Payment for Clinical AI

Manatt Health recently supported the Peterson Health Technology Institute (PHTI) in convening senior leaders from health systems, health plans, technology developers, investment firms, academia, and federal agencies to discuss payment that supports the adoption of high-value clinical AI. The workshop centered on current and future payment models for assistive and autonomous AI, focusing on hypertension management to illustrate how care delivery and payment could evolve as AI takes on a greater role in clinical care delivery.

Participants explored the following questions around :

• Which existing payment options can be adapted for increasingly autonomous AI delivery models?
• Where do payment options fall short and where are incentives misaligned?
• How should future payment options be designed to support high-value clinical AI adoption?

Key takeaways:

1. Applying today’s payment options to clinical AI will both inflate costs under fee-for-service and insufficiently incentivize adoption.
2. Payment models for AI should be deflationary, outcome-based, and adaptive to evidence and an evolving clinician role.
3. Autonomous clinical AI requires new payment models, not incremental modifications to existing ones.

Looking Ahead

Clinical AI presents a once-in-a-generation opportunity to fundamentally redesign how healthcare is delivered. Unlike previous new technologies, clinical AI has the potential to reshape the underlying economics of care itself by increasingly substituting technology for human labor. If deployed thoughtfully and at scale, this could dramatically expand access to care, improve patient outcomes, and lower healthcare costs over the long term. The decisions we make today on how to pay for AI-enabled clinical care will shape not only the pace of clinical  AI adoption, but the impact on our healthcare system for years to come. PHTI is committed to advancing new payment models for technology-enabled care.

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