Policy & Payers
Amazon, Google, Meta, Oracle and Axon back the CMS prior auth pledge
Signing as self-funded employers, they're asking their insurers and TPAs to extend the pledge's electronic prior auth improvements to their own health plans.
Read the full story →CMS admits WISeR isn’t working
A CMS deputy administrator said “a lot of things” about the AI-assisted Medicare prior auth pilot running in six states are not working. Expect more scrutiny of AI-led denials.
Read the full story →Funding & M&A
Suki raises $90M Series E
It plans to take its ambient AI beyond documentation into clinical, financial and operational workflows, and works with 250+ healthcare organisations.
Read the full story →Brellium raises $23M
Brellium raises $23M for AI that checks documentation before billing. It's expanding into cardiology, pain management and primary care.
Read the full story →Sunbound closes a $24M Series A
Sunbound closes a $24M Series A and acquires Richter Healthcare Consultants, combining AI RCM with services for senior living.
Read the full story →RCM services keep consolidating
Sustainable Medical Billing announced two acquisitions in two days (SMRTDO and Impact Healthcare Solutions), adding 300+ nearshore staff.
Read the full story →Leadership Moves
Omega Healthcare
Senthil Velayutham, formerly Nextiva’s product and technology chief, joins as CTO (announced in September) to lead its AI strategy and the Omega Digital Platform.
Read the full story →The pattern
RCM AI companies are building out their C-suites as they scale. Adonis named its first CRO (Doug Pickett, ex-Cedar) and a CPO from Oscar Health this summer.
Source →Talent Insight
Capital is concentrating, so commercial hires must pay back fast
- Just 20 rounds took 45% of the $7.4B raised by US digital health startups in H1; the other 224 deals shared the rest.
- The most valuable hires bring payer or health-system relationships on day one: Account Directors and VPs of Growth who have already sold into revenue cycle teams.
- For 2027 plans: For 2027 plans pair every new seller with implementation capacity. With the CMS deadline coming, go-lives sell the next deal.
Building a team in Digital Health & Healthcare AI?
Issy Eaden specialises in Digital Health & Healthcare AI hiring at QP Group. Talk to Issy about the market, salaries or a search.
