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Tuesday, 12 May 2026

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Continuous scrutiny

Last week, I was reminded that reporting on AI in healthcare requires continuous scrutiny of the incentives that drive it.

Thanks to a fellowship hosted by SABEW, in partnership with NIHCM, I spent Thursday and Friday with other reporters in Philadelphia touring local health system Penn Medicine, attending workshops and discussing how the economics of healthcare in America often don’t line up with what patients need.

Some examples:

AI can process more imaging scans with more precision, saving time for radiologists and spotting conditions early on. But the technology has also pumped up referrals to other specialists, and risks over-diagnosing mild cases that previously went undetected, which can make patients anxious, physicians at Penn Medicine told us. And there’s been little research so far into whether more scans actually translate into better results for patients.
The term “human in the loop” is supposed to reassure people it’s safe to use AI, because a human clinician will be overseeing what the AI produces. But clinicians are susceptible to automation bias where they trust AI — often marketed as being trained on top-tier medical journals — even when it goes against their expertise.
And we always hear the phrase that AI has the potential to lower costs — but for whom? Providers and insurers use AI to capture as many codes as possible, for example, which can make each visit more expensive for patients and whoever covers their health insurance.

I left the fellowship ready to question all the basic assumptions I’ve held toward AI in healthcare, like not assuming it will work until I see evidence otherwise. By focusing on what's working and what isn't, the hope is for the tech to keep getting better, and eventually make healthcare more available and affordable for everyone involved.

- Ngai

Here’s what’s new

Exclusive: Knit Health raises $11.6M for 'fundamentally different' approach to healthcare AI

A startup that spun out of UC Berkeley aims to improve healthcare operations by getting AI to think like a doctor would.

Optum Rx unveils pharmacy model with clear fees, building on transparency push

UnitedHealth Group’s Optum Rx on Monday unveiled a new approach to prescription drug benefits that it said offers its customers transparency into the entire drug supply chain.

Weight loss coverage

The percentage of employers surveyed by Business Group on Health that cover GLP-1s for weight loss. Of those that currently cover the medications, only 72% said they would likely keep covering them in 2027. Cost, of course, weighed heavily on the coverage considerations. The survey consisted of 105 employer members of the group, which includes the majority of Fortune 100 companies.

This week in health Тech

Hims doesn’t plan to be the first to offer peptides, opting instead to take time building out the product line. "I think when we step back, we believe that we've got a combination of things, the brand, the infrastructure and ultimately the capabilities to really be a leader in this emerging category as the regulatory path becomes more clear in July,” CEO Andrew Dudum said in Hims’ first-quarter earnings call on Monday.

That comes after the FDA in April said it plans to reclassify at least a dozen peptides, with a key advisory committee meeting slated for July. The Hims execs said they believe the telehealth company’s advantage lies in the compounding pharmacies it owns.

Forus, which uses AI to automate administrative steps from a medicine prescription to its approval, raised $160 million. The company was previously known as Tandem and entered a partnership with medical search startup OpenEvidence last month, Endpoints News reported.

Google Health is… back? Google rebranded the Fitbit app as the Google Health app. That’s by our count the third iteration of Google Health, the last of which shuttered in 2021. (The first try was a personal health record that closed in the early 2010s.) This time, the Google Health app will track wellness data, let you import medical records and include an AI coach.

Early stage venture firm Wisdom Ventures raised $77.7 million in its second fund. Wisdom backed companies like OpenAI, Anthropic and Function Health with its first fund.

Highmark Health hired Heather Cianfrocco, the former head of Optum and longtime executive at UnitedHealth Group, as its chief operating officer. Cianfrocco left UnitedHealth in March.

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