The Promise of AI in Health Care

AI is Transforming Patient Care

The use and acceptance of artificial intelligence (AI) is expanding rapidly in health care. A recent survey reveals most Americans are both comfortable with AI in health care and recognize its potential benefits. Health care leaders are also optimistic, with many calling AI the most exciting emerging technology in the industry.

• Adoption: Medical scribe technology is increasingly being used to assist doctors with administrative tasks. Competition between AI companies for partnerships with health systems is intensifying. While several AI tools are tested and approved for use, some researchers think there are ways to provide more rigorous assessment.
• Equity: A new investigative series by STAT examines how race-based algorithms persist in health care and how misusing race as a health risk factor harms Black patients by leading to underdiagnosis. At the same time, there is optimism that AI could address health inequities by reducing human biases and better identifying at-risk patients.

Resources & Initiatives

• The FDA’s drug center is establishing a new Artificial Intelligence Council to improve the agency’s ability to regulate AI.
• The Department of Health and Human Services Office for Civil Rights published new regulatory requirements holding health care organizations responsible for mitigating discrimination in AI tools.
• NIHCM webinars have addressed AI’s potential to transform health care and its promise for health equity.
• Harvard Business Review features Blue Cross Blue Shield of Michigan’s leadership in employing AI to improve care delivery while ensuring data security and compliance.
• Florida Blue is utilizing AI to improve patient experiences through an in-house AI chatbot that supports customer service.

Health Care Industry News

Health care utilization is rebounding to pre-pandemic levels and spending has increased. In the first quarter of 2024, health care spending exceeded pre-pandemic levels, with inpatient and outpatient services emerging as the main contributor to rising costs. Various stakeholders are exploring solutions.

• Drug Pricing: The Centers for Medicare and Medicaid Services (CMS) shared results on their new Medicare drug negotiation program, estimating savings of $6 billion on 10 selected drugs, if the program had started in 2023. Drugmakers are voicing concerns about how the negotiations should work, and experts warn the program may be overestimating projected discounts. Prices in the US for the same drugs are still double those of other wealthy nations.

• Rising Care Costs: Employers are expressing concern over growing health care costs due to increased demand for weight loss drug coverage, expensive cancer treatments, and cell and gene therapies, which has prompted them to plan for a ~8% increase in 2025. Access to weight loss medications is limited for certain populations due to underlying economic and racial disparities. Meanwhile, obesity experts explain that weight loss medications are not a cure for obesity.

• Value-Based Care: A new paper shows the first reduction in socioeconomic disparities in outcomes under value-based care (VBC) using mandatory hospital participation. However, another study examines how underperformance in VBC remains a challenge, finding that physicians were required to track an average of 57 quality measures each year, posing a potential barrier to successful implementation.

Resources & Initiatives

• Independence Blue Cross and Jefferson Health demonstrate how supportive oncology programs are associated with fewer in-patient and emergency room visits.
• Healthcare Triage, a NIHCM Grantee, shares why prescription drugs have high costs and what drives drug development.
• To address the high cost of care, health systems are investing in affordable housing to reduce avoidable visits by patients experiencing homelessness.
• CMS shares multiple steps to prioritize and leverage data sharing within their models to improve participation in VBC.

Infectious Diseases: Schools, COVID, & More

COVID levels were high this summer. Efforts to reduce its spread include new vaccines and free tests. There are additional concerns about the spread of common and uncommon infectious diseases, such as the West Nile virus, potential transmission of bird flu, and others. Concurrently, there is a rise in concern about viruses as children start the new school year.

• Back to School: Schools are preparing to stay open amidst high COVID rates, even though there is increasing vaccine hesitancy among parents in some districts. In 2022-2023, kindergarten vaccine exemptions rose to a national median of 3.3%, up from 2.7% the previous year, varying by state. A Centers for Disease Control and Prevention (CDC) report found the Vaccines for Children program saved $2.7 trillion in societal costs over 30 years.

• COVID: As COVID spreads, the predominant variant (KP.3.1.1) has been detected across the US. Virus-related emergency department visits have been rising since mid-May, with the South and Southeast showing the highest levels. A new COVID vaccine is available, but experts are dubious about the long-term effectiveness given the rapid mutation of variants. Federal health officials have relaunched free COVID tests ahead of seasonal changes.

• Other Infectious Diseases: The CDC issued a health alert citing a rise in human parvovirus B19, also known as ‘slapped cheek’ virus. Measles is also increasing, there have been cases reported by 31 states and 13 outbreaks so far in 2024. Eastern equine encephalitis, a rare mosquito-borne illness with a high death rate, has caused one death in New Hampshire and has been detected in humans in five other states.

Resources & Initiatives

• CMS updated hospital requirements to electronically report on flu, COVID-19, and RSV.

• The CDC provides resources to stay up-to-date with COVID-19 and additional strategies to reduce the spread of infectious diseases within schools.

• An NPR article answers frequent questions about the ‘slapped cheek’ virus.

• Anthem Blue Cross, a subsidiary of Elevance Health, and a local news station collaborate to support families ahead of back to school season.

Concerns About Parent and Child Mental Health

The Surgeon General recently issued a public health advisory calling attention to the crisis in parent mental health. In addition, youth mental health continues to be a concern.

• Parents: Parents experience higher levels of stress than other adults. The most common stressors include financial strain, time pressure, and concerns about children’s health and safety. The recent advisory outlines actions governments, employers, and communities can take to support parents.

• Children: A study found the pandemic’s impact on children’s mental health varied by individual characteristics. While mental health issues persisted or increased in some children, low-income and Black youth experienced minor decreases in distress, ADHD, and depression, possibly due to a break from school-related stressors such as high rates of school-based violence.

• Federal Initiatives: The Substance Abuse and Mental Health Services Administration (SAMHSA) announced $65.7 million in grants and funding to address mental health and substance use, including $8 million for the wellness of children ages 8 and younger.

Resources & Initiatives

• NIHCM’s recent infographic Building Strong Foundations: Children's Mental Health shares crucial data, including that 50% of mental health problems develop by age 14.

• Florida Blue Foundation is awarding $2.4 million in grant funding to organizations to address youth mental health challenges and increase the mental health professional pipeline.

• Wellmark shares information for parents on how to keep an eye on their children's mental health and when to seek care.

• Mental Health America shares a variety of parenting mental health resources.

September is Suicide Prevention Month. SAMHSA shares resources on how to raise awareness, including learning about the warning signs and risk factors.