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Tuesday, 24 February 2026 |
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| CMS is about to start paying for tech-supported care for Medicare enrollees. |
| The pilot, called ACCESS, is a big deal. It opens up a huge new market of 30 million US seniors for digital health companies and their healthcare tools and programs. The companies will only get paid full rates by CMS if they can prove they actually improve patients’ chronic health problems. |
| The health tech industry has been excited about the ACCESS program since it was first announced last year. But enthusiasm waned in the last couple of weeks after CMS unveiled payment rates that some observers complained are too low. In a new story, I report that this is exactly the point: CMS wants to encourage automated tools with little clinician
involvement. Expensive programs with lots of humans in the loop probably won’t be able to profit from the ACCESS program. |
| My big question, though, is whether these fully digital tools can succeed in caring for Medicare patients. So far, digital health’s track record has been mixed. |
| A few points didn’t make it into the story, but I’ll share one that stuck with me from Tom Cassels, managing director at consulting firm Manatt Health. He told me that when he was an investor, he’d get frustrated during startup pitches when inevitably there would be no payment code for what the new company was trying to do. If there’s no code, the technology and any early evidence about whether it worked suddenly didn’t matter — they couldn’t bill. |
| Often the startup would have to change its business model to add medical professionals with licenses who could bill for care, even though that often meant moving toward more expensive services and away from value, Cassels said. |
| With ACCESS, that obstacle may fall. |
| “The CPT code book is no longer a requirement for market entry. That is a huge impact for digital health companies,” Cassels said. |
| - Shelby |
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Hims says it spoke with stakeholders to pull weight loss pill
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Hims & Hers said it pulled its controversial weight loss pill after discussions with "ecosystem stakeholders" during its fourth-quarter earnings call on Monday. The company saw the pill as part of its efforts to offer more personalized treatment for users, CEO Andrew Dudum said.
Hims also received a letter this month from the Securities and Exchange Commission notifying the company that it is under investigation, the company disclosed in an SEC filing Monday evening. |
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Quote of the week
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"We believe there's a really durable weight business, even if you think in a draconian scenario of compounding GLP-1s not being there." |
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Hims CEO Andrew Dudum on the company's fourth-quarter earnings call |
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This week in health Тech |
The FDA appears to have sent another batch of warning letters to GLP-1 compounders, after it sent more than 100 to compounders in the fall. It’s not clear how many letters were issued in this round. The FDA’s statement to Endpoints News did not include that information, instead saying the agency “monitors telehealth companies for potential false and misleading claims of products offered on their websites.”
One attorney told Endpoints several of his clients contacted him about the letters. A redacted copy of one warning letter dated Feb. 20 reviewed by Endpoints concerns “false and misleading” ways the drugs were advertised on one company’s website. |
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Worldwide made. Thanks for reading.
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