Dan McCoy, MD
Ignition by RocketTools
Healthcare is getting optimized by AI. But optimized for whom? Ignition by RocketTools breaks down the systems, incentives, and technology reshaping how care gets approved, denied, and paid for — with data, not hype.
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How One Reused Password Cost Change Healthcare $2.5 Billion (Healthcare Security, Part 1) 02.06.2026 9:02
In February 2024, hackers walked into the largest healthcare clearinghouse in America through a Citrix portal that didn't have multi-factor authentication. They used credentials stolen from a previous breach — someone, somewhere, had reused their password. Within hours they had ransomware running. Within days, pharmacies across the country couldn't fill prescriptions. The ransom payment...
The Target Story Isn't About Coupons. It's About Healthcare AI. 29.05.2026 11:28
Twelve years ago, a Target statistician built a model that could predict pregnancy from 25 shopping items. The story usually gets told as a privacy parable. I'm telling it differently — as a preview of how healthcare AI is going to work for the rest of our lives. Your smartwatch can already flag atrial fibrillation days before a cardiologist would. It can detect depression weeks before clinic...
The 9-Person Insurance Company and the Real Line in AI-First Healthcare 28.05.2026 5:59
Y Combinator has a name for it: burn tokens, not headcount. A health insurance company called Decent runs with nine people total. Twofold does revenue cycle management with three. Deep Cura Health handles patient scheduling, prior authorization, and insurance verification with two humans and seven AI agents. The AI-first model is real. It's working. And in healthcare, every one of these compa...
Are the Blues AI-Ready? Blue Cross vs. the Optum Platform Race 21.05.2026 15:47
In March 2026, the Blue Cross Blue Shield Association published research blaming hospitals' AI billing tools for $2.3 billion in added healthcare costs. It was a grievance — not a strategy. And it stands in sharp contrast to 1981, when the same Association faced a national-platform problem and built something: BlueCard, the shared claims-routing layer that turned 36 independent regional plans...
The Hospital Cost Crisis: How Washington Banned Cheaper Care 20.05.2026 9:59
You've been told American healthcare is expensive because of greedy insurers, pharma profits, or the cost of innovation. That story is incomplete to the point of being misleading. The largest single driver of US healthcare spending isn't drug companies — it's hospitals. And hospital prices haven't merely risen; they've grown roughly 3x faster than overall inflation since 2...
Is Your Local Hospital Doing Exactly What Musk Says OpenAI Did? 10.05.2026 18:32
There's a billionaire fight happening in an Oakland federal courtroom right now. The headlines are calling it Elon Musk versus Sam Altman—tech titans, AI drama, billions at stake. But here's what almost nobody is telling you: if Elon wins this case, the next phone call won't be from Silicon Valley. It'll be from the general counsel's office at every nonprofit hospital in A...
21st Century Cures, 20th Century Accounting: Why a $3M Gene Therapy Just Broke Insurance 04.05.2026 12:27
A 6-month-old named KJ Muldoon just received the first personalized CRISPR gene therapy ever made — designed, manufactured, and administered for his exact mutation in six months. Nature named him to the Top 10 People Who Shaped Science of 2025. The miracle is real. The financing model isn't. Gene therapies run $2M to $3.5M each. Insurance contracts are annual. Gene therapy benefits last a li...
Med Students Are Choosing the Wrong AI Specialty 30.04.2026 17:30
If you're a medical student picking a specialty in 2026, you're being asked to bet a decade and $300,000 in debt on a market nobody is teaching you to read. This episode is the framework I wish someone had given me — plus the data nobody else is putting in front of med students. In this episode: • Why 76% of all FDA-cleared medical AI targets a single specialty — and why residency applic...
Nobody In The MultiPlan Lawsuit Is The Good Guy 26.04.2026 11:46
Last week the Texas Medical Association joined a federal antitrust lawsuit against MultiPlan — recently rebranded as Claritev. The story being told is doctors versus insurers, an unlawful cartel, $19B in alleged underpayments. It's a clean story. The moment you look at the actual fee math from the complaint, it falls apart. In this episode I walk through MDL 3121, the $1,000 → $200 cascade, t...
The Stop-Loss Crisis: Why Your Safety Net May Have a $4 Million Hole 23.04.2026 13:36
49% of plan sponsors reported claims exceeding $1 million last year — double the rate from the year before. And stop-loss carriers are responding not by covering you better, but by finding creative ways to limit their exposure to the most expensive treatments. In this episode, I break down: → Why stop-loss insurance was built for a different era (when catastrophic meant $300K, not $4.25 million) →...
Karpathy's $0.35 AI vs. Your Benefits Broker's 20 Hours 20.04.2026 11:30
Andrej Karpathy just released AutoResearch — a 630-line Python tool that lets AI agents run hundreds of experiments overnight on a 35-cent GPU rental. In one test, 35 autonomous agents completed 333 experiments while everyone slept and found 20 improvements that worked. No humans involved. Meanwhile, your benefits broker spends maybe 20 hours on your entire annual renewal — most of it pulling quot...
How to Build an AI Startup with Other People's Money 19.04.2026 11:54
The AI labs are selling you $10,000 a month in computing power for $600. They're doing it at massive losses. And they have very specific reasons you should understand. In this episode, I break down the $670B subsidy era fueling healthcare AI — what it means for builders, when it ends, and four strategies to exploit it before the economics correct themselves. We cover: Why AI pricing follows t...
Amazon Just Put a Doctor in Your Shopping Cart 09.04.2026 5:37
Amazon launched an AI health agent inside the Amazon Shopping app — the same app where you order paper towels. It books appointments, manages prescriptions, explains lab results, and connects you to real doctors. Prime members get five free virtual care visits covering 30+ conditions. This isn't a chatbot experiment. Amazon built this on Bedrock using a multi-agent architecture with auditor a...
Hacking DNA: What Anthropic's Mythos Model Means for Medicine 08.04.2026 2:37
Anthropic just announced Claude Mythos Preview — an AI model so capable at finding software vulnerabilities that they won't release it publicly. Instead, they launched Project Glasswing with Apple, Google, Microsoft, and others, committing $100M to use the model defensively. In weeks, Mythos found thousands of zero-day vulnerabilities across every major operating system and browser — includi...
The Injection Economy: When AI Whispers in Your Ear 06.04.2026 11:18
Meta acquired Moltbook. OpenAI put ads in ChatGPT. Microsoft found 31 companies actively poisoning what AI assistants recommend. Everyone's calling it AI-native marketing — but what they're really describing is an influence mechanism with no disclosure, no regulation , and direct access to how people make decisions. In this episode, I break down Microsoft's AI Recommendation Poisoni...
Why Healthcare AI Keeps Failing — It's Not the AI, It's the Integration 29.03.2026 6:56
What's really happening with AI in healthcare? The common story is that health systems just need to find the right tool — the best ambient scribe, the smartest chatbot. But the reality is more complicated. In this episode, I break down why Sutter Health's AI agent deployment through Hyro tells us everything about where healthcare AI is actually heading, why 63% of healthcare leaders say...
Tele-Doom: Why AI Is Rewriting the Future of Telehealth 27.03.2026 11:14
The telehealth boom was supposed to revolutionize healthcare forever—but what went wrong? In this episode, Dan McCoy unpacks the dramatic fall of industry giants like Teladoc and Amwell, revealing how their high-profile bets on nationwide distribution networks failed to stand the test of time. More importantly, you'll hear why the real disruptor isn’t a return to in-person care, but the explo...
The Network Arbitrage Game: How Employers Are Overpaying for Healthcare 20.03.2026 10:52
Most employers think they're getting a deal on healthcare. They're not. The exposed rate data tells a different story — one where the same knee replacement costs wildly different amounts depending on which hospital and which network you're in, even within the same city. In this episode, I break down the network arbitrage game: how hospital systems use their leverage to extract premi...
When AI Knows the Diagnosis But Misses the Action 19.03.2026 3:23
Mount Sinai just published the first independent safety evaluation of ChatGPT Health — and the findings should change how you think about AI in healthcare. Published in Nature Medicine, researchers ran 960 patient interactions across 21 medical specialties. What they found wasn't that ChatGPT gets medicine wrong. It's that it gets the diagnosis right, then tells you to do the wrong thing...
The 15% Trap: How a Single Number Broke Healthcare Pricing 12.03.2026 20:37
Mark Cuban's Cost Plus Drug Company sells a cancer drug for $47 a month. That same drug often costs well over $2,000 at your pharmacy. Both include a 15% markup. The markup is the same — the price is dozens of times higher, and nobody's asking why. In this episode, I break down why percentage-based pricing is the single most inflationary structural design choice in American healthcare. N...
What AI Prior Authorization Actually Looks Like — And Why It Will Demand More From Providers, Not Less 10.03.2026 20:58
Everyone's pitching AI as the solution to prior authorization . And they're right — the technology is about to solve it. Ambient scribes capturing every detail. Clinical decision support guiding every order. Automated systems submitting perfectly optimized requests. Approval rates heading toward the high 90s. But here's what nobody's talking about: what happens to healthcare co...
Are Tokens the New RVU? Why Healthcare's Measurement System Is About to Break 06.03.2026 11:46
What if the way we measure a doctor's productivity is completely wrong? Software companies have already abandoned "lines of code" as a productivity metric — they now budget in tokens, the fundamental unit of AI work. Some developers spend $10,000-20,000 a month on AI agents. Microsoft says 30% of its code is AI-written. The old measurements are dead. Meanwhile, healthcare is still s...
AI, Healthcare Privacy, and the Pentagon: Why HIPAA Can't Protect You Anymore 04.03.2026 8:07
The Pentagon just labeled Anthropic — the company behind Claude AI — a national security supply chain risk. Not because they're a foreign adversary. Because they refused to remove two guardrails: no mass surveillance of Americans and no autonomous weapons without human oversight. The $200 million contract is canceled. The Trump administration ordered every federal agency and defense contracto...
Your Rural Clinic Is a Hacker's Easiest Target 03.03.2026 7:10
The common story about healthcare cybersecurity is that big hospital systems are the targets. The reality is more complicated. Rural America is ground zero — and the math is brutal. The Change Healthcare attack knocked out 50% of all U.S. medical claims processing. 80% of physician practices lost revenue. 300 hospitals didn't even apply for federal relief — mostly small and rural. But that wa...
$60M to Replace Benefits Brokers. The Disruption Is Here. 01.03.2026 9:55
Gyde just raised $60 million to build the first AI-native insurance brokerage. Not a tool for brokers — a replacement for the brokerage model itself. Led by Lightspeed, backed by Optum Ventures, founded by a 10-year Oscar Health veteran. In this episode, I break down three things: First — what Gyde actually is and why this isn't another SaaS platform. They're acquiring agencies and rebui...
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