| | | The Lead Brief | Mehmet Oz, who leads the Centers for Medicare and Medicaid Services, said at the conference held by Accountable for Health that a key part of a retreat he held with the agency’s senior leadership revolved around incorporating AI into their day-to-day work so as to gain confidence in it. “In the trenches where the actual battle will be won, we have to begin to incorporate some of these technologies,” Oz said. Later, Chris Klomp, who runs Medicare at CMS, expanded on the agency’s views on AI at the Better Medicare Alliance forum. At the leadership retreat, CMS honed its objectives — and “embedded in nearly every major component is AI,” Klomp said, “and for good reason.” He said that the technology has the ability to help regulators “streamline and improve what we’re doing at CMS and across the department broadly,” but it could also be used to transform the health care industry — though that’s not, he said, inevitable. “I’m convinced this will be the single most transformative technology in well over a century, certainly more than the internet. But we should not take for granted that it is a foregone conclusion, that it is going to fix all of these problems,” Klomp said. “Health care has a stunningly impressive ability to take a phenomenally powerful, disruptive technology and pile-driving it into the ground and deriving zero value from it.” One of the challenges Klomp noted is working to make health records and data truly interoperable within the health care system: “It’s 2026 we can no longer be held hostage by assuming that data is going where it needs to be,” Klomp said. → Klomp also highlighted the increasing AI arms race between providers and insurers. He said AI is being used by physicians to more easily develop billing codes for a medical visit, but there’s also been an increase in providers using AI to charge for more services or add more expensive services — known as “coding intensity” — during office visits. However, patients don’t necessarily see improvements or health outcomes that correspond with the more intense coding. “Candidly, that’s a little worrisome to us,” Klomp said. “On the flip side, we see payers that are trying to swat this down, and so they’re arming” themselves, Klomp said, referring to insurance companies. What to watch: Both Oz and Klomp highlighted the agency’s voluntary pilot program to increase the use of technology to provide better care for patients in traditional Medicare who have certain conditions. The Advancing Chronic Care with Effective, Scalable Solutions — or ACCESS — model is set to take place over 10 years, beginning on July 5. |