Brent Bellm

FORCING CHANGE IN SITE OF CARE McKinsey & Company's recent paper on the forces pressuring healthcare, including the possibility of margin compression of up to 13 percentage points for health systems, does a good job of putting numbers around what most operators already feel. Two of the biggest drivers they mention are policy shifts in reimbursement and rising utilization driven by an aging population. The cohort of 70+ year old Americans will grow the fastest over the next 5 years, and it is well established that older patients have more complex needs, more chronic disease, and more touchpoints within the healthcare system. Layer that on top of continued clinical workforce shortages, and the supply-demand gap widens further. From my perspective, optimizing for site of care is the most important lever we have to address this challenge. We can’t quickly reduce how much care older patients need, but we can change where and how services are delivered. Supporting aging patients in lower-cost settings like the home, ambulatory sites, and virtual environments is no longer just a preference or convenience, it’s a necessity. This is where the conversation around site-neutral payments becomes so relevant. CMS is moving quickly in this direction, and hospital outpatient departments (HOPDs) are squarely in the crosshairs. The shift will undoubtedly clamp down further on hospital margins, but it shouldn’t be surprising. We’ve been talking about the demise of HOPD reimbursement for years, and the health systems that will fare best are the ones who are working towards aligning their approach with where patients can be treated safely, efficiently, and at lower cost, rather than relying on legacy reimbursement structures to fill the gap. And just like it doesn’t make sense to try to replicate a hospital or nursing home environment in a patient’s home, we also shouldn’t try to carry the same clinical staffing model into every care setting. Yes, there are non-negotiables when it comes to patient safety and clinical expertise, but there’s also a meaningful opportunity to rethink how teams are built. That means clinicians at every level working at the top of their licenses, thoughtfully involving family members and community resources, and using technology to surround these sites of care with non-clinical operational support. From my health system days, I understand why rising costs, margin pressure, and site-neutral payments feel like threats. While painful, I’m hopeful they can also serve as a positive forcing function, pushing us toward care models that are better aligned with our aging population and the realities of today’s workforce.

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🧬 This week's Austin Bio & Health Roundup has a new unicorn, a vision for Healthcare AI, insights on AI deployment, & collaboration across the Texas Bio Triangle infrastructure. 🧬 💰 Funding & Capital Signals Say hello to Austin's newest Bio & Health unicorn! Curative raised a $150M Series B at a $1.275B valuation to expand its $0 out-of-pocket, AI-enabled health plan into new markets. 🤝 Partnerships & M&A L7 Informatics is teaming with Leica Biosystems to integrate L7|ESP with Leica platforms to deliver AI-ready, end-to-end pathology lab informatics. 💡 Insights from Local Builders & Innovators 8VC’s “A Vision for Healthcare AI in America” argues that regulation, not technology, is the main bottleneck keeping AI out of direct care delivery. 🏙️ Community HIMSS Central Texas Chapter's December 12 CXO Forum is bringing together health and technology leaders. I will be moderating a panel with Kevin W. Barron, FHFMA, EHRC, FACHE, Brandon T., and Crystal Kilburn, MHA, RHIA, CRCR on AI in the revenue cycle. Come join us. 🤠 Texas Bio Triangle Houston & San Antonio: Salarius Pharmaceuticals is partnering with Texas Biomedical Research Institute on avian flu studies to generate first in vitro data on pan-influenza candidates, including H5N1. Houston: Avance Biosciences, Inc. opened a Potency and Cell-Based Assay Center of Excellence in Houston to support GMP-compliant potency and functional assays for biologics, RNA therapeutics, vaccines, and cell and gene therapies. What’s Next? 🤠 🚀 🦾 🧬

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Nice quote from one of our Partners Andrew Brackin in TechCrunch: “This was one of the biggest use cases of ChatGPT,” Andrew Brackin, a partner at Gradient who invests in health tech, told TechCrunch. “So it makes a lot of sense that they would want to build a more kind of private, secure, optimized version of ChatGPT for these healthcare questions.” https://lnkd.in/gY3TV5VD

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🔥🔥 PANEL ALERT 🔥🔥 What gaps may AI fill with the recent policy impacts on Medicaid?  Coyote Ventures 2025 Health Equity Innovators Fall Gathering will feature an expert panel discussing the impact of AI in Healthcare with a particular focus on its implications for Medicaid and Medi-Cal. As we are past the mid-point mark of 2025, AI and OBBBA are reshaping U.S. health policy in profound ways, from expansive new federal and state guidelines to sharp debates around oversight and authority. Our discussion will dive into the themes of bias, equity, and accountability in AI, and what these evolving mandates mean for those developing, deploying, or relying on AI-driven solutions in healthcare. With Medicaid and Medi-Cal covering some of our most vulnerable populations, the stakes couldn’t be higher. I’m looking forward to an engaging conversation with Priyanka Vaidya, Pooja Mittal, and Stella Tran - exploring how we can ensure AI not only advances innovation but also builds trust, fairness, and better outcomes. Curious to hear your thoughts: can AI truly help reduce disparities in Medicaid care, or will it deepen them?

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Doximity just released a free AI scribe for US clinicians, accelerating commoditization/the race to the bottom. Their product won’t integrate into the EHR like Abridge, but it’ll be interesting to see how much it impacts their ability to acquire customers, drive usage and maintain retention. This is the start of a trend that will continue across every vertical market. Counterpositioning with free products to undercut upstarts and incumbents alike. Buckle up. Your margin is someone else’s opportunity.

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“The thing I am most proud of is that because we built the entire tech stack that we own, from the member app, the company, the client dashboard, to electronic medical records systems and other internal tooling.   We enable providers to spend more time with the patient.” How much longer? 3x longer than the average primary care visit.   This week on the Digital Health Heavyweights Podcast I sit down with Joseph Kitonga, CEO and founder of Vitable Health. Joseph shares his journey from a family background in caregiving to creating a health plan that addresses the needs of underserved workers. He discusses the inspiration behind Vitable, his experience with the Thiel Fellowship, the prestigious Y Combinator,and the unique aspects of Vitable's direct primary care model.   “We are growing extremely quickly” The conversation also covers the challenges of hybrid care models, the importance of empathy in healthcare, and the company's growth trajectory. Joseph emphasizes the need for accessible healthcare and shares insights on building a successful startup in the healthcare space.   How is Vitable impacting clients? An average savings of about 12%   Takeaways ✨ Joseph's family background in caregiving inspired him to create Vitable Health. 💙 Vitable Health aims to provide affordable healthcare for underserved workers. 🎓 The Thiel Fellowship provided Joseph with the opportunity to focus on his startup. 🚪 Vitable's model reduces barriers to accessing primary care services. 📈 The company has about 100,000 members and is growing rapidly. 💻 Vitable's approach integrates in-home and virtual care effectively. 🤝 Building empathy through direct interaction with clients is crucial for Vitable. 🗣️ Joseph emphasizes the importance of talking to users to build a successful product. 🚀 The Y Combinator experience was pivotal for Vitable's growth. 🧘 Joseph practices mindfulness and reading to manage stress and maintain focus. Check out the episode and be sure to like comment and subsc https://lnkd.in/dVAzHMQZ

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🚨 Big news from the frontlines of healthcare innovation: Ellipsis Health just announced a $45M funding round led by Salesforce Ventures, Khosla Ventures, and CVS Health Ventures—and it’s making headlines in the Wall Street Journal. We’ve been proud backers of Ellipsis Health at E12 Ventures because they’ve taken a bold, contrarian approach: instead of chasing efficiency at the cost of patient experience, they’ve built an emotionally intelligent AI that brings humanity back to healthcare. Meet Sage — the AI Care Manager trained on millions of real clinical conversations and powered by Ellipsis’ proprietary Empathy Engine. It delivers 24/7 support to patients with complex needs — the same patients who typically slip through the cracks because of capacity constraints and staffing shortages. This is a huge leap forward. Instead of forcing trade-offs between quality and scale, Sage shows we can have both. It’s not just automating workflows — it’s reimagining what scalable, empathetic care looks like. Strategic investors across the ecosystem — payers (CVS), platforms (Salesforce), and deep tech VCs (Khosla) — all recognize the same thing: emotionally intelligent AI is the next frontier in healthcare. Congrats to the Ellipsis team — thrilled to be on this journey with you. #AI #HealthcareInnovation #EllipsisHealth #EmpathyEngine #VentureCapital #DigitalHealth #E12Ventures https://lnkd.in/giVckKyq

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So energized by the conversation and company at Mayo Clinic PlatforMed 2025 - a gathering of 300 leaders from 7 countries from academia, government, and industry who are innovating in healthcare and technology. It was a highlight to join the panel discussion Digital Health Capital: Where Investors are Placing Their Bets, with: Jun Jeon, MD of Khosla Ventures Kelly Krajnik of Mayo Clinic Andy Walter of Granger Management Moderated by Andy Danielsen, Chief Business Development Officer at Mayo Clinic Some nuggets from our discussion that stood out to me: 1 -- Investors remain focused on team, tech differentiation, promising distribution/GTM strategies when looking on where to place bets. 2 -- We discussed thoughts on why we have not yet seen a platform company in healthcare with the success we have seen in the consumer realm (Apple, Uber, Amazon, etc). When we do, will that be a B2B or B2C company? The economics of healthcare and the flow of funds is where some of these challenges sit. (I posit that for innovation at scale, we need both top-down and bottoms-up innovation and to work within the existing infrastructure of healthcare and thus B2B is critical to that solution) 3 - Consumer voice and spend is critical to the conversation, with consumer demand driving a lot of the innovation and early work (willingness to pay drives utilization and engagement; could this lead to ROI to new reimbursements?) 4 - Healthcare has complex requirements for compliance and from a regulatory perspective - what new emerging technologies can help with this? I believe that the applications of AI will be the most impactful use case for AI in our lifetime. Building with extreme care and thought is required - and it's a very exciting frontier ahead. Thanks for including Bread and Butter Ventures and me! #healthcare #digitalhealth #venturecapital #AI #investing

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In our latest newsletter, I go deep into why we believe the next three years of healthcare innovation will be defined by two specific trends: Voice Agents and Hybrid AI Care Models. Here is the quick breakdown: 🎤 Amplifier Health (Voice AI Diagnostics): Amit Mehta, Jeremy Barber, and Peh Keong are doing the impossible. They have built a Large Acoustic Model that can screen for multiple medical conditions from a phone call. By focusing on the physical properties of sound rather than just words, they are creating a screening and diagnostic tool that is accessible to anyone with a phone. 🧠 Meru Health (Hybrid AI-Enhanced Care): Kristian Ranta, Riku Lindholm, and Henri Koponen are solving the "efficacy crisis" in mental health. Their 12-week program treats the mind and body together by combining licensed clinicians with biofeedback technology. With millions of lives covered, they are proving that value-based care is the only way forward. The Bigger Picture: We believe the "Golden Age" of healthtech is moving toward a model where AI handled the routine data and diagnostics while humans focus on high-level clinical decisions. Whether it is a voice agent triaging a patient or an AI-enhanced clinician monitoring recovery, this hybrid approach is how we solve for both access and quality. Read the full breakdown of our investment thesis #HealthTech #VentureCapital #AI https://lnkd.in/dqDGBnJF

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#AmTech Weekly Roundup: Ambience Healthcare raised $243 million in Series C funding from Oak HC/FT, Andreessen Horowitz, OpenAI, Kleiner Perkins, Optum Ventures, and Town Hall Ventures. Ambience is building AI documentation software to record patient appointments, generate comprehensive medical notes, and standardize coding/authorization workflows.   Michael Ng, Nikhil Buduma    Reveal Technology raised $30 million in Series B funding from Ballistic Ventures, Shield Capital, Booz Allen Hamilton, and others. Reveal’s two main offerings are 3D mappings generated from drone videos and mobile biometrics. They are deployed with the US Army, Special Operations Command, Marine Corps, and other NATO forces.   Garrett Smith    Prophet Security raised $30 million in Series A funding from Accel and Bain Capital Ventures. Prophet is applying agentic AI to Security Operations Centers (SOCs), or hubs for cybersecurity defenses within an organization.  Kamal Shah, Vibhav Sreekanti #VC #HealthTech #Healthcare #Defense #Cybersecurity

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