Maeve (O'Meara) Duke

At HLTH a few weeks ago, I found the employer channel surprisingly light on attendance and discussion — yet nothing could be clearer: the employer channel remains a critical access point for health coverage for most Americans. According to the Kaiser Family Foundation (KFF), employer-sponsored health insurance is the single largest source of coverage for Americans under 65, covering about 60.4% of that population (source: KFF Health System Tracker). That means approaching the employer channel the right way really matters. Cost pressures continue to create opportunities in this channel: • Average family premium for employer-sponsored coverage in 2025: $26,993, up ~6% from prior year (KFF) • Workers’ average annual contribution toward that: $6,850 (KFF) • Employers facing projected cost increases of ~9% (driven by drugs, specialty care, utilization) (WSJ/benefits consulting commentary) Given those pressures, the value proposition and low-friction implementation becomes more important than ever. Employers are not just looking for new benefit models; they’re looking for ones that integrate easily, drive measurable value, and address the high-cost levers. In conversations at HLTH, I heard many themes that we've been thinking about for years: • Managing high-cost drug trends (especially specialty / novel therapies) and high-cost conditions. • Exploring new benefit models and pricing structures: DPC (direct primary care), dynamic co-pays, reference-based pricing. • Since existing point solutions are increasingly expanding scope, what really stands out are differentiated solutions that have no other comparables in market. The employer channel may not have been top of mind at the conference, it is very much alive and evolving — especially for those who offer differentiated value and efficient implementation. Current portfolio companies worth watching: • RxSaveCard – Enabling employers to access cash-prices for prescription medications (e.g., over 65,000 pharmacies) without changing their PBM, helping reduce cost and improve employee out-of-pocket burden. (Which just had an exciting fundraising announcement today!) • Posterity Health – Leading men’s health platform (fertility, hormone/Low T, preventive) that is offering employer-integrated benefit services; investing $1 in male fertility is shown to return $2.3 in savings in female fertility. • Tuned – A digital hearing-health company offering employer-sponsored hearing care benefits, hearing conservation programs and virtual access to licensed audiologists, which helps address workplace health, safety and cost issues.

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If you’re building a health tech startup, here’s a useful perspective from the accelerator side. At ViVE, I spoke with Keith Camhi, Managing Director of the Techstars Healthcare Accelerator powered by Permanente Medicine Mid-Atlantic States. The program invests in early-stage startups and helps founders run pilots with physicians in the Kaiser Permanente ecosystem. Some interesting takeaways: • Techstars still prioritizes “Team, team, team” above everything else; • Founders in the program are interviewed by physicians before acceptance; • The goal isn’t just mentorship — it’s getting real pilots with providers; • AI startups dominate applications, but the focus remains on real clinical problems. Applications for the next cohort open soon, so founders may want to keep an eye on it. Short interview from #ViVE 👇 🎥 Watch here: https://lnkd.in/gNN_5628 #Vive2026 #digitalhealthinsideout #health2tech #digitalhealth

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The latest CalAIM Digest just dropped, and it's packed with insights you won't want to miss! 📊 This August, CHCF's Melora Simon dove into why California's health transformation efforts can't reach their full potential without better data sharing between providers and social services. Plus, we've got the scoop on California's vision for the next five years of Medi-Cal (including CalAIM waiver renewals), what other states can teach us about managing long-term care transitions, and an inspiring story from Ventura County where two community health workers are literally saving lives in the ED. These aren't just policy updates — they're the building blocks of a health system that actually works for everyone. Check it out and see what resonates with your work. https://lnkd.in/gfZs_Z4g

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New blog out for Pave Health Ventures! If you’re a startup tackling health-related challenges, take a closer look at the intersection of two massive, fast-growing industries: Consumer Health & Wellness and Traditional Healthcare. You might be pleasantly surprised. The opportunity is bigger (and closer) than you think. Read the full blog + subscribe to our Substack for more insights at the intersection of wellness and healthcare: https://lnkd.in/gJ2T6WBK

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“This is validation for the movement we’re leading to provide women better healthcare,” - Joanna Strober, co-founder and chief executive of Midi Health. Women's telehealth company Midi Health has raised $100 million in a Series D funding round, valuing the women’s telehealth company at more than $1 billion and cementing its status as a unicorn. The round was led by Goodwater Capital, with new backing from Foresite Capital and Serena Ventures, alongside existing investors including GV (Google Ventures), @Emerson Collective, McKesson Ventures, Felicis Ventures, AVP | Advance Venture Partners and SemperVirens VC. The funding marks one of the largest recent raises in women’s digital health. https://lnkd.in/eiUaVJai

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I’m excited to share that Angle Health, founded by former Palantir Technologies execs Tylon (Ty) W. and Anirban Gangopadhyay, has announced an oversubscribed Series B bringing total funding to nearly $200M. I’m proud to be an early investor and to have led this competitive round with the amazing team at Portage. Why we keep leaning in: - 26x revenue growth since the Series A - Serving 3,000+ employers across 44 states - 80%+ renewal rates Angle Health is rebuilding the healthcare benefits infrastructure for SMBs, who employ nearly half of America’s workforce but have historically been shut out of enterprise-grade coverage. Their AI-native platform helps predict risk and deliver better care at a sustainable cost. This is exactly the kind of product-driven, AI-native company we’re proud to support at Mighty Capital.

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What needs to change first and foremost is healthcare finance. These insurance bizdiots consume more than half your healthcare dollar, up front. Then we need to make the big hospital systems run efficiently. Finally, we need to stop hemorrhaging 84% of healthcare expenditures on avoidable, behavior-based chronic disease. These three financial problems can be solved with education and automation. 1. Automate the health insurance industry. Provide the EMR, pay 150% of Medicare for procedures documented. 2. Provide an ERP style hospital administration system to find cash leaks and inefficiencies. 3. As the insurance company, offer double digit discounts for improved lab results. Problem solved Overview of the solution (that's in production, by the way): https://lnkd.in/eUt_HTQX

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Andreessen Horowitz is one of the world’s most influential venture capital firms Partners David Haber, Julie Yoo, and Daisy Wolf describe companies operating at the intersection of fintech and healthtech as "payvidors"—businesses that not only deliver care but also solve the question of how patients and providers pay for it.This thinking sits at the very center of HealthCap Africa’s investment thesis. We focus on healthtech and fintech because we see, every day, that healthcare delivery is meaningless without the ability to pay for it. A diagnostic lab, a hospital, or a telehealth platform can only scale sustainably when patients have access to financial tools—insurance, credit, payments, or savings—that make care affordable and accessible. That is why our team combines deep subject-matter expertise across both sectors. We back the entrepreneurs building at this frontier: health innovators who improve quality of care, and fintech disruptors who unlock access to it. Together, these companies create the infrastructure for healthier, longer lives across Africa and beyond. 📖 Read David Haber and his team’s excellent piece on payvidors here: https://lnkd.in/dvMJ_KtZ

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Morgan asks the $1TN question: As a healthcare CEO, can you trust OpenAI or Anthropic as your AI one-stop-shop? On the ground implementing AI at healthcare enterprises, the answer is nuanced. It's a trade-off between 2 options: 1. Self-hosted ("Control"): Data security, vendor flexibility, more customizable, more workflow control, but higher maintenance costs. 2. SaaS/API ("Convenience"): SOTA models, built-in best practices, potentially higher availability via SLA, but less workflow control and lower maintenance costs. A hybrid option is emerging: managed AI/automation where you control infrastructure, data, and integration with help from a managed intelligence provider, while the model vendor handles upgrades. AI model companies would be wise to lean into this option. Ultimately it comes down to data security and workflow control. ERP and SaaS cycles taught us that "out of the box best-practice" workflows don't work at enterprise scale without massive customization. AI that learns may ease some of this, but not all. We'll need headless automation that decouples AI models from workflow. (Disclaimer: My own professional opinion, not that of any of our healthcare clients or their PE funds) #AI #healthcare #enterpriseAI

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𝗢𝘀𝗰𝗮𝗿 𝗛𝗲𝗮𝗹𝘁𝗵 𝗠𝗶𝘀𝘀𝗲𝘀 𝗤𝟮 𝗘𝘀𝘁𝗶𝗺𝗮𝘁𝗲𝘀, 𝗣𝗹𝗮𝗻𝘀 𝗟𝗮𝘆𝗼𝗳𝗳𝘀, 𝗮𝗻𝗱 𝗟𝗮𝘂𝗻𝗰𝗵𝗲𝘀 𝗡𝗲𝘄 𝗜𝗖𝗛𝗥𝗔 𝗣𝗹𝗮𝗻 Oscar Health reported a $228M net loss and an 89-cent loss per share in Q2 (well below expectations) just days after slashing full-year guidance by $500M. Revenue reached $2.86B, but the medical loss ratio jumped to 91.1% from 79% due to higher-risk individuals entering ACA exchanges and healthier ones leaving. CEO Mark Bertolini linked this to Medicaid redeterminations and CMS program integrity changes. In response, Oscar plans to cut administrative costs by $60M in 2026 through workforce reductions and AI efficiencies. The company also announced a Hy-Vee Health-branded ICHRA plan in Iowa and made three acquisitions: INSXCloud (a CMS-certified enrollment platform), IHC Specialty Benefits (a brokerage), and healthinsurance.org (a consumer education site). Despite near-term challenges, Oscar is sticking with its long-term financial targets for 2027.

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There's a new question in every health tech buying cycle that didn't exist 18 months ago: "Is this already on the roadmap of our foundation model vendor?" As we discussed in our 2026 healthcare predictions, we are entering a moment where the end user, clinicians and operators included, can increasingly build software themselves using agentic coding environments. In practice, this shows up when a CIO asks whether a proposed point solution is meaningfully different from what their existing foundation model could deliver with internal prompts, guardrails, and a few weeks of engineering time. This shift is quietly reshaping the competitive calculus. Startups selling into healthcare enterprises no longer compete only with the EHR vendor’s roadmap. They also compete with what a foundation model provider can plausibly ship for that customer, often faster and at lower marginal cost. Importantly, while the moat around building software is eroding, the moat around running software in healthcare is not. Healthcare enterprises are not set up to independently handle deep workflow integration, continuous iteration, reliability at scale, and governance across clinical, legal, and regulatory dimensions. That operational gap is where durable companies are still built. We expect this dynamic to introduce real friction into buying cycles for point solutions with thin moats. At the same time, it expands opportunity for companies with defensible data assets, deep workflow entrenchment, and true platform potential. Artera and Atropos Health are two strong examples from Breyer Capital's portfolio, both highlighted in the article. Special thanks to Brian Gormley for featuring our perspective in today's The Wall Street Journal piece on OpenAI and Anthropic's entry into healthcare. Jim Breyer Daniel Breyer Andre Esteva, PhD Brigham Hyde

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Last week, I attended the Rise Health conferences in Scottsdale, Arizona for value-based care, home health, and quality. I've pulled together some of my takeaways below. Healthcare at a Crossroads: Key Insights from 3 RISE Conferences Just as leaders and technologists met to discuss the future of value-based care (VBC), home health, and quality measurement, the "big beautiful bill" was winding its way through Congress.  Five key themes emerged that could reshape healthcare—though their ultimate impact remains to be seen. 1. AI Seeks Its Healthcare Role While AI's potential in healthcare is significant, organizations are still working through fundamental challenges around implementation. Promising developments in predictive analytics and diagnostic tools are emerging, such as those provided by Accorded, but meaningful adoption across healthcare systems will likely take years as organizations work through workflow integration and trust-building with clinical staff. Some key leaders at the conference included Parakeet Health and Confido. 2. Value-Based Care Lingers in Experimentation Mode The transition to value-based care continues to challenge healthcare organizations as they restructure around new payment models. Independent Practice Associations (IPAs) such as Yuvo Health, Accountable Care Organizations (ACOs), and Management Services Organizations (MSOs) are experimenting with new approaches, often leveraging technology like Arbital Health for contracting and collaboration, but many are struggling with the complexity of adoption and the funding environment. Interoperability between systems continues to be one of the greatest challenges. 3. Home Care Shows Promise with Limitations The expansion of home-based healthcare services represents both opportunity and challenge. Hospital-at-home programs, hospice care, and primary care services are demonstrating the potential to deliver care in patients' homes, supported by advancing technology like portable diagnostics, remote monitoring, and even mileage tracking (e.g. provided by Everlance). However, significant barriers remain around reimbursement complexity, regulatory hurdles, and the infrastructure needed to support clinical care outside traditional settings. Experts from organizations such as Medically Home, myLaurel®, and Home Centered Care Institute, shared their thoughts of the present opportunities and challenges, and a vision for the future. 4. Prevention Technologies Seek Market Fit New screening technologies are emerging that could shift healthcare toward prevention, including at-home EEG screenings, dementia detection tools, and comprehensive disease profile tests. Examples at RISE included Caption Care for heart disease and Neurotrack for Alzheimer’s. For the last theme & more takeaways read the full post: https://lnkd.in/eepSG9ZB #RISEVBC25 #HomeCareSummit25 #Qualipalooza2025

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Ease Health has raised a $41M Series A led by Andreessen Horowitz to build an AI-native operating system for behavioral health providers. General Partner Daisy Wolf said Ease is re-architecting the behavioral health tech stack around automation and intelligence, while Co-Founder & CEO Zach Cohen described the platform as a unified CRM, EHR, and RCM system spanning the full patient lifecycle. Providers including Alex Hoffman and Jordan Milby highlighted improved documentation, billing accuracy, and scalability across care settings. https://lnkd.in/e7ivSkyq #AI #HealthTech #BehavioralHealth #DigitalHealth #AIAutomation #HealthcareInnovation #Startups #ArtificialIntelligence

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Say you know me without saying it ... "Hey, let's improve healthcare purchasing!" Durable goods, every day disposables, every part of purchasing in healthcare products continues to be broken. Natan Wise and team Conduit Health are improving the spend process for consumers, healthcare providers. This moves $100b in annual spend, but also improves people's lives. You can read our deeper take at XYZ here: https://lnkd.in/gEhfACtB Thrilled to have more money to run with the Drive Capital partnership! And Maybe you want to improve people's everyday lives? Live in NYC? You probably want to work here: https://lnkd.in/gtGEB8Ku

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The members you can’t reach are often the ones costing you the most. I loved this inteview with Yong Kim, our VP of Health Plan Partnerships at DocGo, discussing care gaps, quality ratings, and why under-engaged populations have such an outsized impact on outcomes and costs. Yong covers what care gaps really mean, how Star Ratings drive financial performance, and how on-site care can reach members traditional approaches miss. Really worth a read for any of our health plan partners or anyone working in value-based care, Medicare Advantage, or managed Medicaid. Check out the article on Proactive Care Now. https://lnkd.in/euJyzEpQ

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The Wharton Health Care Management Alumni Association Conference was a success. It brought together hospital and payer executives, policy leaders, pharma, and technologists for real, grounded discussions about the state of the healthcare industry. One of the most striking takeaways for me, coming from the West Coast, was the emotional difference around AI adoption. The level of concern, hesitation, and fear in parts of the ecosystem was markedly different than what I see in Silicon Valley. While many colleagues have already shared excellent recaps, some of the most candid and forward-leaning conversations happened in a small, intimate roundtable. We took the AI dinner concept that Shehzad Huda, J.D., M.S. (unfortunately missing in action for this one) and I originally built on the West Coast and brought it to Philadelphia, with Kathryn Tong joining as a fantastic co-host. The first for #LuminaryLeague Where we focused our discussion: 1. Identifying real-world ROI and AI use cases that have moved beyond the pilot phase 2. Understanding how generalized intelligence will reshape organizational structures 3. Exploring what it means when AI outperforms clinicians on empathy — and what that reveals about medicine and society Key Learnings 1. Regulation needs to go deeper, beyond guardrails to clear rules of engagement for AI inside clinical and operational workflows. Health systems and innovators need shared definitions, operational standards, and implementation guidance if AI is going to scale safely and effectively. 2. The economics of healthcare data are fundamentally misaligned. Massive value is created from patient data across the ecosystem. As AI extracts even more value from this data, the lack of transparency, participation, and ownership is becoming increasingly untenable. 3. Chronic disease is accelerating  and emerging decades earlier in life. Conditions once seen in patients in their 80s and 90s are now widespread among people in their 30s, 40s, and 50s. Health systems are overwhelmed and actively looking to technology partners to help manage rising acuity and complexity. AI must become the force multiplier that allows clinicians to keep pace. The conversations in Philadelphia made one thing clear: healthcare is at a critical inflection point. The decisions we make now , around regulation, data, and intelligent systems ,will define how prepared we are for the next decade. And more importantly, we are a community that transcends beyond transactional business deals. Our dinner table brought together relationships that span more than 20 years, across different roles, chapters, and phases of life a reminder that progress in healthcare is ultimately built on trust, continuity, shared purpose and true friendship. (Thank you to White Dog Cafe , Elizabeth Tretter, and the Cornell Network,Sydney L. Grims ) Mount Sinai Health System Mayo Clinic Redouble AI MERLE BARI, M.D. AND ASSOCIATES Medint Flagship Health #luminaryleague

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🚨 One week to go — and I’m looking forward to being part of this important conversation. I’ll be facilitating panel of true experts: Annmarie Galli, Dan Weeks, and Karen Frascello, on: “Driving Smarter Decisions by Clarifying the Role of RWD in EAPs” We will be answering a key question: 👉 How do we move from “access only” programmes to smarter, insight-generating EAPs without compromising patient care? Expect a candid discussion on: • Where regulators stand • What’s working (and what’s not) in practice • Examples of evidence generation that has made a difference If you’re working in the MAP space today, this is a conversation you won’t want to miss. Looking forward to seeing many of you there 👇 #ExpandedAccess #CompassionateUse #EAP #RealWorldData #PatientAccess #Pharma #Biotech Maprium

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Thrilled to see this recap of our work at HLTH! What a successful show for AliveCor, highlighting how our KardiaComplete solution is transforming cardiovascular care for employers and health plans. The need is clear: the average wait time to see a cardiologist is 33 days. Our solution addresses this directly, shrinking that wait to just 48 hours through our virtual center of excellence for cardiovascular health. KardiaComplete empowers employees with remote monitoring technology—including a blood pressure cuff and our proprietary, medical-grade 6-lead personal ECG—and virtual access to a care team. This innovative approach is delivering powerful, verifiable ROI: A 68% reduction in unplanned admissions A 58% reduction in ER visits It's a testament to the power of Digital Health to improve access to care, drive better outcomes, and achieve measurable cost savings. Great to be on the ground at #HLTH and share our success! Thanks to the HealthTech Remedy podcast and Edward Daley Daley for the great feature. #HLTH #HLTHUSA #AliveCor #KardiaComplete #EmployeeBenefits #VirtualCare #Cardiology #HealthTech

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