Podnosis

It’s no secret that health insurance is among the most complex parts of healthcare. With many parties involved, and evolving approaches to plan design, patients today are often confused and frustrated by their billing experience. Some health tech companies, like Inbox Health, help providers communicate more proactively with patients about what they might owe and what repayment options are available to them. To explain the current trends in patient billing, senior writer Anastassia Gliadkovskaya chats with Inbox Health’s co-founder and CEO Blake Walker. To learn more about the topics in this episode: Consumer Financial Protection Bureau shake-up leaves medical debt reform in limbo Why one New York health system stopped suing its patients Federal watchdog warns medical debt collectors off illegal tactics See omnystudio.com/listener for privacy information.

Digital health venture capital funding cooled off in 2024 following the fever pitch of investment from 2020 to 2022. But investors still see bright opportunities for the sector. Digital health startups banked $10.1 billion in venture funding in 2024, down from $10.8 billion in 2023 but higher than 2019's funding total. Several key trends shaped digital health investment in 2024: a handful of large, more established players dominated healthcare innovation headlines and heavyweight investors drove sector dealmaking. Investors focused on earlier-stage funding and pulled back on later-stage check sizes, according to Rock Health’s year-end report. Executive editor Heather Landi sits down with Sari Kaganoff, chief commercial officer at Rock Health, to discuss the digital health sector's performance last year and the trends that will shape venture funding in 2025. To learn more about the topics in this episode: Digital health venture funding hit $10.1B in 2024 as investors focused on earlier-stage dealmakingFierce Healthcare Fundraising Tracker—Zoom invests in Suki; Bicycle Health nabs $16.5MDigital health leaders bracing for capital investment boom in 2025. Here's how execs view the economic outlook2024 a mixed bag for health tech venture capital: HSBC reportGeneral Catalyst teams up with AWS to co-develop, deploy AI-driven solutionsSee omnystudio.com/listener for privacy information.

Health tech experts and leaders descended on Nashville last week to discuss the biggest challenges and opportunities facing the digital health sector. Senior Editor Heather Landi, Senior Writer Paige Minemyer and Staff Writer Emma Beavins were on-site for several days of panels, meetings and deep dives. This week, they sit down to take a look back at the trendiest topics from the show floor. (Hint: It’s AI, of course). To learn more about the topics in this episode: ViVE 2025 roundup: Lumeris unveils AI tech for primary care; DoseSpot's latest Rx transparency toolViVE 2025: Where Humana's CenterWell team is exploring the promise of AIViVE 2025: Cleveland Clinic rolls out Ambience's AI for doctors after testing scribe technologiesViVE 2025: Abridge scores $250M, adds new AI tool to streamline 'billable notes'ViVE 2025: Highmark taps Sword Health for pelvic health programViVE 2025: MultiPlan unveils rebrand as it shifts focus to data assets, tech for providers, payers and employersViVE 2025: UPMC Enterprises has AI on its radar as it launches new testing environment for developersSee omnystudio.com/listener for privacy information.

Over the past decade, emergency room visits for mental health-related needs have soared. But the ER is often not the only option for treatment. Certified community behavioral health clinics, or CCBHCs, provide evidence-based care for mental illness and substance use disorder. There are hundreds of these centers around the U.S. today. Fierce Healthcare’s Anastassia Gliadkovskaya speaks to Chuck Ingoglia, president and CEO of the National Council for Mental Wellbeing, about the CCBHC model, how it works and what it takes for states to participate. To learn more about the topics in this episode: Survey: Opportunities for tech investments in behavioral healthLearnings from Indiana's behavioral health system overhaulAvel eCare to offer virtual behavioral health services to people in crisis in North DakotaAI in action: Enhancing suicide risk detection in behavioral healthHLTH24: A look at outcomes in Highmark's new behavioral health programSee omnystudio.com/listener for privacy information.

Women make up half the U.S. population and make most healthcare decisions. Yet only 2% of VC dollars go toward women’s health. A recent report, released at this year’s J.P. Morgan Healthcare Conference, lays out the high-growth potential of the women’s health market and its promised return on investment. The report was published by nonprofit Women’s Health Access Matters (WHAM) and KPMG. Fierce Healthcare’s Anastassia Gliadkovskaya speaks to two leaders involved: Carolee Lee, founder of WHAM, and KPMG U.S. healthcare sector leader Ash Shehata. They walk through the details of the report’s findings and explain how the investment community is increasingly rallying around women’s health. Read the full report here. To learn more about the topics in this episode: JPM25: First Lady Jill Biden committed to improving women's health as White House tenure winds down New collective of women's health companies aims to scale access to specialty care True change 'requires investment': Healthcare leaders react to new $250M Gates fund for women's health HHS announces $27.5M in funding to address women's behavioral health needs See omnystudio.com/listener for privacy information.

With the election over and President Donald Trump officially inaugurated, all eyes in healthcare are turning toward how the sector might change. But as the first two weeks of his second term showed, keeping up with Trump’s actions—and their ramifications—requires full-time focus. In this episode, Fierce Healthcare’s Noah Tong speaks with health policy expert Andrew Schwab to help us break through the noise on Capitol Hill and better understand Republicans’ upcoming legislative priorities. Schwab is founder and CEO of health policy and advocacy firm Platform Government Strategies. Schwab gives his thoughts on the likelihood of Medicaid cuts in a reconciliation bill, his views on the Department of Government Efficiency (or DOGE) and potential areas of bipartisan agreement. To learn more about the topics in this episode: How Trump's DEI executive orders could impact healthcareHow the DOGE agenda could impact Medicaid, veterans' healthcareStates, nonprofits secure sweeping temporary restraining orders against Trump's federal assistance 'pause'What Trump's busy first week means for healthcare: AI policy shifts, HHS comms blackout, patient protections and moreAs Trump puts federal spending in crosshairs, KFF survey finds Medicare, Medicaid remain popular with votersSee omnystudio.com/listener for privacy information.

Another year at the J.P. Morgan Healthcare Conference is in the books. Fierce Healthcare’s Executive Editor Heather Landi and Senior Writer Paige Minemyer made the trek to San Francisco and after the event, sat down to discuss the biggest themes coming out of the conference. While major payers skipped out on attending this year, health tech companies, health systems and insurtechs all made appearances to share their latest updates with investors. In this episode, we’ll also share more about Heather’s fireside chat with former First Lady Jill Biden at Fierce JPM Week, where they dived into her efforts around women’s health. If you missed the event, check out the sessions on demand here. To learn more about the topics in this episode: JPM25, Day 1: CHAI launches working group on use of AI for prior auth; IU Health's focus on team culture JPM25, Day 2: News from Nvidia, Tempus AI and Health Catalyst; A look at Children's Health Dallas' expansion plans JPM25 Day 3: Why 2025 will be a hot year for M&A; Talkspace rolls out new AI-powered tool for therapists JPM25: A look inside Advocate Health's Rewire 2030 strategJPM25: CommonSpirit Health says focus on 'systemness' is driving financial, quality gainsJPM25: Teladoc sees virtual chronic condition management as a key growth driver, joins Amazon's health benefits programJPM25: Checking in with Morgan HealthJPM25: First Lady Jill Biden committed to improving women's health as White House tenure winds down'Own JP Morgan, don't let JP Morgan own you': Biopharma—and Jill Biden—show up for JPM25See omnystudio.com/listener for privacy information.

The U.S. is in the throes of a mental health crisis. Deaths from drugs, alcohol and suicide more than doubled between 2000 and 2017 and continue to rise. As the largest payer of behavioral health services in the country, Medicaid is crucial to serving society’s most vulnerable. But the infrastructure and funding for these services varies by state. Indiana, which had ranked low in national mental health rankings, established a behavioral health commission in 2020. The group was charged with improving the state’s infrastructure and outcomes in mental health. Jay Chaudhary, then the director of the Indiana Division of Mental Health and Addiction, led that effort. In today’s episode, he takes senior writer Anastassia Gliadkovskaya through the overhaul, lessons learned and potential future policy threats to care access. Chaudhary is currently a senior fellow for mental health and community wellness at the Sagamore Institute, a nonprofit, nonpartisan think tank. He also writes a Substack newsletter, Favorable Thriving Conditions. To learn more about the topics in this episode: One year of 988: The crisis hotline's successes and challengesCityblock Health teams with MDwise to open health hubs in IndianaSee omnystudio.com/listener for privacy information.

Price transparency has been a regulatory priority over the past several years. While providers have had time to adapt and adjust, there remain common challenges that many run into as they look to comply with regulatory requirements. Senior writer Paige Minemyer sat down with Turquoise Health’s AVP of Channel Sales Joe Wisniewski to outline these challenges, how hospitals can get ahead of the curve and lessons that payers can take away as regulations tighten for them, too. To learn more about the topics in this episode: Transparency has led to uniformity in healthcare costs—but not necessarily lower prices: white paperPrice transparency startup Turquoise Health picks up $30M series B fundingHospital, payer price transparency compliance improves, but new requirements are kicking in this yearGAO wants CMS to check whether hospitals' price transparency data are actually usable'It isn't normal to operate the way they do': Senators condemn healthcare's resistance to price transparencySee omnystudio.com/listener for privacy information.

Fierce Healthcare hosted the second annual Fierce Health Payer Summit in November. Top leaders and decision-makers in the healthcare and payer industry convened in Austin, Texas, for two days of discussions. During the event, Fierce’s Emma Beavins interviewed several panelists on the show floor about what they think the ideal payer of the future looks like. In this episode, you’ll hear about improving the member experience, reforming prior authorization and leveraging AI. The speakers featured in this episode are: Alex Azar, former Health & Human Services secretary Tanvi Patel, general manager and director of Amazon Pharmacy Michael Anne Kyle, associate professor of health policy at the University of Pennsylvania Ed DeVaney, president of employer & health plans at CVS Caremark Brian Kim, CEO of HighRoads See omnystudio.com/listener for privacy information.

Heather Cox, president of insights and empowerment at Zelis, discussed the challenges of achieving interoperability in healthcare during a recent podcast. She highlighted technical issues, diverse stakeholder needs and data silos as key obstacles. Cox emphasized the importance of real-time, secure data for payer-member engagement and suggested APIs as a promising solution. She also advised health plans on choosing technology partners and advocated for a data-centric approach to improve patient care. Listen to the podcast to learn more. See omnystudio.com/listener for privacy information.

Our early experiences as kids have a lasting impact on our health and wellbeing. From facing adverse childhood experiences to various social needs, kids are especially vulnerable to their environment, as their brains are still developing. Schools play a crucial role in helping to support kids. However, our education system today does not do enough to equip children to understand their mental wellbeing and emotions. So argues Jessica Gomez, Psy.D., a bilingual psychologist in Texas. Gomez is executive director of Momentous Institute, a nonprofit offering mental health services and operating an elementary school in Dallas. In this week's episode of "Podnosis," Gomez walks Fierce Healthcare's Anastassia Gliadkovskaya through the importance of integrating social-emotional learning into education and how doing so early on can have lifelong benefits. To learn more about the topics in this episode: California is funding managed care plans to bring mental healthcare to schools. Here's how it's goingExperts weigh in on how to tackle growing teen mental health crisisEvernorth: How employers can take the lead on addressing youth mental healthCigna taps first 22 awardees in grant program targeted for youth mental healthSee omnystudio.com/listener for privacy information.

Join us for an insightful conversation with Dr. Heather Bassett, Chief Medical Officer at Xsolis, as she shares her unique journey from practicing hospitalist to healthcare technology innovator. With over 20 years of healthcare experience, Dr. Bassett discusses how AI is transforming healthcare administration and reducing clinician burden. Drawing from her background in both medicine and technology, Dr. Bassett offers practical insights on AI implementation, navigating the generative AI hype cycle and the regulatory landscape ahead. She also shares her vision for a healthcare system where technology enhances rather than hinders the patient-provider relationship, and provides valuable perspective on maximizing ROI from AI investments in healthcare. Elsewhere, Dr. Bassett delves into Xsolis' approach to AI adoption since 2015, discussing how the company has moved beyond traditional machine learning to embrace generative AI responsibly. Here, she shares important considerations for healthcare organizations looking to invest in AI, emphasizing the need for strong leadership, comprehensive change management and patience in achieving results. Whether you're a healthcare professional, technology leader or interested in the future of healthcare, this podcast offers essential insights into the responsible adoption of AI in clinical settings. Tune in now! See omnystudio.com/listener for privacy information.

Interoperability has been a major focus in healthcare for the past decade. It is crucial for systems to be able to talk to one another. A patchwork of laws allow for health data sharing today through electronic health record systems and health information exchanges. But some states believe there are situations where sharing sensitive health data may actually do more harm than good. Since the overturning of Roe v. Wade, Maryland has been thinking deeply such scenarios and to that end, passed a law to protect reproductive health data. To understand it, Anastassia Gliadkovskaya speaks to Nichole Sweeney, general counsel and chief privacy officer of the state’s designated HIE, CRISP Shared Services. See omnystudio.com/listener for privacy information.

American Specialty Health Incorporated's ASH Care fall prevention program offers virtual assessments and exercise regimens to address falls among older adults. The program combines remote physical therapist evaluations, personalized exercise plans and coaching to improve balance and strength while reducing fall risks. Initial results show 60% to 75% of participants experienced improvements in outcome measures, with statistically significant gains in balance, strength and reduced fear of falling. ASH Care aims to enhance older adults' health and independence while potentially lowering healthcare costs associated with fall-related injuries. See omnystudio.com/listener for privacy information.

The National Committee for Quality Assurance (NCQA) has long prioritized quality in healthcare, but the COVID-19 pandemic underscored the critical role of equity as a cornerstone of quality. In recent years, NCQA has refined its HEDIS measures to be more inclusive and to better address sociodemographic factors that influence health outcomes. In this week's episode of "Podnosis," Rachel Harrington, Ph.D., assistant vice president of health equity sciences at NCQA, shares insights into the organization’s efforts to measure and improve health equity. She discusses the importance of collecting race and ethnicity data to identify and address disparities, the challenges and progress in data collection and upcoming changes to HEDIS measures in 2025. To learn more about the topics in this episode: NCQA released its annual health plan ratings. Here's how payers faredHow incentives engage and keep patients healthy How providers are leveraging patient engagement tools to close gaps in cancer screeningsSee omnystudio.com/listener for privacy information.

Cyberattacks against healthcare organizations are becoming increasingly sophisticated, with new threats constantly emerging. In this week's episode of "Podnosis," we dive into one of the latest tactics: voice phishing, or vishing. This form of cyberattack uses AI to impersonate voices over the phone to gain unauthorized access to sensitive information. Fierce Healthcare's Anastassia Gliadkovskaya interviews Nametag CEO Aaron Painter, who explains what vishing is, why it's a growing concern, and how organizations—especially in healthcare—can protect themselves. To learn more about the topics in this episode: Disruptive cyberattacks against healthcare on the rise, with increasing impacts to patient care, survey finds100M people impacted by massive Change Healthcare cyberattack: OCRProviders and payers ramp up investments in cybersecurity, AI in 2024Change Healthcare begins breach notifications to firms with impacted members, patientsCybersecurity lessons from the Change Healthcare hackSee omnystudio.com/listener for privacy information.

In this week’s episode of “Podnosis,” we’re diving deep into the current landscape of clinical trials in the U.S. Various stakeholders face a complicated web of challenges in the system. Many patients, particularly from marginalized groups, struggle to find and get into trials. Meanwhile, with the acceleration of decentralized trial sites throughout the COVID-19 pandemic, some research programs are struggling to keep up financially. Between specialized technology, staffing and compliance measures, there’s a lot that goes into ensuring success. And unfortunately, these hardships are enough to turn some physicians away from clinical research. Alexander Saint-Amand is the co-founder and CEO of Topography Health, a company focused on helping medical practices and health systems conduct trials at scale. In this episode, he chats with Fierce Healthcare’s Anastassia Gliadkovskaya about what he sees as lacking in the industry today and what it will take to build out trust and capacity for the future. To learn more about the topics in this episode: HLTH24: Atropos Health unveils chat-based AI co-pilot for real-world evidenceDandelion Health launches AI marketplace for model validation, use in clinical trialsWalgreens eyes 'tremendous growth' for clinical trials as part of transformation strategySee omnystudio.com/listener for privacy information.

Introducing new technology in the healthcare sector can be a challenge, especially when trying to balance innovation and practical application. Startups developing products for a complex ecosystem, like a hospital, may not fully understand the needs of providers on the frontlines and all the dynamics at play. A successful tool should not only address a need but also make it possible for providers to integrate into their workflow seamlessly. To help unpack this, Fierce Healthcare’s Anastassia Gliadkovskaya spoke to Kevin Baumlin, M.D., at the University City Science Center, where he helps founders refine their products and find the right fit within health systems. Baumlin knows firsthand that a meaningful development and implementation process includes providers from the get-go. He breaks down what this type of partnership ideally looks like and gives examples of collaboration in action. To learn more about the topics in this episode: ViVE 2024: Health systems are making big bets on AI. Here's howMount Sinai launches health tech incubator, names clinical decision support startup avoMD as its first participantTaking a page from consumer-facing tech, Providence launches startup to modernize patient engagementSee omnystudio.com/listener for privacy information.

More than one million women reach menopause each year in the U.S. Menopause can bring on many unwanted symptoms and increase the risk of chronic conditions, affecting a woman’s health and quality of life. Yet many report feeling uncomfortable talking about this challenging transition in the workplace and with their healthcare providers. Many also struggle to find relief for their symptoms. Experts say employers and providers should be doing more to care for women in midlife. To close out October, Menopause Awareness Month, Fierce Healthcare’s Anastassia Gliadkovskaya sat down with Kathleen Green, M.D., an OBGYN at Maven Clinic. Like many other physicians, Green did not get formal training on menopause in medical school. She had to learn how to help women through this natural part of aging. In the episode, they discuss why the status quo is not working and what it will take to improve the system. To learn more about the topics in this episode: HLTH24 Day 2: Halle Berry wants to change the dialogue on menopauseHLTH24: Jill Biden announces $110M ARPA-H funding award, prods industry to invest in women's healthMenopause care is still a largely untapped market. Here's why investors and startups should dive inIndustry Voices—Menopause is making headlines. Are healthcare workers keeping up? See omnystudio.com/listener for privacy information.