AdvaMed Proposes Comprehensive Strategy to Improve Medicare Beneficiaries’ Access to Artificial Intelligence and other Software Tools
AdvaMed CEO Whitaker calls on CMS to lead a Comprehensive Medicare AI/Software Strategy
WASHINGTON, D.C. – Today, AdvaMed, the Medtech Association, and CapView Strategies released a white paper detailing ways to help advance the ethical incorporation of innovative artificial intelligence (AI) and software solutions into Medicare coverage and payment policies. The report—Medicare Policy at the Crossroads – Addressing Artificial Intelligence and Software—outlines a comprehensive Medicare AI/Software strategy and makes targeted recommendations to improve Medicare’s payment systems to account for these transformative technologies.
“CMS has taken significant, but only incremental, steps to bring the benefits of AI and software solutions that are themselves medical devices or that improve medical devices used in care for Medicare beneficiaries” said Scott Whitaker, President and CEO of AdvaMed. “The agency must now show leadership in pursuing a strategy to address access, equity and ethical issues for AI/software innovations in Medicare and across the health care system.”
In this first-of-its-kind analysis of AI/software issues across the Medicare program, recommendations are made to advance the following comprehensive steps:
- Strengthening CMS’ leadership role on AI/software issues, including the appointment of a Chief AI Officer.
- Taking action on key policy issues and evolving CMS policy to account for the unique features, functions and costs associated with the use and development of AI/software. This includes developing appropriate guardrails to maximize the benefits of AI/software while establishing beneficiary protections.
- Leveraging CMS’ marketplace power to improve collaboration with government and private sector stakeholders to promote ethical and equitable access to AI/software across the health care sector.
A detailed regulatory analysis of Medicare’s benefit categories and payment systems also outlines 25 targeted recommendations to better incorporate AI/software into Traditional Medicare, Medicare Advantage, and alternative payment models. Specific issues are addressed across the individual payment systems (hospital inpatient, physician, outpatient hospital, etc.), and a range of solutions are proposed such as:
- Clarification of the data and evidence needed for coverage and payment of these innovative solutions;
- Appropriate consideration of the unique attributes and costs of AI/software, including costs for collecting data, conducting analyses that require significant computing power, and maintaining and updating systems (including cybersecurity), as well as expanding the use of remote patient monitoring and other digital communications between patients and providers; and
- Improvements to payment mechanisms that are designed to support the introduction of new technologies.
The report concludes by urging that the time is now for CMS to harness its leadership role in health care to build a comprehensive strategy on AI/software. “Taking these important and timely steps will improve access and quality of care for Medicare beneficiaries and across the health care system” said Lu Zawistowich, President of CapView Strategies. “CapView is excited to have collaborated with AdvaMed on addressing these important health care and societal issues.”
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