What is the problem
In late 2020, payers began reimbursing clinicians and health systems for each use of select image-based AI devices. The experience with traditional medical devices has shown that per-use reimbursement may result in the overuse use of AI. How should we move from the traditional reimbursement system to reimburse AI?
What are we doing
In Nature Digital Medicine, we put forth one of the first proposals for revamping the payment system for AI. In this article, described five alternative reimbursement approaches, including incentivizing outcomes instead of volume, utilizing advance market commitments and time-limited reimbursements for new AI applications, and rewarding interoperability and bias mitigation
Impact
Our article spurred a series of Nature counterpoints and summary documents that will shape the debate over reimbursement of medical AI. Our work was cited in a 2022 Medicare Proposed Rule.
