Special Episode: The ChatGPT Health Study

Mount Sinai just published the first independent safety evaluation of ChatGPT Health—the AI tool 40 million people are using daily to decide whether they need emergency care. The findings are sobering: a 52% under-triage rate on true emergencies, anchoring bias that follows when family members minimize symptoms, and suicide crisis safeguards that triggered inversely to actual risk. But the story isn't all bad. An NEJM AI study shows what AI triage looks like when it's designed to support clinical judgment instead of replace it—and the results are genuinely encouraging. We break down what the research says, what's actually working, and what healthcare leaders should do right now. Plus, Deep Thoughts with Shelby on the difference between keeping the peace and making the peace.

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Health Insurers Turn to AI to Cut Billions in Costs — Providers Should Be Paying Attention Squeezed margins are pushing major payers to deploy AI across utilization management and prior auth, raising concerns about rising denials and lack of transparency.

Health Systems Go All In on Agentic AI for End-to-End Clinical Workflows The conversation has moved past scribes — systems like Mayo Clinic and Intermountain are investing in AI that handles scheduling, prior auth, care coordination, and follow-up without human intervention.

Digital Therapeutics Finally Have a Path to Get Paid New Medicare billing codes and fresh funding signal that app-based treatments are moving from failed pilots to real budget line items for health systems and payers.

Headline 1: My Experience with Earl 2 Shelby returns after experimenting with OpenClaw (formerly MoltBot), the viral open-source AI agent that autonomously executes tasks on your computer. Despite security researchers calling it a "disaster waiting to happen," he installed it to understand firsthand what autonomous AI actually feels like. His experience provides crucial context for understanding the AI disruption hitting healthcare.

Headline 2: Congress Passes Landmark PBM Reform On February 3rd, Congress passed comprehensive PBM reform requiring 100% rebate pass-through to plan clients starting in 2028. The law also bans spread pricing in Medicare Part D and mandates massive transparency requirements. After decades of PBMs operating in a black box, the rebate retention business model is dead.

Headline 3: HHS Scraps 340B Rebate Pilot The Department of Health and Human Services abandoned its controversial 340B rebate model after hospitals sued and won. The proposed pilot would have required providers to front full drug costs and wait for rebates—creating massive cash flow problems for safety-net hospitals. While hospitals are relieved, the fight over 340B isn't over.