Health Tech Nerds Radio

News & Analysis from Health Tech Nerds   - Anthropic partnered with Blackstone, Goldman Sachs, and a roster of the world's largest asset managers to launch an enterprise AI services firm, a straightforward move to speed adoption of the technology by addressing the implementation bottleneck. - Devoted Health CEO Ed Park made a bold statement at the Medicarians conference, "Please pay MA plans l...

Amanda Rees, CEO and Co-Founder of Bold, joins to discuss Bold's AI-powered healthy aging platform and how CMMI ACCESS fits into a model the company has already been building in Medicare Advantage. Bold started with falls prevention and has expanded into chronic condition support, weight management, and musculoskeletal pain — delivered digitally and without requiring additional devices. The conver...

Patrick Keavy and Rebecca Springer from Bailey & Company join following the Medicarians conference and the release of their MA brokerage market report. Patrick walks through how the 606 accounting change in 2019 reshaped the MA brokerage market by requiring brokers to recognize lifetime commission value upfront. Combined with rapid MA enrollment growth, this inflated EBITDA in ways that didn't...

Neil Batlivala, CEO and Founder of Pair Team, joins to discuss how Pair Team provides AI-powered care management for safety net populations, addressing social needs alongside clinical care through a virtual medical group model and partnerships with social care providers. The conversation centers on how Pair Team is thinking about CMMI ACCESS. Neil describes the rates as a feature, not a bug; CMS d...

Alli Oakes, Chief Research Officer at Trilliant Health, walks through Trilliant's behavioral health report across demand, supply, and emerging treatments. On demand, roughly one in four Americans is affected by a mental or behavioral health condition, and untreated costs extend well beyond direct care — unmanaged behavioral health issues exacerbate physical conditions and drive expensive downstrea...

Kevin and Martin open on a busy first week of healthcare earnings, where a January snowstorm and collapsing respiratory volumes turned out to be a bigger driver of HCA's quarter than ACA expiration or state directed payments combined. They cover Elevance's nearly billion-dollar accrual on the flash drive saga, Molina's marketplace MLR optics, and the rising patient-pay dynamic Cedar flagged on Lin...

Hospice and palliative care remain widely misunderstood and underused, leading many seriously ill patients in their final year of life to endure unmanaged symptoms, little advance care planning, and avoidable ER visits and hospitalizations.  Empassion CEO, Robin Heffernan, explains supportive care, distinguishing palliative care (any stage) from hospice (typically the last six months), and describ...

Russell co-founded Yuzu as a health plan before pivoting to become the infrastructure layer powering alternative health plans. He walks through what the team learned building a plan from scratch: that technology alone doesn't differentiate, that the employers most in need aren't startups but cost-pressured blue-collar businesses, and that the real opportunity was in powering the plans already winn...

Patrick Sheehan, VP of Value-Based Care at Withings, walks through why a connected device company sees the CMMI ACCESS opportunity differently than pure digital health players. For Withings, the device is the core cost structure, which changes the rate math entirely. Plus, their existing relationships with ACOs and health systems give them a coordination foundation that most ACCESS applicants are...

Shiv Rao, CEO and Co-Founder of Abridge, walks through how the company is expanding beyond AI scribing following new partnerships with JAMA and NEJM. He frames the expansion around a pre-visit, during-visit, and post-visit product framework, using the context captured across the full clinical encounter to surface relevant evidence and close workflow gaps at the right moment. The conversation cover...

Neel Shah, Chief Medical Officer at Maven Clinic, breaks down one of the most consequential and underreported changes in healthcare payment: the end of the global maternity care bundle. For roughly 40 years, pregnancy and childbirth were paid for as a single bundled payment. Starting January 2027, care will be paid for through individual CPT codes. Neel walks through why the bundle is ending. Team...

Kevin and Martin open with the CMMI ACCESS participant list. Roughly 150 applicants, but many original interested parties opted out presumably over rates, raising real questions about whether digital health can build a sustainable model at current payment levels. They also cover the FDA's peptide deregulation signals, and a price transparency study showing providers raised prices post-implementati...

Sidecar Health's approach is different from traditional health plans: set a fair price for every service and drug, give members that budget upfront, and let them keep a portion of the savings if they come in under it or pay the difference if they go over. Nancy Wang and Craig Allen, who lead strategy and actuarial at Sidecar, walk through how that model works, from the actuarial complexity of pric...

Will Gordon, senior advisor at Manatt Health and former CMMI Chief Informatics Officer, explains CARA (a voluntary component of the ACO REACH/LEAD model starting in 2027) and why it matters for value-based care in specialties.  He outlines three converging themes: episode-based bundles—especially surgical/orthopedic—have shown savings (often from post-acute care); ACOs have struggled to operationa...

Conor Green of Truehelm (formerly TT Capital Partners) joins to discuss the firm’s rebrand, its healthcare-only growth equity/growth buyout strategy, and current market dynamics. He outlines Truehelm's focus on founder-owned, tech-enabled services businesses selling to hospitals, health plans, employers, and life sciences, often bootstrapped and “skipping venture."  Conor and HTN cover today’s val...

Andrea Ippolito joins Health Tech NErds to discuss SimpliFed’s $10.8M Series A and how the company is expanding from virtual breastfeeding and baby-feeding support into a broader virtual OB model.  She explains SimpliFed’s insurance-covered care model across commercial, Medicaid, and TRICARE; its go-to-market strategy through health plans plus provider enrollment and integrations with OB/GYN workf...

Gabe Drapos, Pearl Health COO and coauthor of the paper informing the LEAD Model, broke down LEAD, the successor to ACO REACH launching in 2027, framing it as a hybrid of REACH and MSSP. Three key changes: bringing specialists formally into total cost of care models for the first time; collapsing the standard and high-needs tracks so ACOs don't have to choose; and piloting AI-inferred risk adjustm...

The Grand Roundup | April 13, 2026 Kevin and Martin unpack the MA final rates reaction (2.48% and what it means for plans cutting benefits), break down ACO LEAD with Pearl Health's COO Gabe Drapos, and get the inside story on CARA, the specialist bundle component inside LEAD. Plus: Teladoc's activist investor drama, TrueHelm's growth equity thesis, Blues consolidation inadvertently accelerating, a...

This week, Martin takes a step back and look at the early GLP-1 era—where the drama is coming from, how costs are reshaping coverage, and why the care model around these drugs matters as much as the molecule itself.  Evan Richardson, Founder and CEO of Form Health, shares how his time at Castlight and Grand Rounds/Included Health shaped a thesis that higher-quality care drives better outcomes and...

Martin welcomes Chris Johnson (Co-Founder and CEO) and Dr. Michael Glazier (CMO) of Bluebird Kids Health to discuss worsening U.S. child health trends and what better pediatric care could look like, especially for Medicaid populations.  They note that about half of U.S. children are covered by Medicaid/CHIP and describe how lower Medicaid reimbursement contributes to pediatric “care deserts,” wors...

On Health Tech Nerds Radio, Kevin interviews Medicare Director Chris Klomp about the 2027 Medicare Advantage final rate notice, which came in at a 2.48% expected average change versus 0.09% in the advance notice, after 40,000+ comments and updated cost data.  Chris explains the roughly 40 bps increase, continued normalization of coding risk patterns, a delay in further model updates given V28’s ea...

Neil Machhar , CEO of Greenbrook Medical , makes the case that despite near-term pressure, now is actually a compelling time to build in Medicare Advantage. Drawing on a long-term view of the market, he argues that recent policy changes are less about breaking MA and more about “rationalizing” a program that grew rapidly during a period of generous funding and benefit expansion.  As CMS pulls doll...

HTN hosts Kevin and Martin discuss the anticipated Medicare Advantage rate notice day and dig into CMMI’s new 10-year ACO LEAD model, focusing on CARA, inferred risk, and changes aimed at reducing gaming in provider attribution.  The conversation shifts to state Medicaid budget pressure, with Idaho and Colorado cutting provider reimbursements and limiting coverage programs, raising questions about...

Kevin interviews Sam, Co-Founder and CEO of Oshi Health, about the GI market and the Peterson Health Technology Institute report, which found clear savings for GI solutions focused on IBS and IBD.  Sam explains the difference between wraparound programs and clinician-led models that can diagnose and prescribe, noting GI access shortages and that many counties lack gastroenterologists. He describes...

Psychiatry still relies heavily on medication management and talk therapy, leaving many patients—especially those with treatment-resistant depression—cycling through SSRIs without response, despite FDA-approved options like TMS (approved 2008) and Spravato/esketamine (approved 2019) that show roughly twice the effectiveness versus standard treatments.  Ben Kuhn, co-founder and CEO of Everbright He...