Health Tech Nerds Radio

A physician-turned-founder's take on making prior auth actually work | Jeremy Friese (Humata Health)

Jeremy Friese spent a decade as a physician at Mayo Clinic navigating prior auth from the provider side. Now he runs Humata Health, which helps large health systems submit better prior auths to every plan in the country. Humata is a participant in CMMI's WISeR program, handling Oklahoma's fee-for-service Medicare prior auth, and six months in, providers are submitting almost exclusively through Humata's portal. Jeremy's view on fixing prior auth: use AI only to say yes, build real transparency into the rules, and let humans sort out the small fraction that actually requires a fight. Links referenced * CBS article on WISeR rollout in Oklahoma: https://www.cbsnews.com/news/medicare-ai-program-wiser-prior-authorization-errors-delays/ [https://www.cbsnews.com/news/medicare-ai-program-wiser-prior-authorization-errors-delays/] * Substack on AI usage in prior auth: https://spinalcolumn.substack.com/p/the-algorithm-is-denying-your-auth [https://spinalcolumn.substack.com/p/the-algorithm-is-denying-your-auth] * Humata Health: humatahealth.com [http://humatahealth.com] * Jeremy Friese: jeremy@humatahealth.com [jeremy@humatahealth.com] For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe

The Grand Roundup: Agentic voice AI wars, recent funding roundup, Cityblock acquires Homeward, UpDoc's FDA clearance, Humata's WISeR rollout, and more

Kevin and Martin start with a discussion about a crowded week in healthcare AI funding. Prosper AI and Assort Health’s fundraising announcements were released on back-to-back days, with nearly identical customer quotes claiming each was "the only true platform." Kevin and Martin work through what that signals about the agentic voice AI space. They also cover Alan's €480M raise at a $6.3B valuation, Trase's $107M seed round, Cadence's RPM-to-chronic-care-management pivot, Hera's CCM play, Upside's Medicaid housing engagement numbers, the Cityblock-Homeward acquisition, and UpDoc's FDA 510K clearance. They close by explaining stop-loss lasering and what it means for insurability when the bag keeps getting passed. Then Jeremy Fries, CEO and founder of Humata Health, joins to talk through WISeR — the CMMI prior auth program now live in Oklahoma. Jeremy walks through how the program works (AI says yes instantly; humans adjudicate everything else), what the rollout has actually looked like on the ground, why provider adoption numbers are better than the headlines suggest, and why he thinks prior auth, done right, is one of the few places in healthcare where payers and providers can actually find common ground. Links referenced * Bloomberg article on MyConnections: https://www.bloomberg.com/news/features/2019-11-05/unitedhealth-s-myconnections-houses-the-homeless-through-medicaid [https://www.bloomberg.com/news/features/2019-11-05/unitedhealth-s-myconnections-houses-the-homeless-through-medicaid] * WSJ article on UpDoc: https://www.wsj.com/pro/venture-capital/updocs-ai-gets-fda-nod-to-act-as-concierge-doctor-between-visits-2b7fa41b [https://www.wsj.com/pro/venture-capital/updocs-ai-gets-fda-nod-to-act-as-concierge-doctor-between-visits-2b7fa41b] * Marsh McLennan report on lasering: https://view.ceros.com/marsh-mma-mid-atlantic/success-stories/p/19 [https://view.ceros.com/marsh-mma-mid-atlantic/success-stories/p/19] * CBS article on WISeR rollout in Oklahoma: https://www.cbsnews.com/news/medicare-ai-program-wiser-prior-authorization-errors-delays/ [https://www.cbsnews.com/news/medicare-ai-program-wiser-prior-authorization-errors-delays/] * Substack on AI usage in prior auth: https://spinalcolumn.substack.com/p/the-algorithm-is-denying-your-auth [https://spinalcolumn.substack.com/p/the-algorithm-is-denying-your-auth] * Humata Health: humatahealth.com [http://humatahealth.com] * Jeremy Friese: jeremy@humatahealth.com [jeremy@humatahealth.com] For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe

The liability gap holding clinical AI back — and who should solve it | JD Friedland (Cleveland Clinic)

JD Friedland is the executive director for ventures at Cleveland Clinic, where he evaluates and deploys emerging health technology across one of the country's largest and most research-intensive health systems. He walks through what Cleveland Clinic has actually built — some examples include: sepsis detection with Bayesian, clinical trial recruitment via Dyania, and surgical note generation through Theator's ambient video platform. He gets into why Cleveland Clinic's data is worth more today than it will be once the window to be an early contributor has closed, why OpenEvidence's pharma-advertising model gives him pause, and why the liability question, not the technology, determines the speed of clinical AI deployment. Brought to you by Ursa Health: Join HTN, Atlas Oncology Partners, and Ursa Health this Wednesdsay, June 24 at 12pm ET to dive into specialty value-based care. Register to attend and receive the recording: luma.com/htn-ursa-atlas [http://luma.com/htn-ursa-atlas] For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe

The Grand Roundup: Anti-tiering contracts and the OhioHealth ruling, Thoreau/Ensemble update, 340B and Eli Lilly, OpenLoop's D2C play, Cleveland Clinic on AI trust, and more

Kevin and Martin by discussing the OhioHealth DOJ settlement and what banning anti-tiering, anti-steering clauses in hospital contracts could mean for employer plan design, narrow networks, and upstart insurance models. They talk about the $12B Ensemble Health Partners deal: what it says about the RCM market's appetite for holistic versus point-solution approaches, and where it might fit into Matt Holt's broader Thoreau acquisition agenda. The Clover-Stars recalculation gets a full breakdown: what the judge sided with, what CMS did next, who won, and the uncertainty now rippling through payer teams, provider comp models, and the whole vendor ecosystem built around Star scores. Martin digs into the 340B program via Minnesota's annual state report, explaining Eli Lilly's decision to freeze discounts for non-compliant hospitals, the FQHC access problem at the center of it, and whether a rebate model actually helps or just punishes the safety net players the program was designed for. And Kevin walks through OpenLoop's Shopify-for-telehealth launch, what it would actually mean if anyone with an audience could create a D2C GLP-1 brand in hours, and why the economics of that model are an interesting question. Then JD Friedland, Executive Director for Ventures at Cleveland Clinic, joins to walk through how one of the country's flagship health systems is thinking about AI deployment. JD talks about what Cleveland Clinic has actually built with ambient listening, clinical trial enrollment via Dyania, and surgical documentation through Theator. He gets into the data consortium question—why your institution's data is most valuable when you’re an early contributor—and the liability and brand risk that makes health systems cautious about deploying forward-facing AI solutions they don't fully control. Brought to you by Ursa Health: Join HTN, Atlas Oncology Partners, and Ursa Health this Wednesdsay, June 24 at 12pm ET to dive into specialty value-based care. Register to attend and receive the recording: luma.com/htn-ursa-atlas [http://luma.com/htn-ursa-atlas] Links referenced OhioHealth / DOJ Settlement: https://www.justice.gov/opa/pr/justice-department-requires-ohiohealth-stop-using-anticompetitive-healthcare-contract-terms [https://www.justice.gov/opa/pr/justice-department-requires-ohiohealth-stop-using-anticompetitive-healthcare-contract-terms] Minnesota 340B Report: https://www.health.state.mn.us/data/340b/docs/2025report.pdf [https://www.health.state.mn.us/data/340b/docs/2025report.pdf] For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe

The tasks AI should take off doctors' plates — and the ones it shouldn't | Hashem Zikry (Counsel Health)

Hashem Zikry is a practicing emergency physician at UCLA, a researcher focused on unnecessary ED utilization, and the medical director for clinical research and policy at Counsel Health — which, this week, began integrating Oura biometric data into clinical decision-making for the first time. That combination of roles gives him an unusual perspective on the question everyone is asking: what should AI actually be allowed to do in clinical care? He also speaks about regulation — the current state-by-state landscape ranges from Utah's live AI sandbox to New York and Colorado bills that would sharply limit patient-facing AI — and Zikry argues a federal floor would accelerate innovation rather than constrain it. On the Oura partnership, he pushes back on the concern that wearables drive unnecessary utilization, contending that access to a clinician at the point of data — not just the data itself — is what changes the demand curve. Brought to you by Ursa Health: Join HTN, Atlas Oncology Partners, and Ursa Health on June 24 at 12pm ET to dive into specialty value-based care. Register to attend and receive the recording: luma.com/htn-ursa-atlas [http://luma.com/htn-ursa-atlas] Links referenced Hashem’s LA Times story: https://www.latimes.com/opinion/story/2026-04-25/ai-democratize-medicine-regulation [https://www.latimes.com/opinion/story/2026-04-25/ai-democratize-medicine-regulation] Follow Hashem on LinkedIn: https://www.linkedin.com/in/hashem-e-z-87243529a/ [https://www.linkedin.com/in/hashem-e-z-87243529a/] For more from Health Tech Nerds, subscribe to our weekly newsletters: https://www.healthtechnerds.com/subscribe