KFF's The Business of Health with Chip Kahn

Guardrails for AI in Health Care — How High?

AI is racing into everyday medicine. The rules of the road are still being written. Dr. Michelle Mello of Stanford, professor at both the Law School and the School of Medicine, and co-leader of its Healthcare Ethical Assessment Lab for AI, joins Chip to address the questions that trail every advance this series has covered: who makes the rules, who ensures the technology gets it right — and who answers when it doesn't? ---------------------------------------- Hosted on Acast. See acast.com/privacy [https://acast.com/privacy] for more information.

The AI Arms Race in Administrative Health Care

Caroline Pearson, executive director of the Peterson Health Technology Institute (PHTI) and the Peterson Center on Healthcare, joins Chip to discuss who really benefits as AI moves into health care's back office. A quiet arms race is underway — providers deploying AI to code, bill, and capture revenue and insurers deploying it right back to review, deny, and hold the line. The open question is whether any of this lowers what the country actually spends or just speeds up the fight over the dollar. Pearson brings a rare vantage: PHTI runs rigorous, independent evaluations of health technology — from a now-famous assessment that found digital diabetes tools didn't lower the total cost of care, to its own examination of the administrative AI arms race in prior authorization and medical billing. She and Chip dig into whether AI can deliver better care and real savings, or simply more activity — and how incentives and policy decide which way it breaks. ---------------------------------------- Hosted on Acast. See acast.com/privacy [https://acast.com/privacy] for more information.

AI: Rewiring the Machine

In a conversation focused on the technology underlying AI in health care, Chip is joined by Seema Verma, former administrator of the Centers for Medicare & Medicaid Services (CMS), and now Executive Vice President and General Manager at Oracle Health and Life Sciences, the second largest electronic health records (EHR) platform in the U.S. Seema shares her insights on the evolution of EHRs and why it’s necessary to redesign these systems to better integrate AI capabilities and improve the quality of care. ---------------------------------------- Hosted on Acast. See acast.com/privacy [https://acast.com/privacy] for more information.

AI: Show Me the Outcomes

Chip talks with Dr. Toyin Ajayi, co-founder and CEO of Cityblock Health, which delivers value-based care to more than 100,000 Medicaid and dual-eligible members across ten states, many of them people of color managing chronic conditions. Ajayi makes a pointed case: Roughly 60 percent of health care AI investment goes to billing, coding, and risk adjustment — making sure someone gets paid — while only a fraction goes to delivering care. If we continue to concentrate AI there, she warns, it will drive up cost without improving outcomes. She says there is a better way — AI built for care can lower costs by improving care for those hardest to reach. She and Chip discuss what that looks like and how Cityblock is using AI now to improve care and the patient experience for its members. ---------------------------------------- Hosted on Acast. See acast.com/privacy [https://acast.com/privacy] for more information.

Is AI (Still) Biased?

In this episode, Dr. Ziad Obermeyer joins Chip to talk about AI bias in patient management, including how far the health care industry has come since his groundbreaking research that revealed alarming biases in a widely used algorithm that underestimated the health needs of Black patients. The discussion emphasizes that while AI can analyze data with remarkable precision, it is the context surrounding that data that ultimately determines its efficacy, usefulness, and fairness. Dr. Obermeyer is an emergency department physician, researcher, co-founder of Nightingale Open Science [https://docs.ngsci.org/access-data] and Dandelion [https://dandelionhealth.ai/], and associate professor at the UC Berkeley School of Public Health and the College of Computing, Data Science, and Society. ---------------------------------------- Hosted on Acast. See acast.com/privacy [https://acast.com/privacy] for more information.