to know your thoughts! Just hit reply to this email. – Blake |
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