Matt Pierce

Why do healthcare strategic partnerships fail? In Kaufman Hall's latest article, Why healthcare strategic partnerships fail: lessons from the deal table, Andre Maksimow and Nora Kelly share why well-intentioned partnerships unravel and what leaders can do to prevent it. Drawing on transaction experience, they outline five practical lessons to help organizations structure partnerships that deliver lasting value. Read more: https://lnkd.in/gs5by5Xw

22

2 Comments

2025 was a defining year for Hyro. We raised $45M, worked with dozens of enterprise health systems, won category awards and pushed our responsible AI chat/voice agents to new heights. Below are 6 highlights we’re extremely proud of: 1) We are now partnered with 50 major health systems across the US. In 2025, we welcomed over a dozen new enterprise health systems and expanded deeply with long-standing partners across more service lines, workflows and patient journeys. 2) Raised $45M to accelerate AI agent adoption in healthcare. We raised $45M in a round led by Healthier Capital, with participation from new investors -- Define Ventures, Norwest, ServiceNow and Mercy Health -- and existing investors: Macquarie Capital and Black Opal Ventures. We’re grateful for this major vote of confidence in our mission! The new funding allows us to: - Further deploy our responsible AI agents across more major US health systems to improve patient access - Build five new engineering teams to support new workflow layers - Expand our focus to mid-market health systems and specialty clinics (orthopedics, pediatrics, etc) 3) Won 3 major awards for Hyro’s responsible AI agents. In 2025, Hyro received three major awards: - Salesforce 2025 Partner Innovation Award - CB Insights Digital Health 50 - Fierce Healthcare Innovation Award 4) Launched proactive outreach for patient access and coverage. In 2025, we expanded beyond inbound automation with: - Proactive Px™ for outbound patient communications - ARMR™ Outreach to support patients at risk of losing coverage due to regulatory changes (e.g. OBBBA) Health systems can now proactively reach patients via voice and SMS in order to close care gaps, improve access and help patients stay covered. 5) Real customer impact at scale at the Tens of Millions. Our AI agents worked this year at never-before-seen scale: - Tens of Millions of patient interactions handled successfully over voice, web/mobile chat, and SMS - Tens of Millions of staff hours saved - Tens of Millions in dollar value of appointments scheduled Every one of these numbers reflects patients who received faster care and staff who got back more time to focus on what matters. 6) Rang the NYSE bell. Very fun, and a nice prep for the future :) Last but not least, thank you to our entire team of Superhyros! Couldn’t be more proud of our team’s incredible ambition, execution, and care this year for patients. Onto 2026!

271

34 Comments

Since the announcement of Risant Health in 2023 with the original acquisition of Geisinger followed by Cone Health, there's been a tremendous amount of interest and a corresponding number of questions about what exactly it is and how it works. A recent article published in NEJM Catalyst by Jaewon Ryu, Chris Cable, MD and Marc Mora, MD provides a detailed description of Risant and its rationale. "Risant Health will help scale Kaiser Permanente’s (KP) value-based care (VBC) best practices to the pluralistic environments outside of KP’s core integrated care and coverage model and markets. Pluralistic refers to multipayer, multiprovider, multipayment models." The article also describes key components of the "Value Based Platform (VBP)" that is intended to drive improvements in affordability, access and health care quality for participating Risant Health systems. "The VBP incorporates clinical knowledge, technological tools, workflows, and operational models from across KP and Risant Health organizations." Read the full article here - in it, you'll get a deeper sense of what differentiates KP from other health organizations and some early indicators on the impact of this work. https://lnkd.in/gqsbn2Ge

135

3 Comments

Are ACOs misunderstood—or just HMOs in disguise? Tomorrow’s episode of Analyzing Healthcare is going to be an eye-opener. In tomorrow's analyzing healthcare podcast, Liz Fowler— former Director of CMS & CMMI — joins Roy Bejarano to set the record straight on Accountable Care Organizations (ACOs). Get ready for an honest take on how Medicare and value-based care are being misunderstood — and misrepresented. Episode drops tomorrow, stay tuned! #ACO #Medicare #HealthcareReform #ValueBasedCare #SCALECommunity #AnalyzingHealthcare #CMS #USHealthcare #podcast

5

In this exclusive interview, our co-founder and Chief Growth Officer Joe Benardello sits down with Becker's Healthcare Healthcare to discuss how accountable AI partnerships and agentic AI are transforming healthcare delivery. This wide-ranging interview covers: - Why an accountable partner with more than just capabilities is critical - The importance of knowing your patients not just clinically, but also behaviorally and financially - Why building a trust pipe creates meaningful relationships - Why 2026 is the year of responsible and accountable AI Listen to the podcast here: https://hubs.la/Q03SNMMt0

77

Tuesday Patient Lending Tip Enrolling in a patient lending program is only the first step. If your team isn’t actually using it with patients, you’re wasting time energy opportunity. Here’s the reality: unused programs don’t help anyone. Not your patients. Not your practice. Not your bottom line. Enrollment without utilization = shelfware. Utilization = increased case acceptance, healthier patients, stronger revenue. Your patients deserve access to care today and your practice deserves to thrive because of it. Don’t just enroll. Train your team. Use the program. Track the results. That’s how lending stops being a checkbox and quickly becomes one of your single biggest growth strategies.

36

10 Comments

We took the feedback from 50+ virtual care acquirers and aggregated them into actionable insights for business owners. This will be a 4 part series over the next 4 weeks. See below part 1 Part 1: Reimbursement Risk Insight: Telehealth remains stable overall, but acquirers scrutinize your specific billing codes and whether they’ll hold up long-term. The focus now is on outcomes and medical necessity. Action: Avoid relying on a single billing code or payer, diversify both. Pro Tip: Offering multiple service lines within your niche helps reduce reimbursement concentration risk and increases valuation. Final note: These acquirers are focused on companies over $1.5M profit.

11

Target Audience: Healthcare Administrators, Payers, and Tech Providers. Headline: The 7-Day Countdown is Here: Are You Ready for the New CMS Prior Auth Rules? Starting January 1, 2026, the "waiting game" in healthcare is officially changing. The CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) is now in effect, and the impact is massive: Faster Decisions: Payers must now respond to standard prior auth requests within 7 calendar days (and just 72 hours for expedited ones). Total Transparency: No more "denied" without context. Payers are now required to provide specific, structured reasons for every denial. Public Accountability: Payers must now publicly report their approval/denial metrics. This is a huge win for patient care, but a major operational lift for providers and payers alike. Is your team's workflow ready for these tighter windows? #CMS #HealthcareCompliance #PriorAuthorization #HealthIT #PatientCare #2026Regulations

3

AI + Efficiency = Profitability. PRISM+ is transforming our distribution model by improving routes, reducing waste, and strengthening margins at scale. This is the operational foundation behind GPOX’s national expansion strategy. Learn more at https://bit.ly/43eux3C

2

1 Comment

Monetize Asynchronous Telehealth: Lean Billing Workflows for Small BH & Primary Care Practices Most practices treat secure messages and portal check-ins as ‘free’ care—here’s a lean, compliance-first playbook (codes to use, documentation snippets, payer-clarification prompts, and a short audit trail) that helps you stop leaving telehealth revenue on the table while protecting clinicians from burnout. Turn routine secure messages into reliable reimbursement with a simple, front-desk intake step that captures patient consent, start/end times, and visit reason so your team can choose the correct time-based or CPT code without burdening clinicians. Use short, repeatable documentation snippets and a one-line audit trail (timestamp + staff initials + message summary) to meet payer requirements while keeping notes concise and defensible. Add a payer-clarification prompt to your intake checklist to confirm whether the insurer requires an advance phone call, modifier, or specific CPT when submitting asynchronous care, so claims aren’t denied for policy variance. Small changes to intake, templates, and a minimal audit trail can unlock steady asynchronous telehealth revenue and reduce clinician admin time. BAC-Office, LLC Phone: 808-909-2003 Fax: 808-909-2004 Email: info@bac-office.com #AsynchronousTelehealth, #TelehealthBilling, #BehavioralHealthBilling, #PrimaryCareBilling, #ComplianceFirst, #PayerClarification, #MinimalAuditTrail

3

1 Comment

Here’s your recap of the last week's health IT news. 🗞️👇 🤝 𝗙𝘂𝗻𝗱𝗶𝗻𝗴, 𝗠𝗲𝗿𝗴𝗲𝗿𝘀, 𝗮𝗻𝗱 𝗔𝗰𝗾𝘂𝗶𝘀𝗶𝘁𝗶𝗼𝗻𝘀 • Prescription access company Forus, fka Tandem, raised $160M. • Specialty referral automation company Basata raised a $21M Series A. • Denials management and revenue intelligence vendor Anomaly raised $17M. • Agent-building platform Champ AI emerged from stealth with $8.5M in funding. • Hospital workforce management company Chromie Health raised a $2M pre-seed round. • Healthcare software and services firm IKS Health acquired ARAI Solutions to continue building out its agentic AI technology stack. 🚀 𝗣𝗿𝗼𝗱𝘂𝗰𝘁 𝗮𝗻𝗱 𝗣𝗮𝗿𝘁𝗻𝗲𝗿𝘀𝗵𝗶𝗽 𝗛𝗲𝗮𝗱𝗹𝗶𝗻𝗲𝘀 • Willis Knighton Health selected Commure as its enterprise ambient AI scribe partner. • University of Michigan Health deployed Avenda Health’s Unfold AI to map prostate cancer in 3D for treatment planning. • Ardent Health partnered with FUJIFILM America to deploy Synapse enterprise imaging across radiology and cardiology. • University Hospitals integrated Fullscript within its Epic instance so clinicians can recommend supplements within EHR workflows. • University of Michigan Health-Sparrow expanded its Canopy deployment to include wearable panic buttons for hospice and home care staff working outside hospital settings. • OpenAI added HIPAA support for eligible ChatGPT Enterprise workspaces using Codex in local environments. • Clearinghouse vendor, Stedi launched ERA views in its portal to help providers review electronic remittance advice alongside claims. • Viz.ai launched Viz Pulmonary Suite to coordinate detection and follow-up workflows for pulmonary embolism, COPD, and lung nodules • Pharmacy access vendor, D2 Solutions added text message updates to UltraTouch Verify so patients can track prior authorization status. • EHR vendor, Medbridge launched Medbridge Outcomes to track patient-reported outcomes and automate CMS reporting for rehab providers • Azra AI partnered with RevealDx to combine incidental findings workflows with lung nodule characterization tools.

25

4 Comments

Reality check for healthtech founders 🎯 EMR alignment determines adoption, compliance and clinical trust. I broke down the exact steps we use to help startups build EMR-ready products that clinicians actually use. Full blog link in comments.👇🏻👇🏻👇🏻

5

1 Comment

𝗢𝘀𝗰𝗮𝗿 𝗛𝗲𝗮𝗹𝘁𝗵 𝗮𝗻𝗱 𝗘𝗹𝗲𝗸𝘁𝗿𝗮 𝗛𝗲𝗮𝗹𝘁𝗵 𝗟𝗮𝘂𝗻𝗰𝗵 𝗙𝗶𝗿𝘀𝘁 𝗔𝗖𝗔 𝗣𝗹𝗮𝗻 𝗳𝗼𝗿 𝗪𝗼𝗺𝗲𝗻 𝗡𝗮𝘃𝗶𝗴𝗮𝘁𝗶𝗻𝗴 𝗠𝗲𝗻𝗼𝗽𝗮𝘂𝘀𝗲 Oscar Health and Elektra Health have launched 𝗛𝗲𝗹𝗹𝗼𝗠𝗲𝗻𝗼, the first ACA plan tailored for women experiencing menopause. The new plan offers $0 primary care, gynecology, and behavioral health visits, along with no-cost labs, hormone therapy, insomnia medications, and bone density scans. Through Elektra, members can connect anytime with menopause specialists and save an estimated $900 annually on healthcare costs. The plan also includes low-cost treatment options for autoimmune conditions like rheumatoid arthritis and Crohn’s disease. HelloMeno continues Oscar’s focus on niche, condition-specific plans designed to make high-need services more affordable. For 2026, Oscar Health will offer plans in 573 counties across 20 states, expanding into Alabama and Mississippi. Oscar Health also unveiled 𝗢𝘀𝘄𝗲𝗹𝗹, an AI-powered assistant built on OpenAI technology to help members navigate benefits, refill prescriptions, and access care more easily.

1

Midi Health Raises $100M in Series D Funding Led by CEO Joanna Strober, Midi Health is a women’s telehealth company that provides accessible, insurance-covered services in all 50 states, designed by medical experts. The round was led by Goodwater Capital with participation from new investors Foresite Capital and Serena Ventures, as well as continued support from AVP | Advance Venture Partners, GV (Google Ventures), Emerson Collective, SemperVirens VC, McKesson Ventures, and Felicis Ventures V LP. https://lnkd.in/ezaH9pkE

11

Introducing KTA -> 4Healthcare. I am pleased to share the launch of our new healthcare division. The mission of KTA -> 4Healthcare is to provide patients, providers, researchers and healthcare organizations with the tools they need to manage change. From introducing and training ai to solving foundational operational challenges, Transformation Insights will work every day to provide solutions that improve the system and make it better for all. Our first solution is KTA -> 4Length of Stay, Developed by Dr. Nirvani Goolsarran, M.D., our solution provides an ai-enabled change office dedicated to helping hospital teams better understand and manage patient flow. To learn more, please visit Ti's website. Special thank you: Daniel J Haller MD MBA FACS, Dr. Nirvani Goolsarran, MD, MBA, FACP, Rebecca Gampel, Kelechi Basil, Cesar Deschamps and Dana Fine #kinetictransformation

6

𝗡𝗲𝘄 𝗘𝗽𝗶𝘀𝗼𝗱𝗲 | 𝗕𝘂𝗶𝗹𝗱𝗶𝗻𝗴 𝗩𝗶𝗿𝘁𝘂𝗮𝗹-𝗙𝗶𝗿𝘀𝘁 𝗖𝗮𝗿𝗲 𝗧𝗵𝗮𝘁 𝗛𝗲𝗮𝗹𝘁𝗵 𝗦𝘆𝘀𝘁𝗲𝗺𝘀 𝗔𝗰𝘁𝘂𝗮𝗹𝗹𝘆 𝗧𝗿𝘂𝘀𝘁 This week, Michael Dalton, Founder and CEO of Ovatient, joins MedTech Gurus to share how he transformed a virtual care strategy at MetroHealth into a company redefining care delivery for health systems nationwide. Before co-founding Ovatient, Michael served as Entrepreneur-in-Residence at MetroHealth System, where he developed innovative, value-based care models for underserved populations. Through a partnership between MetroHealth and MUSC Health, Ovatient is proving that virtual-first care does not have to be transactional telehealth—it can deliver integrated, longitudinal care while maintaining deep connections to trusted health systems. In this episode, you’ll learn: • Leadership lessons from building innovation inside a major health system • Why trust is finite and cannot be “printed” • How speaking the language of health systems (Epic integration, workflows, governance) unlocks adoption • The real story behind Ovatient’s formation and its MetroHealth and MUSC partnership • Why time and distance no longer limit quality outcomes • How Ovatient achieved an 87 NPS while serving Medicaid populations • The distinction between episodic urgent care and true longitudinal virtual primary care • Strategies for scaling virtual care while protecting quality and trust With nearly 100,000 patients served and expanding remote monitoring capabilities, Michael shares insights on building health system partnerships, integrating innovation inside existing infrastructure, and creating virtual care models that remain entirely human. Episode 316 releases Wednesday, available on Apple Podcasts, Spotify, and YouTube. #VirtualCare #DigitalHealth #HealthSystems #Telehealth #ValueBasedCare #HealthcareInnovation #PrimaryCare #PatientExperience #EpicIntegration #MedTechGurus

25

Developing an AI solution for our physicians' clinical conversations has provided valuable insights into the fissures within the healthcare system. The current emphasis on specialty care and the search for sickness has overshadowed the importance of wellness and the role of Primary Care. Each day, I come across articles highlighting this growing issue and the movement towards directing private care practices. Stellicare has recently launched a tool designed to help physicians reduce their workload by automating the workflow for making notes and charts, giving them over an hour or more back each day. This innovation aims to restore work-life balance for healthcare professionals. At the recent Direct Primary Care Summit in Atlanta, Dr. Kant, CEO and Founder of Stellicare, spoke eloquently about the significance of Direct Primary Care and the much needed changes to the medical care industry. Here is a link to this thought provoking talk: https://lnkd.in/eXBDCP9B #DPC #DirectPrimaryCare #Wellness #PrivatePhysicians #DPCAlliance

14

1 Comment

Selling into the employer market? The “Big Beautiful Bill” could shift costs, access, and buyer expectations in ways that matter for your employer GTM strategy. Cuts to Medicaid and marketplace support are expected to drive up employer's costs. As providers treat more uninsured patients, this is likely to increase costs in the commercial market. Employees and family members who were previously on Medicare or a marketplace plan, may turn to employer plans which they previously considered too expensive. At the same time, rural hospital strain is expected to limit local options, leading to delayed care, higher-cost episodes and members seeking care at higher cost facilities. This shifts more burden to employers, making solutions that improve access, support navigation, manage costs and provide alternative coverage options for part-time or lower-wage workforces losing coverage more attractive. So, how should you adjust your employer sales approach? - Quantify near-term impact. Employers need ROI they can take to finance teams as they face increased uncertainty. - Make access central to your story. Show how you help employees get timely, appropriate care — whether through navigation, virtual visits, or partnerships — to prevent bigger issues. - Position around risk management. Help employers handle higher enrollment, more complex care needs and other unknowns with fewer surprises. - Support alternative coverage strategies. Highlight how your solution fits into plans that address gaps for workers who may lose Medicaid or ACA options. - Simplify rollout. Make purchasing and implementation easy for lean HR teams juggling competing priorities. - Showcase how you keep people healthy and working. Especially in areas with fewer local options, demonstrate how you keep employees functioning and on the job. Have thoughts on how this will shape the self-funded employer market? Drop them below. ******* Trying to grow in the employer benefits market? My company, Spark Health Advisors, helps healthcare and benefits companies build a scalable employer channel. Follow or DM me to chat.

9

3 Comments