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Rae Woods officially joins Kevin and Martin at the table this week, and since the CVS and midterm news got its own emergency pod, the crew starts with Devoted. Job postings and comments from investor Annie Lamont suggest the high-flying MA plan is coming for large-group ASO. Kevin walks through the vertical-integration math behind the $100-to-$90 pitch. Then he explains why he thinks the leap probably won’t work, and why an acquisition might be the only shortcut. Rae breaks down the final 2027 physician fee schedule: a deeper cut to the base rate, a bigger bonus for doctors in ACOs, remote patient monitoring rules pushed out to 2029, and a softened same-day visit discount that still stings for derm, ortho, and ENT. That leads into a debate over whether MSSP is the quiet winner of this era. Kevin reports from athena’s Thrive Summit in Nashville on agentic AI, auto-refills, and the race to be the practice’s trusted partner. The show closes with employers pulling back on GLP-1 coverage, Omada’s slide, strong quarters for Hinge and Progyny, and the week’s quick hits. Links referencedWhat is Devoted up to in the commercial market?Annie Lamont (Oak HC/FT) on SourceryThe 2027 Fee Schedule: A Pay Cut, a Reprieve, and a DeadlineAI unlocking a delightful EHR experience: Takeaways from athenahealth's Thrive Summit For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe

Kevin and Martin dig into a busy Q3 earnings week where payers keep winning and providers keep absorbing the affordability squeeze. Centene beat and raised, hit MA breakeven a year early, and barely mentioned ICHRA. Alignment stumbled on a claims platform migration, high-cost cases and a Stars drop in its core California plan. On the hospital side, more of HCA’s ACA members went uninsured than it expected. CHS says commercial patients are pushing hip and knee replacements into next year, and Tenet keeps doubling down on ASCs. Teladoc had a huge week, DaVita’s kidney care business raised guidance again, and Kevin checks the math behind Lilly’s claim that GLP-1 Bridge saves Medicare $20 billion. Next comes Medicaid. A judge blocked CMS’s medical frailty rule less than two months before work requirements start, and Martin explains why 2027 is the hospitals’ problem and 2028 is the payers’. They wrap with AI agents shopping for care through Zocdoc and Walmart’s Better Care Services, a study finding AI recommends roughly three times what physicians do, and what happens when your health agent is free. Links referencedWall Street Journal: “Investors Are Betting a Blue Wave Will Hospitals. Don’t Count on It."Michael Albert Substack: a breakdown of the USC preprintUSC preprint: the $20B Medicare savings from GLP-1 BridgeNEJM AI study: AI care recommendations vs. physician costs For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe

Kevin and Martin open with the surprise news that Bon Secours is buying Surgery Partners, plus the Advocate headache of patients linking MyChart to ChatGPT, which sent Epic API calls up 7,000% and left Advocate paying for them. Then it’s Q3 payer earnings. Elevance beat, but mostly on investment gains, and says IDR costs are landing on its ASO book, which means employers are paying them. Molina’s 7% Medicaid rates against roughly 4.5% trend back up the “trough year” story. The guys also ask why Molina is staying in the ACA, and whether D-SNP or C-SNP is the more durable bet. On the employer side, they go through the KFF survey, Oxbridge’s $45M raise for employer episode bundles, and Aon’s  Access Choice marketplace. Along the way they accidentally invent insurance companies from first principles. They also dig into STAT’s reporting on iMPROve Health, an IDR arbitrator whose financials have turned into a hockey stick. To close, they cover Bob Wachter on who AI should serve and the coming “AI death panels” fight, General Medicine’s own medical group and its new Walmart partnership, Daniel Nadler’s drug discovery pitch for OpenEvidence, and Horizon buying Summit for about $1B. Brought to you by Lorikeet is a leading platform health tech companies use to build, test, and deploy AI concierges for patient and provider support. Your patients' AI agents get the same answers and identity checks your patients do. lorikeetcx.ai/healthtech Links referencedLRV Health and CVS paper on the AI agent explosionBecker’s: “Patients linking MyChart to ChatGPT jumped 7,000% at Advocate. Who pays?”Trilliant Health 2026 market trends report For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe

Earnings season is here, and Kevin and Martin preview what they’re listening for in Q3, starting with government programs. They discuss Medicare Advantage plans pruning PPOs in favor of C-SNPs and D-SNPs, the growth outlook for Humana and Alignment, and Clover’s five-star rating heading into AEP. On Medicaid, they cover plans’ view that 2026 is the trough and early disenrollment data from Nebraska’s work requirement rollout. On the commercial side, they get into UnitedHealthcare’s commentary on trend above 11% and No Surprises Act IDR payments as a share of medical spend. They also talk through Omada and Hinge’s selling season, the state of the ACA market, the big three PBMs’ outlook, and state laws separating PBMs from specialty pharmacy. The conversation then turns to hospital operators, covering affordability, delayed elective procedures, and uninsured rates, alongside cash-pay consumer models. The episode closes with value-based care and how AI is showing up on public company earnings calls. Brought to you by Lorikeet is a leading platform health tech companies use to build, test, and deploy AI concierges for patient and provider support. Your patients' AI agents get the same answers and identity checks your patients do. lorikeetcx.ai/healthtech Links referenced STAT report on IDR arbitrator profitability: https://www.statnews.com/2026/10/19/no-surprises-act-billing-arbitration-profits-stat-investigation/ For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe

Kevin and Martin start with a discussion of the 2027 Stars ratings. The big takeaway: the results were good enough for most plans that Congress won’t feel pressure to fix the program. From there, they cover the fight between Atrium and the NC State Health Plan. That leads into Frank Pallone’s bill to replace No Surprises Act arbitration with an inflation-adjusted QPA, and the real question underneath it: who should pay. They close on consumerism: General Medicine’s $120M raise and TJ Parker’s case that “the agent needs a store,” Megan Fox selling ED meds for Ro, and why brand still beats rational choice in healthcare. Plus quick hits on Option Care, Centene and Marathon, CMS scrutiny of CCM billing, and Utah’s AI sandbox. Brought to you by Lorikeet is a leading platform health tech companies use to build, test, and deploy AI concierges for patient and provider support. lorikeetcx.ai/healthtech Links referenced KFF on the role of healthcare in the midterms: https://www.kff.org/from-drew-altman/a-guide-to-the-role-of-health-in-the-midterms/ CBS News on the No Surprises Act: https://www.cbsnews.com/news/no-surprises-act-medical-bills-arbitration-system-loophole/ NY Times Magazine on health misinformation: https://www.nytimes.com/2026/10/04/magazine/alternative-cancer-clinics-treatment-father.html For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe

Kevin and Martin spend the first half of this week's episode on Devoted Health, which formally announced a $1.18B Series G at a $25B valuation. They get into the NAIC filings showing a 1.1% margin, confirmation that Devoted is profitable at the parent level, the 13 Series F investors who sat this round out, and why 133 new C-SNP plans in the MA landscape file might be the real story. Is the AI-driven admin cost edge durable, or a head start the incumbents eventually close? From there it's Oura pulling its IPO, what that says about the gap between private and public markets, and Martin's bet on a post-midterms window. Then Cigna's Investor Day: Evernorth's specialty engine, Select's growth with small employers, and what that means for the challenger plans renting Cigna's network. They round it out with Grindr buying Freddie, MultiCare launching an MA plan while others exit, Anthropic joining ARPA-H's ADVOCATE, HealthPartners and Essentia merging, and Thoreau's $500M commitment to Ortet. Brought to you byLorikeet is a leading platform health tech companies use to build, test, and deploy AI concierges for patient and provider support. lorikeetcx.ai/healthtech Links referencedBusiness Insider: Devoted Health could be valued at $25 billionhttps://www.businessinsider.com/healthcare-startup-devoted-health-could-be-valued-at-25-billion-2026-8Axios (Dan Primack): Oura delays its IPOhttps://www.axios.com/2026/09/29/oura-ipo-delayed-smart-ring For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe

Kevin and Martin kick off with the latest Citrini report and its argument that AI agents will turn friction from a profit center into a cost center, with health insurance as exhibit A. Martin doesn't buy the idea that payers unwind, but thinks bots that fight every denial and prior auth mean higher premiums down the road. Kevin brings in the NYT story on SmarterDx and McLaren to ask whether all this coding automation just builds another middleman profit pool. From there it's Rightway's $155M raise at a $1.75B valuation and 45 Fortune 500 clients. If transparent PBMs are winning, why isn't anyone at dinner parties saying their healthcare got better? Martin pulls up Drug Channels data, notes the CAA just made transparency table stakes, and lands on the iron law of insurance: bigger risk pools win, and every innovation gets metabolized. In longevity, Superpower's B2B deal with Sequoia, August's $39 a month membership, Neko's 25,000-person New York waitlist, and PE money flowing into Aligned Modern Health. They close with Heidi Health, Corridor, Basalt, Oura's IPO, and Cigna's investor day. Brought to you by Lorikeet is a leading platform health tech companies use to build, test, and deploy AI concierges for patient and provider support. lorikeetcx.ai/healthtech Links referencedCitrini Research, "Agentic Reality" (Sept. 22, 2026): https://www.citriniresearch.com/p/agentic-realityNew York Times article on Blue Cross Blue Shield Association data about hospitals using AI coding: https://www.nytimes.com/2026/09/24/business/ai-hospitals-insurers-health-care-costs.html For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe

Kevin and Martin open with a wild AI story: a personal-assistant app is now negotiating discounts with telehealth vendors on users' behalf, opening up some genuinely strange territory around bots negotiating with other bots. From there it's Oscar's Investor Day: Bertolini's pitch that the individual market is a $350 billion opportunity, the ICHRA/Choice and Lucie marketplace ambitions, and whether any of it holds up against a shakier ACA market and skeptical brokers. Then Alignment Health, down 35% this week during CMS's Stars blackout, and OpenEvidence's confusing week — a $250 million raise at a lower valuation than they reportedly turned down over the summer, plus a surprise pivot into drug development. Quick hits close the show: Thatch's $108 million raise, Walmart's new Scan partnership and pharmacist health-coaching pilot, and RCM moves at Waystar and Datavant. Brought to you by Lorikeet is a leading platform health tech companies use to build, test, and deploy AI concierges for patient and provider support. lorikeetcx.ai/healthtech Links referenced Forbes article on OpenEvidence's $250M raise and Memorial Sloan Kettering partnership: https://www.forbes.com/sites/innovationrx/2026/09/16/a-premier-cancer-hospital-makes-its-data-available-to-doctors-nationwide-through-openevidence/ For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe

Kevin and Martin open on where autonomous clinical AI actually stands post-ARPA-H awards and the Zeke Emanuel conversation. They then discuss whether employer-sponsored insurance is nearing its end — Julie Yoo’s "Great Health Plan Replacement" thesis, Surest, and the CrowdHealth risk-pool debate Next, they dig into Omada's inaugural investor day: the PBM-as-channel go-to-market strategy and updated margin targets now at 80% gross and 30% adjusted EBITDA. From there, InnovAge's Q4 earnings — the company is planning a growth era following two years spent fixing operational issues in California and Colorado, with CEO Patrick Blair flagging unusually strong federal interest in expanding the PACE model beyond dual eligibles. Private markets stay busy: Fullscript's buyout by L Catterton (with a Thorne/P&G footnote), Thyme Care’s $125M round and new "Thyme Companies" parent entity, Forus’s $150M specialty-pharmacy raise, a senior-living round for Inspiren, and Epsilon Health's radiology raise. Brought to you by Lorikeet is a leading platform health tech companies use to build, test, and deploy AI concierges for patient and provider support. lorikeetcx.ai/healthtech Links referenced Conversation with Zeke Emanuel: https://www.healthtechnerds.com/p/autonomous-ai-and-the-future-of-clinical-care-an-expert-interview-with-ezekiel-emanuel-md-phd Julie Yoo on The Great Health Plan Replacement: https://a16z.com/the-great-health-plan-replacement/ Omada Investor Day presentation: https://investors.omadahealth.com/static-files/fbe637ba-7eba-40d3-8829-761b670be4e7 For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe

This week's Grand Roundup is a replay of last week's Health Tech Nerds company presentation: Kevin sits down with Leah Sparks, CEO and founder of Wildflower Health, for a look into the maternal health and women's health market. Leah walks through Wildflower's model — a digital and AI-enabled wraparound care layer that fills the gaps between OB visits for pregnant and postpartum patients, working across payers, providers, and now, following its recent acquisition of Every Mother, direct-to-consumer. She shares two case studies (a retained-placenta catch and a self-harm intervention routed through 988) and the metrics behind the business. The conversation turns to the upcoming unbundling of the global prenatal fee and what it means for cost variation, employer spend, and value-based care. Kevin and Leah also get into the Medicaid-versus-commercial "it can't scale" myth, the case for D2C in maternity care, and where the postpartum journey (and Wildflower's involvement in it) actually ends. Brought to you by Garner uses industry-leading analytics to identify the best-performing doctors and reimburse employees when they see them, helping over 2.5 million people find better care at lower cost. Explore careers with Garner. GarnerHealth.com/careers Apply to attend Differential, an invite-only gathering for 100 of the most promising early-stage health tech founders and builders. differential.healthtechnerds.com For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe

Kevin and Martin are out this week, so TGR is running our Q2 earnings wrap-up with HTN's Sean Leimbach, covering the quarter across the HTN Research coverage universe. First up: AI. Centene's Sarah London gave what Kevin calls “the quote of earnings season” on the risk of spending big with no return, while Astrana pointed to a 210 basis point G&A win and Doximity's stock jumped 30%. From there, it's managed care's comeback: Humana as the sector's bellwether, Centene retreating from markets while Alignment and SCAN (teaming with Costco) push for share, Medicaid MCOs landing rate wins, and Molina stuck in its own little mini death spiral on ACA risk transfer. They also cover a run of confusing stock reactions to beat-and-raise quarters, the employer health boom behind Hinge, Omada, and Virta (plus Hinge's Cylinder acquisition), Hims CEO Andrew Dudum's Squawk Box pitch for a Bluetooth pill box, and Teladoc's BetterHelp cash-pay cliff. They close on hospital softness and ACA headwinds heading into 2027. Brought to you by Garner uses industry-leading analytics to identify the best-performing doctors and reimburse employees when they see them, helping over 2.5 million people find better care at lower cost. Explore careers with Garner. GarnerHealth.com/careers Links referenced The WSJ piece on healthcare as an "AI hedge”: https://www.wsj.com/finance/stocks/healthcare-investing-is-now-an-ai-short-in-disguise-104cb020 Kevin’s interview with Amit Shah, Virta Health: https://www.healthtechnerds.com/p/building-a-durable-metabolic-care-business-in-the-glp-1-era-virta-health-company-presentation-and-q Andrew Dudum's Squawk Box interview: https://www.cnbc.com/video/2026/08/18/watch-cnbcs-full-interview-with-hims-hers-ceo-andrew-dudum.html For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe

Kevin and Martin open on employer health: Bloomberg is asking staff to contribute to health insurance premiums after years of covering 100%, and a new survey shows small employers fleeing the big-three PBMs for centers of excellence and advanced primary care. Then they discuss Aligned Marketplace's $20 million raise and an HRA Council survey showing ICHRA lives roughly doubled year over year. They also talk about a Yale preprint claiming Medicare for All would save a trillion dollars a year — but nobody's grappling honestly with what that means for access and quality. There are lots of private market updates: Pearl Health's admin cost, a STAT investigation into Commure's Athelas unit over referral deals that raise kickback questions, Main Street Health's 533% growth, and Cityblock's new Humana partnership in North Carolina. They close with Hims & Hers earnings, where gross margin slid from 76% to 64% amid a shift to branded GLP-1s, and a managed care quarter where both the shrink-and-focus insurers and the grow-at-all-costs insurers somehow both won. Brought to you by Garner uses industry-leading analytics to identify the best-performing doctors and reimburse employees when they see them, helping over 2.5 million people find better care at lower cost. Explore careers with Garner. GarnerHealth.com/careers Links referenced National Alliance of Healthcare Purchaser Coalitions survey: https://www.nationalalliancehealth.org/news/employers-with-claims-data-access-take-more-action-on-healthcare-costs-national-alliance-survey-finds/HRA Council survey on ICHRA covered lives: https://hracouncil.org/report/Milliman/Society of Actuaries report on DPC cost savings: https://www.soa.org/globalassets/assets/files/resources/research-report/2020/direct-primary-care-eval-model.pdfYale School of Public Health preprint on Medicare for All: https://www.medrxiv.org/content/10.64898/2026.07.22.26358689v1STAT investigative reporting on Commure/Athelas: https://www.statnews.com/2026/08/12/inside-commure-athelas-mad-dash-automate-health-care/Thursday’s live Q2 public markets recap: https://luma.com/3bw3xhq3For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe

Kevin and Martin dig into a busy week of Q2 earnings, starting with Doximity's whiplash quarter. From there they run through then payer calls: Oscar and Clover both grew close to 50% while improving MLR. They discuss Oscar's Oswell radiology agent and Clover's Counterpart licensing play, Hinge Health's investor day excitement and Cylinder acquisition, and Bank of America's $250 million GLP-1 spend. They close on Minneapolis' HCMC bailout, a Denver hospital antitrust standoff, and the current "value-based care is back" moment powered by Vytalize, Agilon, and a wave of new AI-enabled ACO enablers — before previewing Hims' earnings as a bellwether for consumer healthcare affordability. Brought to you by Garner uses industry-leading analytics to identify the best-performing doctors and reimburse employees when they see them, helping over 2.5 million people find better care at lower cost. Explore careers with Garner. GarnerHealth.com/careers Links referenced Bank of America CEO on GLP-1s: https://fortune.com/2026/08/07/bank-of-america-splashing-out-250-million-a-year-on-weight-loss-drugs-for-staff-great-impact-ceo-says/ Challenges for HCMC: https://www.startribune.com/minneapolis-hospital-burned-through-cash-reserves-amid-behind-the-scenes-turmoil/601841297 For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe

Kevin and Martin chat about a packed earnings week: Teladoc's BetterHelp cash pay business fell off a cliff in mid-May, Humana passed its 2026 MA stress test but is still terming 600,000 members from low-star plans to hit its 2028 margin target, Centene raised ACA guidance a week after Molina's "death spiral" quarter, and Centene’s Sarah London's blunt AI cost-management comments drew comparisons to Palantir's Alex Karp. Cigna, Waystar, and Alignment round out the earnings discussion. They then move into private markets: Function raised $450 million in revenue-based financing from General Catalyst's Consumer Growth Fund, Included Health acquired Firefly Health, pairing navigation with an advanced primary care model, and Helia Health raised $14 million on a plan-optimization pitch that Martin calls a short-term arbitrage window rather than a durable business. They close on Iowa's governor's race, where Medicaid managed care itself is on the ballot, and a broader debate about whether the country is drifting back toward fee-for-service. Brought to you by Garner uses industry-leading analytics to identify the best-performing doctors and reimburse employees when they see them, helping over 2.5 million people find better care at lower cost. Explore careers with Garner. GarnerHealth.com/careers For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe

Kevin and Martin kick off with Q2 payer earnings. Elevance's stock fell 11% despite beating estimates because the company signaled Medicaid market exits without giving Wall Street any sizing to work with, while United warned that the No Surprises Act is driving commercial trend higher than expected. They then discuss the OpenEvidence-Doximity documentation fight, with both citing the same study as proof that they’re winning, as well as reports that OpenEvidence turned down a $20B valuation while fielding acquisition interest from a "large tech player.” They close on the physician fee schedule — clearing up the misleading "CMS cuts pay" coverage and walking through the notice-and-comment process — before a rapid walkthrough of recent private deals: Corner Health's staff-free NP clinic model, Bunkerhill Health's $25M raise and the point-solution-versus-platform debate, and Neko Health's eyebrow-raising $7B valuation on eight clinics. Links referenced The Information on OpenEvidence: https://www.theinformation.com/articles/chatgpt-doctors-mulls-new-financing-20-billion-valuation Fortune on Bunkerhill Health: https://fortune.com/2026/07/16/bunkerhill-health-raises-55-million-ai-agents-work-inside-hospitals/ For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe