AdvaMed, the Medtech Association and CapView Strategies today released a white paper on the ethical incorporation of AI and software in Medicare.
The report — Medicare Policy at the Crossroads – Addressing Artificial Intelligence and Software — details the ways to help advance this incorporation into Medicare coverage and payment policies. It outlines a strategy for Medicare AI and software and makes targeted recommendations to improve Medicare’s payment systems, accounting for these 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.”
The AdvaMed recommendations include steps to strengthen CMS’ leadership role on AI/software issues. That includes the appointment of a chief AI officer.
Recommendations also feature a move to take action on key policy issues and evolve CMS policy to account for the unique features, functions and costs associated with the use and development of AI/software. That includes developing appropriate guardrails to maximize benefits and establish beneficiary protections.
According to a news release, the white paper also outlines a plan to leverage CMS marketplace power. This aims to improve collaboration with government and private sector stakeholders to promote ethical and equitable access to AI/software in healthcare.
More on the AdvaMed Medicare recommendations
In addition, a detailed regulatory analysis of Medicare’s benefit categories and payment systems outlines 25 targeted recommendations to better incorporate AI/software. This includes in Traditional Medicare, Medicare Advantage and alternative payment models. It addresses specific issues across individual payment systems, including hospital inpatient, physician, outpatient hospital and more.
AdvaMed said the analysis seeks clarifications on the data and evidence needed for coverage and payment of AI/software solutions. Additionally, the groups are looking for the appropriate consideration of the unique attributes and costs of AI/software. That includes costs for collecting data, conducting analysis that require significant computing power and maintaining and updating systems. It also extends to expanding the use of remote patient monitoring and other digital communications between patients and providers. They also seek improvements to payment mechanisms designed to support the introduction of new technologies.
The report urges CMS to “harness its leadership role in healthcare” to build a strategy on these technologies.
“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.”
