Comparing Medicare Advantage and original Medicare

News & Analysis from Health Tech Nerds
 
- Anthropic partnered with Blackstone, Goldman Sachs, and a roster of the world's largest asset managers to launch an enterprise AI services firm, a straightforward move to speed adoption of the technology by addressing the implementation bottleneck.
- Devoted Health CEO Ed Park made a bold statement at the Medicarians conference, "Please pay MA plans less," which seems counterintuitive for an MA plan growing 120% year-over-year. Kevin's hypothesis: Devoted is building toward a fully integrated payer-provider model that uses MA as the entry point to capture the full healthcare dollar, with ambitions closer to UnitedHealth Group than a traditional MA plan.

Q1 earnings covered Alignment Healthcare, Humana, Cigna, and Teladoc.

- Alignment Healthcare: Alignment raised guidance on revenue and membership despite its stock dropping on growth trajectory concerns. The most notable moment from the call: CEO John Kao said MA plans are paying hospitals exactly what they deserve to be paid, a direct statement that most people in the industry would only say off the record.
- Humana beat Q1 expectations and held guidance. CEO Jim Rechtin opened repeateadly with "We are right where we expected to be," signaling vindication after a rough stretch. The question is whether they can retain membership through the benefit cuts they're signaling for 2027.
- Cigna exited the ACA market and is exploring strategic options for Evicore.
- Teladoc showed signs of turning a corner after pivoting from subscription to insurance fee-for-service. Meanwhile, BetterHelp is generating $75M ARR, growing toward $125M ARR by year end and is generating 20% higher visit completion rates versus cash pay. It appears to be an undervalued asset for the organization, suggesting Teladoc itself is undervalued.

The CVS MinuteClinic / Mass General Brigham NPI deal was flagged by regulators to increase healthcare spending by at least $40M annually, a reminder that expanding access costs money, and health systems billing at hospital rates is a known problem with no easy political solution.

Nebraska is the first state to implement Medicaid community engagement requirements. Martin's observation: based on Nebraska's initial definition of medical frailty, as many as 50% of the Medicaid population may qualify for the exemption, raising questions about how meaningful the requirement will be in practice.

Guest: Eliana (Joyful Health)
Joyful Health recently announced a $17M Series A to build "financial infrastructure" for healthcare, addressing what they view as the root problem of revenue cycle, data fragmentation. They aim to address the costly, labor-intensive processes required to recover the 10-20% of revenue left on the table.

Guest: Bryan Roberts (Venrock)
Bryan discusses Venrock's thesis in seeding Kelonia, a gene therapy company recently acquired by Eli Lilly for $7B, what stood out about how Kelonia operated compared to most biotech companies, and his perspective on cell and gene therapy landscape and costs. 

Guest: Natalie Davis (United States of Care)
Natalie shares results on public trust in healthcare, illustrating the broad disapproval in US healthcare: 71% agree costs are unaffordable, 69% are unsure whether measures taken are meant to benefit patients, and most respondents make their recommended solutions to healthcare costs clear. She also discusses early results of public perception of AI in healthcare, suggesting a 50/50 split, with a desire for transparency and more time with providers.

Guest: Brian Miller (NC State Health Plan / Hoover Institution)
Brian pointedly describes the changes being made to turn around the NC State Health Plan: income-adjusted premiums, maxing out-of-pocket to avoid penalizing those with chronic conditions, and leveraging volume for steering and purchasing (Costco analogy). He also delves into biosimilar regulation as an underappreciated drug cost lever, and a nuanced framework for the MA versus original Medicare cost comparison.

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Referenced:

Anthropic: https://www.blackstone.com/news/press/anthropic-partners-with-blackstone-hellman-friedman-and-goldman-sachs-to-launch-enterprise-ai-services-firm/

Devoted: https://medcitynews.com/2026/04/ceo-of-for-profit-ma-plan-tells-cms-pay-us-less/?_bhlid=a2a53a17c3a7deac5a3afcbd556f7913be68c650ust 

Alignment: https://ir.alignmenthealth.com/events/event-details/alignment-healthcare-first-quarter-2026-earnings-call

Joyful Health: https://www.joyfulhealath.com/post/joyful-health-raises-22m-to-build-denial-intelligence-recovery-infrastructure

Mass General Brigham and CVS: https://medcitynews.com/2026/05/cvs-mass-general-brigham-primary-care-prices/

Kelonia: https://www.linkedin.com/feed/update/urn:li:activity:7452001270321643523/

Full earnings coverage: https://www.healthtechnerds.com/p/weekly-health-tech-reads-5-3-26

Public trust poll: https://unitedstatesofcare.org/wp-content/uploads/2026/04/Affordability-Poll-Polling-Memo.pdf

Medicaid work requirements: https://www.kff.org/medicaid/a-closer-look-at-the-work-requirement-provisions-in-the-2025-federal-budget-reconciliation-law/