Policy & Payers
Amazon, Google, Meta, Oracle and Axon back the CMS prior auth pledge
They join the push to speed up prior authorization and make it more transparent by 2027. Big Tech is moving into payer workflows.
Source: 21 Oct →CMS admits WISeR isn’t working
A CMS deputy administrator said “a lot of things” about the AI-assisted Medicare prior auth pilot running in six states are not working. Expect more scrutiny of AI-led denials.
Source: 15 Oct →Funding & M&A
Suki raises $90M Series E
Its ambient AI now links clinical documentation to financial workflows, and it works with 250+ healthcare organisations.
Source: 13 Oct →Brellium raises $23M
Brellium raises $23M for AI that checks documentation before billing. It's expanding beyond behavioural health.
Source: 13 Oct →Sunbound closes a $24M Series A
Sunbound closes a $24M Series A and acquires Richter Healthcare Consultants, combining AI RCM with services for senior living.
Source: 15 Oct →RCM services keep consolidating
Sustainable Medical Billing made two acquisitions in a week (SMRTDO and Impact Healthcare Solutions), adding 300+ nearshore staff.
Source: 21–22 Oct →Leadership Moves
Omega Healthcare
Senthil Velayutham, formerly Nextiva’s product and technology chief, joins as CTO to lead AI across its revenue operations platform.
Source: 20 Oct →The pattern
RCM AI companies are building out their C-suites as they scale. Adonis named its first CRO (Doug Pickett, ex-Cedar) and a CPO from Oscar Health this summer.
Source →Talent Insight
Capital is concentrating, so commercial hires must pay back fast
- Just 20 rounds took 45% of US digital health funding in H1 ($7.4B in total). Most companies are raising smaller rounds and have to show revenue quickly.
- The most valuable hires bring payer or health-system relationships on day one: Account Directors and VPs of Growth who have already sold into revenue cycle teams.
- For 2027 plans: For 2027 plans pair every new seller with implementation capacity. With the CMS deadline coming, go-lives sell the next deal.
issy.eaden@qpexec.com