The Pulse
CMS stood up a new office to oversee digital health, AI, and interoperability.
The Centers for Medicare and Medicaid Services created the Office of Health Technology Products to govern AI, digital tools, and data exchange across federal programs.
For the last few years, digital health scaled in a light-touch regulatory lane. A dedicated federal office signals that lane is narrowing.
If you’re building on AI intake, automated messaging, or data-heavy personalization, assume the compliance bar rises from here. Build it in now, not after a letter arrives.
Hims lined up $400M from JPMorgan to fund its pharmacy build-out.
Hims secured a $400 million receivables facility with JPMorgan Chase to support pharmacy operations, on top of its pending Eucalyptus acquisition.
The incumbent is financing vertical integration at a scale a smaller brand cannot match on supply or capital.
You don’t win that fight on infrastructure. You win it on the patient relationship, which is the one asset a receivables facility can’t buy.
Clair Health raised $11.6M for a wearable that tracks hormones without a blood draw.
The women’s-health startup combines biosensors with AI voice analysis to monitor cycles, perimenopause, and inflammation continuously.
Continuous, passive health data is coming to categories well beyond weight loss.
The brands that wire that signal into their lifecycle will trigger off what’s actually happening in a patient’s body, not off a form they filled out once.
The Deep Dive
Your lifecycle revenue isn’t capped by your copy or your offer. It’s capped by whether the email lands.
And for a lot of telehealth brands, it quietly stopped landing this year.
Since November 2025, Gmail hard-rejects non-compliant bulk mail. Not the spam folder. A permanent 5xx rejection before the message reaches anyone.
Most operators never saw it happen, because a rejection doesn’t show up as a complaint. It shows up as a slow, unexplained decline in email revenue.
The GLP-1 boom quietly made you a bulk sender.
More signups, bigger lists, more sends. Somewhere in the last year, a lot of brands crossed 5,000 messages a day to Gmail and Yahoo without noticing.
That number is the line. Cross it and you’re held to a stricter standard:
SPF, DKIM, and DMARC all authenticated and enforced.
One-click unsubscribe on every marketing send.
Spam complaints kept under 0.3%.
That last one is brutal on a fast-grown list. 0.3% is three complaints per thousand. Blast a big, half-cold GLP-1 list and you breach it in a single campaign.
Every disengaged subscriber is a tax on the ones who convert.
This is why deliverability is an expansion tax, not a technical footnote.
When you mail your whole list to chase reach, the non-openers drag your sender reputation down. The filters learn you’re low quality.
Then the patients who actually buy from you stop seeing you too. You didn’t lose a campaign. You lost the channel.
We watched this play out with a brand whose email revenue slid for two straight months with no obvious cause.
The copy was fine. The offers were fine. The dashboards looked normal.
Their complaint rate had crept to 0.4% after a big intake push, and Gmail had quietly started bouncing a slice of every send before it landed.
The fix wasn’t a sharper campaign. It was cutting the list back to the people who actually wanted the mail, and the revenue came back within weeks.
What protects the channel.
Authenticate properly and put one-click unsubscribe on every send. This is table stakes now, not optional.
Segment by real engagement, not opens alone. Sunset the subscribers who haven’t engaged in 90 days.
Warm any list that’s been sitting. Don’t drop a cold 50,000-contact send in one go.
The takeaway: deliverability is the ceiling on every dollar lifecycle can produce. Fix the ceiling before you write another campaign, because the best offer in the world earns nothing from an inbox it never reaches.
Quick Takes
The molecule costs the same everywhere now, so a retention discount is just lit money.
GoodRx recently matched the direct price on oral semaglutide, joining Amazon, LillyDirect, and Ro at the same number.
When the price is identical across every channel, a patient isn’t leaving you over cost, so a “come back” discount isn’t saving anyone. It’s subsidizing people who were staying anyway.
Spend that margin on the provider check-in that actually changes whether they stay.
The next data moat is passive, not asked.
That Clair Health wearable in the Pulse is a preview. Continuous monitoring means lifecycle triggers you don’t have to survey for.
A brand firing a check-in off a real biosignal will out-personalize one still relying on a single intake form every time. Start deciding now which passive signals you’d want wired into your flows.
One Thing to Try
Pull your last 30 days of email sends.
Check two numbers: your hard bounce rate and your spam-complaint rate. If complaints are anywhere near 0.3%, or bounces are climbing, that’s your revenue leak.
Stop sending to anyone who hasn’t opened in 90 days and sunset the never-engaged entirely.
Then confirm SPF, DKIM, and DMARC are enforced and one-click unsubscribe is on every send.
Takes under an hour to diagnose, and it protects every campaign you send after it.
If retention is your biggest revenue leak, that’s what we fix. growthtrigger.xyz
Reply to this with your biggest retention challenge. I read and respond to every single one.