Reminder: Accept your invitation to Hospitalogy membership to access exclusive content, connect with healthcare execs, and more.

Welcome to Thursday, Hospitalogists,

Today’s send is a light one filled with some hot takes in healthcare AI brought to you jointly by Rik Renard, Product Lead at Sword Health and yours truly. I’ve also included a nice snippet of UnitedHealth’s Q2 from Grant Hesser who drops great nuggets on Twitter and finally a comparative scorecard style graphic on hospital Q2 earnings below.

Enjoy!

BLAKE'S BREAKDOWN

Going deeper on an interesting topic, theme, or trend 

Ambience Healthcare just raised $243M from a16z, the same investor who led Abridge's $300M round. What the hell is happening?

This comes right after Doximity said they're giving away AI scribes for free. Yes, we all know it: scribing is becoming a commodity, but healthcare leaders don't really care about perfect transcripts anyway. They care about getting paid.

Look at how Ambience talks about themselves now versus their Series B:

• Series B: "the most comprehensive AI operating system."
• Series C: "leading platform for documentation, coding and clinical documentation integrity."

They ditched the noble "we're saving doctors from burnout" story and went straight for what hospital CFOs actually want: billing optimization.

Because transcribing what the doctor said isn't the real product. It's what you do with that information that counts. Ambience says their AI "surpasses clinician performance by 27% in medical coding." That's the real value. Not better notes, better reimbursement.

Stephen Hemsley, UnitedHealth’s new CEO, basically spelled it out in their investor meeting: they're worried about "more aggressive care provider coding and billing technologies." Health systems are getting squeezed, and every patient encounter needs to generate maximum revenue.

I had a conversation with a CIO in the first part of 2025. He’d had a few drinks. Hear it straight from the horse’s mouth: “I want to be able to do the exact same things, provide the exact same services…and get paid more.” You don’t think payors are taking note of that?

AI scribes are table stakes now. The real game is revenue cycle optimization, and Ambience just raised a quarter billion to play it.

(as a small aside, I - Blake Madden - love Ambience’s website font and think the differentiation in marketing language is just as interesting as the gigantic land grab and advancement in innovation happening)

Lots more red than normal on this table for UnitedHealth Group in 2025:

As I dig deeper into the disaster that is UnitedHealth Group in 2025, here’s a quick snippet from Grant Hesser on the managed care behemoth’s woes in Q2:

• UNH's 2Q raises more questions than answers unfortunately and paints a picture of a business that isn't going to recover quickly. Investors have been shellshocked here - and rightfully so - as the largest health insurer by a wide margin has now reduced their earnings by almost 50% for 2025.

More to come on the comparative front, but here’s the quarterly earnings snapshot comparing the four major hospital operators, with CHS change in net income driven by divestitures (normalized out - $229M - in the table view):

MISCELLANEOUS MADDENINGS

I’ve been writing up hospital quarterly earnings reports and a few of you (some more rudely than others) have reached out and asked about inclusion of quality metrics, patient satisfaction, etc. And my simple answer to those people is - those aren’t reported to investors and they’re not as straightforward to track down. So I have an ask to Hospitalogists: are there any notable quality metrics reported on a consistent basis (ideally quarterly) that I could tie into these quarterly summaries? Where would I find this info? Also - what else would you like to see in Hospitalogy earnings tear sheets? I’m all ears.

Thanks for the read! Let me know what you thought by replying back to this email.

— Blake