Darwin's Our Take: Anthropic, OpenAI unveil new AI tools for health care enterprises

A day after Open AI launched its ChatGPT Health, the company introduced OpenAI for Healthcare, a suite of AI products designed to help health care organizations “deliver more consistent, high-quality care for patients — while supporting their HIPAA compliance requirements.”

One of the new products is ChatGPT for Healthcare, which offers a centralized workspace with role-based access controls and organization-wide user management. Organizations using ChatGPT for Healthcare maintain control over their patient data and personal health information, OpenAI noted.

By integrating with an organization’s other systems, ChatGPT for Healthcare can incorporate the organization’s policies, pathway documents, and operational guidance in its responses, according to the company.

The platform draws from peer-reviewed research, public health guidance, and clinical guidelines to provide clinicians with answers “grounded in relevant medical sources,” OpenAI said, along with transparent citations.  

ChatGPT for Healthcare can also automate workflows with templates for discharge summaries, patient instructions, clinical letters, and prior authorization support, the company said.  

A few days after the launch of Open AI for Healthcare, Anthropic introduced Claude for Healthcare, a suite of AI tools and resources designed for use by health care providers, payers, and consumers to make health-related information easier to find, access, and understand, Anthropic said in its announcement.

Anthropic initially announced Claude, a next-generation AI assistant, in March 2023. Last October, the company unveiled Claude for Life Sciences, an expansion of Claude’s features that allows the platform to be used as a “research partner for scientists and clinicians.”

The latest expansion, which also includes new life sciences capabilities, builds on “major recent improvements” Anthropic has made to Claude’s general intelligence. These advances make the platform “dramatically more useful for real-world health care and life sciences tasks,” according to the company.  

In Claude for Healthcare, Anthropic has added tools that allow users to give the AI assistant direct access to other platforms. These tools allow Claude to pull information from other systems and databases, such as CMS’ coverage database, the ICD-10 coding system, and the National Provider Identifier Registry. HIPAA-compliant organizations can also use Claude to access PubMed.

Claude for Healthcare also has new agentic skills: FHIR development, which helps to improve interoperability, and a sample prior authorization review skill.

According to Anthropic, providers and payers can use Claude for Healthcare to:

• Speed up reviews of prior authorization requests
• Support claims appeals
• Coordinate care and triage patient messages

Consumers will be able to use Claude for Healthcare in ways similar to Open AI’s ChatGPT Health. For instance, users who subscribe to certain Claude plans can choose to give the platform secure access to their lab results, medical records,  insurance records, and health and fitness apps.

By giving Claude this access, consumers can ask the AI assistant to summarize their medical history, explain their test results in plain language, find patterns in their fitness and health records, and prepare questions they can ask during medical appointments, according to Anthropic.

Anthropic noted that Claude for Healthcare users can choose which information they share with the AI assistant, and they can edit or revoke permissions whenever they want.

Google also announced updated and new open medical AI offerings last week. In addition to releasing a new version of its open medical generative AI model, MedGemma, which now supports three-dimensional imaging such as CT scans and MRIs, the company introduced MedASR, an open model for medical automated speech recognition.

OUR TAKE: The rivalry among AI model companies is intensifying as they train their sights — and their models — on health care.

With the splashy launch of ChatGPT Health, Open AI seemed to be putting more effort into attracting consumers. That would make sense because, as the company pointed out in a recent report, more than 40 million people in this country alone use ChatGPT every day to get answers for health care questions.

However, the immediately subsequent introduction of ChatGPT for Healthcare makes it clear that OpenAI is courting health care organizations as well.

Anthropic, on the other hand, appears to be focusing its Claude for Healthcare product primarily on enterprise customers, with a secondary focus on the consumer market.

While both OpenAI and Anthropic can count major life sciences companies and health systems among their client roster, Anthropic may have an edge as far as enterprises are concerned.

Sunil Dadlani, chief information and digital transformation officer at Atlantic Health, told Becker’s Hospital Review that Claude for Healthcare is a “game-changer.”

Dadlani pointed out that, unlike its rivals, Claude is built on a “constitutional AI” framework (which Anthropic explains in this post). He said this aspect of Claude gives the platform a “predefined ethical compass.”

“For a patient or a health care consumer, this is a massive win — it means the AI is hardwired to be cautious, honest, and far less likely to ‘hallucinate’ a medical answer just to be helpful,” Dadlani added.

Eric Kauderer-Abrams, Anthropic’s head of biology and life sciences, told Fierce Healthcare, “A big piece of the challenge of using AI in health care is there’s basically no room for error. The cost of hallucinations, for example, or even the cost of non-reproducible analyses, is very high. We’ve done a lot of work to solve those problems.”

According to Kauderer-Abrams, Claude for Healthcare’s HIPAA-ready infrastructure makes the platform a “plug-and-play” option for health care organizations.

What else you need to know

Boston Scientific agreed to acquire Penumbra for approximately $14.5 billion. Based in Alameda, Calif., Penumbra develops technologies used in thrombectomies. “[T]his acquisition offers Boston Scientific an opportunity to enter new, fast-growing segments within the vascular space,” said Mike Mahoney, Boston Scientific’s CEO, in the Jan. 15 announcement.

Penumbra’s portfolio includes devices to treat conditions such as acute limb ischemia, aneurysms, deep vein thrombosis, heart attacks, pulmonary embolism, and stroke. Both companies’ boards have approved the definitive agreement, which values Penumbra stock at $374 per share. Boston Scientific plans to pay for the transaction with a combination of cash and stock. If shareholder and regulatory approvals are received and other customary closing conditions are met, the companies expect to complete the acquisition this year.

Earlier in the week, Boston Scientific announced a separate definitive agreement to acquire Valencia Technologies, a privately held company in Valencia, Calif., that develops technological treatments for bladder dysfunction, for an undisclosed sum. Boston Scientific anticipates closing that acquisition, which is also subject to customary closing conditions, by midyear.

UnitedHealth Group has used “aggressive strategies” to inflate reimbursement for members enrolled in Medicare Advantage plans, according to an investigation the Senate Judiciary Committee started nearly a year ago. After reviewing more than 50,000 documents provided by UHG, the committee’s Oversight and Investigations Unit found evidence that UHG “has turned risk adjustment into a major profit-centered strategy,” according to their report. “UHG uses aggressive strategies to maximize [its] risk adjustment scores and … appears to be able to leverage its size, degree of vertical integration, and data analytic capabilities to stay ahead of CMS’ efforts to counteract unnecessary spending related to coding intensity,” they wrote. Moreover, they noted, since other Medicare Advantage organizations (MAOs) contract with UHG for various services and support, the opportunities UHG has identified and strategies it has developed “permeate the entire MA industry.”

Although the report does not allege misconduct, it states, “[The investigation has … shown that risk adjustment in MA has become a business in itself — by no means should this be the case. MAOs should receive payments that are commensurate to the complexity and acuity of the Medicare beneficiaries they insure, not their knowledge of coding rules and their ability to find new ways to expand inclusion criteria for diagnoses.” Sen. Chuck Grassley, R-Iowa, who chairs the Judiciary Committee, issued a news release summarizing the report.

A company spokesperson said UHG disagrees with the committee’s “characterizations of our Medicare Advantage coding practices and HouseCalls program,” Becker’s Payer Issues reported. Meanwhile, senators on the Finance Committee recently renewed their inquiry into UnitedHealth’s nursing home practices.

Health care spending in the U.S. increased 7.2% in 2024, reaching $5.3 trillion, according to CMS. The increase was similar to a 7.4% rise in spending a year earlier, but larger than the 4.1% and 4.8% increases seen in 2021 and 2022 (during COVID-19). According to an analysis published on Jan. 14 in Health Affairs, “non-price factors” — mostly greater volume and intensity of care — were largely responsible for the higher growth in spending seen in 2023 and 2024.

A breakdown of the overall 7.3% increase in 2024 revealed that price increases (largely hospital prices) accounted for 2.5% of the growth, and population growth accounted for another 1%. The remaining 3.6% was attributed to the non-price factors.

The total amount spent on health care in 2024 translates into an average per-person expenditure of $15,474, up from an average of $14,580 the previous year. The increased growth in health care spending outpaced growth in the U.S. gross domestic product both years (GDP growth was 5.3% in 2024 and 6.7% in 2023).

The authors of the analysis noted that the share of the U.S. population with some type of insurance coverage peaked at 92.5% in 2023 but declined slightly to 91.8% in 2024. (Lower Medicaid enrollment resulting from redetermination efforts in 2024 was offset in part by increased enrollment in plans offered on Marketplace exchanges.) A related Health Affairs article written by Michael Chernew, chair of the Medicare Payment Advisory Commission, provides additional insight into factors driving the higher growth in health care spending.  

Hawaii Pacific Health and Hawaii Medical Service Association (HMSA) will affiliate under a new nonprofit parent organization known as One Health Hawaii, Becker’s Payer Issues reported. Talk of a potential merger between the two organizations surfaced early last month. Honolulu-based Hawaii Pacific Health operates four hospitals and includes an ACO called Hawaii Health Partners. HMSA, an independent licensee of the Blue Cross Blue Shield Association, is the state’s largest health insurer. Raymond Vara, CEO of Hawaii Pacific Health, said the sole intent of the affiliation is to create “an affordable, sustainable, high-quality, accessible health care system for the people of Hawaii.” Dr. Mark Mugiishi, CEO of HMSA, referred to the proposed system as an “open system” that encourages 100% provider participation, Becker’s reported. The affiliation will require regulatory approval.  

D.C. developments

Six medical organizations will ask a federal court to restore childhood vaccine recommendations the Centers for Disease Control and Prevention had in place last April, before Health Secretary Robert Kennedy Jr. fired the entire Advisory Committee on Immunization Practices (ACIP), a panel of experts that advises the CDC, and formed a new panel consisting of individuals whose view more closely align with his own. Early this month, the Department of Health and Human Services and the CDC bypassed ACIP when they announced changes to the CDC immunization schedule. The new schedule includes universal recommendations for vaccines targeting 11 diseases, whereas the one in effect last spring targeted 17 diseases. The vaccines removed from the universal recommendations are now instead recommended under shared clinical decision making.

The American Academy of Pediatrics (AAP) and the five other medical organizations listed as plaintiffs in the legal action will ask the court to grant an injunction blocking the immunization changes. A preliminary hearing is slated for Feb. 13. At that hearing, the plaintiffs will also ask the court to stop the February ACIP meeting. Additional details on the legal efforts are available in this AAP press release. More information on the vaccines eliminated from the schedule is available in this post by FactCheck.org.

What we’re reading

Growth In National Health Expenditures: It’s Not The Prices, Stupid. Health Affairs, 1.15.26

The Price of Healing—A Growing Barrier for Aspiring Physicians. JAMA, 1.12.26

Agentic AI and the race to a touchless revenue cycle. McKinsey & Company, 1.9.26