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As lawmakers race to pass a bill to keep the government open by the end of the week, health tech is on the agenda. At the end of the month, policies that expanded Medicare coverage for telehealth during the pandemic will expire, unless Congress acts to extend them. Extending the policies for several years is a popular idea, but that proposal is likely contingent on getting an actual budget — rather than a stop-gap bill.
- Over the weekend, House lawmakers circulated a bill to fund the government through September that included short-term telehealth extensions, as expected. But with a possible shutdown looming and intense political friction in Washington, there’s no telling what might happen. This might be out of date by the time you read it.
- Ahead of the deadline, researchers from the University of Michigan published a couple of preprints that paint a rosy picture of telehealth’s budget impact. One paper examines traditional Medicare claims for “evaluation and management” before and after the pandemic and concludes that despite a growth in telehealth use this did not lead to growth in E&M use. Notably, the paper includes claims from 2024. Another paper analyzes claims and concludes that expanding telehealth use may reduce downstream Medicare costs. If this is actually true, the case for telehealth becomes difficult to refute.
- The findings of these papers may inform the Congressional Budget Office’s thinking but that office previously concluded that an expansion of telehealth will lead to more spending. (Here’s an interesting CBO deck on this, by the way, which outlines the levers that may tip spending one way or the other.)
- In a Health Affairs perspective Ateev Mehrotra and Jared Perkins suggest policymakers ought to consider paying for telehealth at a lower rate as a way to make permanent expansion of telehealth in Medicare “more affordable” — and thus, more politically feasible. After all, telehealth in theory should cost less to deliver. I asked Mehrotra if lower payment rates might discourage providers from offering the service, and he noted that this question of price elasticity, or how much change in use of telehealth would occur for a decrease in reimbursement, is crucial. He is currently studying this question.
Hormone therapy over telehealth raises concerns
Dozens of wellness and direct-to-consumer telehealth companies, including well-known players like Noom and Hims and Hers, are expanding their offerings to include hormone treatments for low testosterone, perimenopause, and menopause. The move comes as the business model around selling compounded copies of GLP-1 weight loss medications becomes increasingly tenuous.
As STAT’s Katie Palmer reports there’s a potential to expand access to care that can be hard to get for conditions that carry stigma. But hormone treatments can come with risks, and there’s concern that new firms might offer substandard care. At least one secret shopper study found that telehealth companies can prescribe testosterone even when it’s not medically necessary. Read more here
Google changes health equity to ‘health optimization’
For years, Google has made health equity a central piece of its health messaging, but when the company released a detailed report on its impact on health last month, I noticed something curious: Not a single mention of the term.
As I report in a new story, Google has since January revised its website and made other changes to remove mentions of health equity and other references to the idea of addressing social, economic, and other factors that contribute to disparities in health outcomes for different population groups. Its page on health equity is now titled “health optimization” and its global head of health equity has a new job title: Global head of health optimization. The timing of the changes gives the appearance of a capitulation to a Trump administration that has been hostile to diversity, equity, and inclusion.
In the story, I detail more changes and deletions, point to some of the company’s important work on health equity, and speak to Google’s former chief health equity officer about why the changes are significant. Read more here
Hinge files to go public and other news
- Hinge Health to go public. The virtual physical therapy company filed to go public on Monday, as it was rumored they would sometime soon. A first peek at the financials: The company made $390 million in revenue in 2024 and posted a net loss just under $12 million. For now, I don’t have any searing takes, but one observation is that it’s curious to see the company go forward with its offering even as others have decided to hold back given the rocky market created by the Trump administration’s early actions.
- An update on AdvocateMH. Last week, I wrote about the new mental health company from former Cerebral CEO David Mou and former NIMH head Thomas Insel. They’ve now told me that they raised $6.2 million in seed funding led by Morningside.
- Sunny projections before Memora’s sale to Commure. A very good Axios story uncovered that before clinical workflow management company Memora Health sold in a surprise “fire sale” to General Catalyst-backed Commure, the company’s CEO Manav Sevak told investors the company had $20 million in annual recurring revenue. The reality: “[R]evenue was $1.2 million in 2023 and roughly $1.5 million year-to-date as of October 2024, per [a] document shared with investors at the time of the Commure merger.”
- VA’s Oracle implementation inches forward. The Department of Veterans Affairs announced that 13 facilities will be live with the Federal Electronic Record System in 2026. The system, which is a contract with Oracle Health, is now expected to be live at all VA medical facilities “as early as 2031.” The update follows a government watchdog report claiming existing estimates vastly undersell the cost of modernizing the VA’s systems and recommending an updated schedule for the very slow-moving project.
What we’re reading
- Millions in U.S. live in places where doctors don’t practice and telehealth doesn’t reach, KFF Health News
- Abortion pill prescriptions are now being tracked in parts of the US — with help from a little-known tech company, Business Insider
- Five years of Covid exacted a terrible toll. Another epidemic has claimed even more lives, STAT