There is no other parallel to the fact that the advancement in medical innovation should be pushing for a higher scale of care as well as improvements when it comes to healthcare outcomes for patients.
The point is that as medtech advances, so must the public policy, specifically the one that has Medicare reimbursement, or else there will be many patients who will face a dearth in terms of medical and scientific breakthroughs, ambiguous inequities when it comes to access to care as far as undeserved communities are concerned.
Just take the instance of artificial intelligence led medical imaging devices. These tools can go on to enhance clinical care as well as the operation when it comes to medical practices. The fact is that the AI tool can go on to enhance the ability of radiologists so as to spot a scan abnormality that probably would have been overlooked, thereby enabling them to pinpoint and also target treatable cancers in a much more easy and effective way.
AI can also make sure to alert the radiologists to a scan that needs immediate and urgent attention, hence bumping it right in the front. There are AI-powered medical imaging devices that happen to enable radiologists to go ahead and perform their respective tasks with greater efficiency.
It is well to be noted that these technologies can go on to make use of lower doses of radiation, thereby reducing the risks to the health of a patient and enhancing their well-being.
AI-based medical technology is also enabling the improvement of efficiency when it comes to physicians and, at the same time, productivity as well. It helps in decreasing the often burdensome administrative assignments, thereby enabling the providers to go ahead and stress more on the care of patients. All this is helping to alleviate one of the major causes as far as the physician burnout phase goes, which is especially prevalent within the undeserved and also the much understaffed rural as well as urban lot.
The fact is that to date, the FDA has gone on to authorize the usage of almost 700 AI-enabled medical devices, with the most ones that happen to be made use of in radiology. Although this should indeed be marked as a pretty steep and welcoming development in terms of patient care, the Centers for Medicare and Medicaid Services- CMS has gone on to give its nod to less than ten AI-led medical device applications in terms of reimbursements, with quite challenging ways to pay when it comes to other new technologies. There happen to be complicated policies as well as limited reimbursements, which has led to physicians and hospitals having issues with adoption as well as offering numerous kinds of such revolutionary technology.
Due to the growing usage of AI in terms of medical imaging and its presence across the healthcare sector, it is now indeed time to look into how Medicare is going to pay physicians and hospitals that happen to invest in groundbreaking technology. The question pertaining to how these advanced technologies are going to be or rather should be reimbursed has indeed become a talking point. If payers that happen to be led by Medicare go on to come up with new mechanisms to reimburse the offerors for making use of AI-led tech, which happens to be enhancing the patient outcomes and also reducing the costs, patients who are unable to afford to put-in higher out of pocket expenditures will get the same access to innovative tech as against the ones who can. The AI-specific payment gateways as well as the distinct reimbursements for usage in terms of clinical tools through the payers happens to be the most likely so as to make sure of a better access to care across all the patient categories.
One should look at the rise in the usage of telehealth post Medicare started reimbursing the physicians for such kind of services. Before the pandemic, physicians weren’t reimbursed when it came to telehealth, and they were kind of pretty reluctant to go ahead and embrace the same. As the pandemic went on to spread, the agencies went on to recognize the advantages when it comes to these techs that were offered and created so as to provide more formal pathways to reimburse the physicians.
All this has expanded the access when it comes to the care for patients, specifically in the medically underserved areas as well as in the ones that happen to be facing health challenges that go on to prevent them from paying a visit to their doctors and that too in person.
The fact is that this similar pattern would come up if Medicare had to follow the same model and also establish a payment method that goes on to reimburse the providers in a separate way when it comes to the usage of FDA-led AI clinical applications. This is the reason why CMS, by way of its yearly rulemaking process, should go on to publish a very formalized pathway of payment for AI within the FDA-regulated medical imaging devices as far as the 2025 Hospital Outpatient Prospective Payment Systems rule is concerned.
It is worth noting that if the gamut of Medicare goes on to act, the potential when it comes to AI-led technologies so as to enhance the healthcare outcomes when it comes to patients, despite of their geographic location or even the socio-economic status will go on to become much closer so as to get utilised in a complete way.
Making sure to reimburse the physicians and at the same time also providers for such increasingly prominent services happens to be the most effective and also straightforward way that CMS can make sure of with all the patients getting to have an equal access in terms of clinical innovations that lead to helping in improving and also saving lives.
