If you're a medical student picking a specialty in 2026, you're being asked to bet a decade and $300,000 in debt on a market nobody is teaching you to read.

This episode is the framework I wish someone had given me — plus the data nobody else is putting in front of med students.

In this episode:

• Why 76% of all FDA-cleared medical AI targets a single specialty — and why residency applications to it are still up 30%
• The four kinds of physician cognition (and why "AI replaces cognitive work" is the wrong frame entirely)
• Which specialties get repriced, restructured, or protected — and why psychiatry might be safer than radiology
• The 2026 CMS efficiency adjustment nobody is talking about — and why it's a ratchet, not a one-time cut
• What medical schools are (and aren't) doing to prepare the next generation of physicians for an AI-driven workforce

Watch the video version with charts and visuals: https://youtu.be/NETog9SBtZs

Full sources and the deep dive: danmccoymd.substack.com

Last week the Texas Medical Association joined a federal antitrust lawsuit against MultiPlan — recently rebranded as Claritev. The story being told is doctors versus insurers, an unlawful cartel, $19B in alleged underpayments. It's a clean story. The moment you look at the actual fee math from the complaint, it falls apart.

In this episode I walk through MDL 3121, the $1,000 → $200 cascade, the DOJ's March 27 Statement of Interest backing the plaintiffs' antitrust theory, and what self-funded employers should be asking their TPA on Monday morning. The bellwether trial isn't until December 7, 2027 — three years of fees away.

About 42% of what the algorithm calls "savings" never makes it to the plan. That's not a doctors-vs-insurers story. It's a third-character story.

▶ Watch the video version: https://youtu.be/H3TQUxJt2Xo 📝 Read the written deep dive (full fee math, sources, 3-question employer checklist): https://danmccoymd.substack.com/p/nobody-in-the-multiplan-lawsuit-is

SOURCES MENTIONED

• AMA on the litigation: https://www.ama-assn.org/health-care-advocacy/judicial-advocacy/health-insurance-price-fixing-real-and-ama-fighting-it
• TMA press release: https://www.texmed.org/Template.aspx?id=67699
• DOJ Statement of Interest coverage: https://www.jdsupra.com/legalnews/doj-adopts-aggressive-stance-against-4076897/
• NYT investigation summary: https://whatleykallas.com/nyt-investigation-shows-how-health-insurers-use-multiplan-to-reduce-payments-to-medical-providers-to-iincrease-their-fees-and-profits-at-the-expense-of-patients/
• Capitol Forum on MultiPlan billing incentives: https://thecapitolforum.com/provider-shows-how-multiplan-incentivizes-him-to-raise-his-billing-rate-multiplan-says-it-does-not-encourage-providers-to-overcharge/
• Seattle Times reprint: https://www.seattletimes.com/nation-world/insurers-reap-hidden-fees-by-slashing-payments-you-may-get-the-bill/
• KFF on 2026 small group premiums: https://www.kff.org/health-costs/how-much-and-why-premiums-are-going-up-for-small-businesses-in-2026/
• Medscape Physician Compensation Report 2025: https://www.medscape.com/slideshow/2025-compensation-overview-6018103

LEGAL DISCLAIMER This episode covers public reporting and pending litigation. All allegations are unproven and may ultimately be rejected in court. MultiPlan, Claritev, and the named insurers deny wrongdoing. Nothing here is legal, financial, or medical advice.

Full sources and the deep dive: danmccoymd.substack.com

49% of plan sponsors reported claims exceeding $1 million last year — double the rate from the year before. And stop-loss carriers are responding not by covering you better, but by finding creative ways to limit their exposure to the most expensive treatments.

In this episode, I break down:

→ Why stop-loss insurance was built for a different era (when catastrophic meant $300K, not $4.25 million)

→ What carriers are actually doing — lasering, exclusions, and reimbursement term misalignment — to push risk back to employers

→ The gene therapy pipeline problem: 48 approved therapies today, dozens more coming, and no historical data to predict frequency

→ Why even jumbo employers who've never needed stop-loss should reconsider

→ The 5 things every self-funded employer needs to do at renewal — including the one question that will tell you everything about your coverage

The mainstream story is that gene therapy is a miracle of modern medicine. It is. But the financial infrastructure wasn't built for this reality, and carriers have decided that the most expensive thing in healthcare is now predictable enough to exclude.

You should find that arrangement concerning.

📺 Watch the full video breakdown:
https://youtu.be/1wwrtwmYAPE

📖 Read the Substack post with sources:
https://open.substack.com/pub/danmccoymd/p/the-stop-loss-crisis-what-self-funded

📧 Subscribe for more healthcare benefits analysis:
https://danmccoymd.substack.com

Andrej Karpathy just released AutoResearch — a 630-line Python tool that lets AI agents run hundreds of experiments overnight on a 35-cent GPU rental. In one test, 35 autonomous agents completed 333 experiments while everyone slept and found 20 improvements that worked. No humans involved.

Meanwhile, your benefits broker spends maybe 20 hours on your entire annual renewal — most of it pulling quotes and formatting spreadsheets — to manage a budget that consumes 25-40% of your total payroll.

In this episode I break down what autonomous research actually is, why the analytical pattern applies directly to healthcare data and benefits design, and three specific questions every employer should be asking their broker at renewal. I also cover the three failure modes of AI research identified by economist Joshua Gans and how Karpathy's system addresses each one.

The benefits consulting industry is about to have its spreadsheet moment. The tools exist, the data exists, the pattern is proven. The only question is whether you'll be the one using it or the one disrupted by someone who does.

Full sources and the deep dive: danmccoymd.substack.com

Also checkout my YouTube Channel.

The AI labs are selling you $10,000 a month in computing power for $600. They're doing it at massive losses. And they have very specific reasons you should understand.

In this episode, I break down the $670B subsidy era fueling healthcare AI — what it means for builders, when it ends, and four strategies to exploit it before the economics correct themselves.

We cover:

• Why AI pricing follows the exact same playbook as early AWS
• The real numbers behind OpenAI's and Anthropic's losses
• Four strategies to maximize subsidized compute (from $600/mo subscriptions to $2,500 local hardware)
• Healthcare startups building real businesses on below-cost AI
• The subsidy timeline: when prices normalize and what to do before they do

Whether you're a healthcare founder, an operator evaluating AI tools, or just trying to understand why trillion-dollar companies are giving away compute — this one lays it out with data, not hype.

Watch on YouTube: https://youtu.be/uDB_VJAX05g

Full sources and the deep-dive subsidy timeline analysis: https://open.substack.com/pub/danmccoymd/p/the-golden-age-of-healthcare-ai-and?r=11z0su&utm_campaign=post&utm_medium=web&showWelcomeOnShare=true

Amazon launched an AI health agent inside the Amazon Shopping app — the same app where you order paper towels. It books appointments, manages prescriptions, explains lab results, and connects you to real doctors. Prime members get five free virtual care visits covering 30+ conditions.

This isn't a chatbot experiment. Amazon built this on Bedrock using a multi-agent architecture with auditor and sentinel agents that escalate to human providers in real time. Combined with One Medical's 200+ clinics, Amazon Pharmacy, specialty referral partnerships with Rush and Cleveland Clinic, and a billing relationship with 200 million households — Amazon now owns the full healthcare stack.

In this episode, I break down how Amazon assembled this over nearly a decade (PillPack in 2018, One Medical for $3.9B in 2023), why the pricing strategy matters more than the AI, and the three things every health system executive should be watching over the next 12 months: the employer channel play, the data advantage, and the behavioral shift that happens when asking a healthcare question becomes as casual as checking the weather.

Watch the full video: https://youtu.be/OhHrxHEnSA0?si=B6MeSTiQTGId8388

Full sources and deep dive: https://open.substack.com/pub/danmccoymd/p/amazon-just-put-a-doctor-in-your

Anthropic just announced Claude Mythos Preview — an AI model so capable at finding software vulnerabilities that they won't release it publicly. 

Instead, they launched Project Glasswing with Apple, Google, Microsoft, and others, committing $100M to use the model defensively. In weeks, Mythos found thousands of zero-day vulnerabilities across every major operating system and browser — including one in OpenBSD hiding for 27 years.

But the cybersecurity headlines aren't the whole story. The same vulnerability chaining capability that links multiple software flaws into sophisticated exploits maps directly to how polygenic disease works — cascading gene interactions across multiple variants that we've never been able to trace. With models like Arc Institute's Evo 2 and DeepMind's AlphaGenome already decoding the genome, Mythos-class reasoning could change everything about how we understand and treat disease.

If we can hack code to break it, we can hack code to fix it — including the code that makes us sick.

Sources and full write-up: https://open.substack.com/pub/danmccoymd/p/hacking-dna-the-anthropic-story-nobodys

Meta acquired Moltbook. OpenAI put ads in ChatGPT. Microsoft found 31 companies actively poisoning what AI assistants recommend. Everyone's calling it AI-native marketing — but what they're really describing is an influence mechanism with no disclosure, no regulation, and direct access to how people make decisions.

In this episode, I break down Microsoft's AI Recommendation Poisoning research, why OpenAI's health advertising exclusions don't actually solve the problem, the insurance company AI lawsuits you should know about (UnitedHealth's nH Predict, Cigna's PXDX), and the 70-year regulatory gap between subliminal advertising bans and prompt injection. When this reaches healthcare — and it will — the implications for patients, providers, and benefits managers get genuinely concerning.

Research sources and extended analysis: https://open.substack.com/pub/danmccoymd/p/prompt-injection-is-subliminal-advertising

Watch the video version: https://youtu.be/4vECwmEUHEs

What's really happening with AI in healthcare? The common story is that health systems just need to find the right tool — the best ambient scribe, the smartest chatbot. But the reality is more complicated.

In this episode, I break down why Sutter Health's AI agent deployment through Hyro tells us everything about where healthcare AI is actually heading, why 63% of healthcare leaders say interoperability is the number one AI capability they want, and why the organizations seeing real ROI did the boring infrastructure work first.

If you're a benefits consultant, health system leader, or anyone advising healthcare organizations — stop evaluating AI tools. Start evaluating integration readiness.

Sources and the deep dive: danmccoymd.substack.com

The telehealth boom was supposed to revolutionize healthcare forever—but what went wrong? In this episode, Dan McCoy unpacks the dramatic fall of industry giants like Teladoc and Amwell, revealing how their high-profile bets on nationwide distribution networks failed to stand the test of time. More importantly, you'll hear why the real disruptor isn’t a return to in-person care, but the explosive rise of AI-powered tools that are decentralizing healthcare delivery.

Dan breaks down the structural shifts pushing telemedicine incumbents to the brink, explores the rapid adoption of ambient clinical AI, and explains how local practices now leverage advanced technology to deliver more personalized, context-rich care. If you care about the future of healthcare—from benefit managers to health system execs to curious entrepreneurs—this episode is your essential guide to what’s next, who’s winning, and why yesterday’s telehealth playbook no longer applies.

Check out my SubStack for a deeper analysis: 

 https://danmccoymd.substack.com/