Kavita Mangal

Aditya Narayan and I are proud to share a Health Affairs Scholar piece on CMMI's new ACCESS payment model. ACCESS will pay for care delivered by AI (with or without a clinician) for Medicare patients. This is the first time ever Medicare will pay for care without a person in the loop. It is for chronic-disease management: recurring, condition-specific payments tied to clinical improvement, rather than billing for discrete encounters or tightly defined remote-monitoring activities. The promise is straightforward, more reimbursement for technology-enabled longitudinal care and more choice and competition for patient care. It could lead to lots of startup and innovation. It could also lead to lots of hard to cancel subscriptions and FWA. There are still many unanswered questions about payment levels, how quality is measured, how risk is adjusted, and how these patients’ facing technology enabled services will coordinate care with the traditional delivery systems. https://lnkd.in/grDfXDH5

148

23 Comments

Excited to share a paper I co-authored with Anoop Tripathi on the Future of Healthcare Intelligence for Payers. In this piece, we explore how data, AI, and modern analytics platforms are reshaping payer decision making - from operational efficiency to value-based care and member outcomes. Would love to hear thoughts from the healthcare and analytics community. Read here: https://lnkd.in/g6bsN2nN #HealthcareAnalytics #PayerTransformation #AIinHealthcare #DataPlatforms #HealthPlans

94

📽️ RTM in 2026: From Technology Add-On to Core Care Strategy RTM isn’t just evolving - care delivery is. In our latest webinar with Vikram Sethuraman, Bryan Lang PT, DPT, MHA, OCS and Mary Rose Strickland - we brought together clinical, operational, and product leaders to unpack what Remote Therapeutic Monitoring looks like in 2026 and why CMS updates signal something much bigger than code expansion. The key takeaway? ➡️ RTM is not a billing strategy. ➡️ It’s a care delivery strategy. As clinicians increasingly manage care longitudinally - not just during visits, but between them - RTM becomes a foundational tool for: •Improving adherence between visits •Increasing plan-of-care completion •Strengthening patient engagement •Driving outcomes with real-time insight •Supporting sustainable, scalable clinical models With CMS separating device supply from treatment management and reinforcing time-based expectations, it’s clear: RTM is meant to support continuous clinical engagement, not function as a tech add-on. During the discussion, our panel explored: •What changed in 2026 and why •The three primary RTM implementation models (full-service, self-service, hybrid) •Common operational friction points and how to mitigate them •Real-world rollout lessons from clinic operators •Financial sustainability benchmarks •How RTM supports PTs stepping further into first-contact and population health roles The clinics succeeding with RTM aren’t layering on software. They’re redesigning workflows, aligning teams, and embedding RTM into their care model. As healthcare shifts toward outcomes-driven, longitudinal care, RTM is quickly becoming a core pillar of modern practice. 🎥 Watch the full webinar here: https://lnkd.in/ejC5vksJ #RemoteTherapeuticMonitoring #MSKCare #RehabTherapy #RTM #CMS #HealthcarePolicy #DigitalCare #PatientEngagement Prompt Health

17

3 Comments

Recent healthcare transactions revealed 3 very clear signals about where investors are placing their bets. If February's fundraises are any indication, investment banks are backing companies focused on: 📝 capitalizing on CMS policy tailwinds 🌐international expansion - especially in India 🤖 and AI (…bet you didn't see that one coming) Here’s what stood out 👇 🔵 FOLLOWING POLICY 🔵 Rainfall Health raised $15M Series A to support the 741+ health systems that are now required to follow the Transforming Episode Accountability (TEAM) Model - per the January 1st CMS mandate. Honest Health secured $140M, presumably by building on continued momentum around CMS's ACO REACH program. Big Health is riding the new 2025 DMHT Physician Fee Schedule G-Codes to the bank for $23.7M as their core offerings are now formally reimbursable. Graici raised a $7.5M to expand its platform helping Medicaid members complete eligibility as health systems frantically prepare for an OBBBA world in which Medicaid redeterminations will be more complex & more frequent. 🔵 INTERNATIONAL EXPANSION 🔵 ACN Healthcare RCM Services Pvt Ltd will boost it's already-rapid growth trajectory with a $16.5M injection for the India-based RCM services company. Care.fi - the company that offers upfront claim disbursement in 10min - raised raise $8M to expand it's AI‑powered hospital revenue infrastructure into new Indian cities, and to enter the US & Middle East markets. 🔵 ADVANCING AI 🔵 Tandem raised $100M Series B for AI-enabled prescription workflows. The three-year old company has already reach a $1B valuation. Talkiatry closed a $210M Series D to expand its AI-enabled front office psychiatry platform. Ease Health - "Fewer clicks. More care" - raised $41M to build an AI-native operating system for behavioral health providers. Third Way Health secured a $15M Series A to further scale and develop its AI-powered patient access services. Synthpop - Healthcare AI raised $15M Series A by leaning into two major overarching rev cycle trends: (1) the shift from generative AI → agentic AI, & (2) consolidation into a single platform. If you're building or investing in healthcare companies, you should know what forces are increasingly shaping where capital flows. Curious what others are seeing — which of these themes (or other themes) will drive the most healthcare investment in 2026? Lead investors included Accel, Andreessen Horowitz, NewSpring, Two Bear Capital, SANTÉ, .406 Ventures, AlleyCorp | Deep Tech, True North Co, July Ventures, Health Velocity Capital, Perceptive Advisors, Ansa Capital Keep an eye out for related February editions covering: 🤝 Strategic Partnerships 💵 Mergers & Acquisitions #HealthcareFinance #RevenueCycle #HealthcareInvesting

23

9 Comments

Value-based care requires both smart policy and interoperable data infrastructure—open standards are the essential foundation that turns payment reform into real-time coordination across the healthcare ecosystem.👇 https://lnkd.in/e3UqbAjY Healthcare IT Today #FHIR Health Level Seven International

40

3 Comments