Improving Patient Access to Artificial Intelligence (AI) Enabled Imaging

 

The promise of AI in medical imaging is improved healthcare outcomes for both patients and providers through accelerated emergent condition identification, improved diagnoses, and better outcomes at lower costs. Many AI solutions can also help to address physician workloads and associated burn-out.

TWO PRIMARY AI USE CASES FOR MEDICAL IMAGING ARE:

  • Asynchronous AI, which describes devices that work “over” the image to perform its function separately from image acquisition (e.g., lung nodule detection), and

  • Integrated AI, which that performs concurrently with the same device that is capturing the image (e.g., iterative reconstruction algorithms).

Unfortunately, how AI is valued and reimbursed under the Medicare system is not conducive to fostering AI innovations. Current reimbursement systems are not designed to properly capture the value and cost of AI devices. 

MITA supports the development of a reimbursement framework by the Centers for Medicare & Medicaid Services (CMS) that recognizes the costs of AI-enabled medical devices for the purpose of calculating annual Medicare reimbursement amounts. MITA also stands ready to work with policymakers on changes to Medicare reimbursement policies that are transparent, predictable, and accountable, with consistent, clearly stated criteria for AI-based technologies to be valued. 

Challenges for Medical Imaging AI

  • Fragmented, inaccessible healthcare data with competing legal and regulatory expectations about data handling to ensure patient privacy and limit or eliminate bias

  • Current reimbursement policies which are not conductive to AI

Potential of Medical Imaging AI

  • Better patient outcomes through faster diagnoses and improved clinical decisions

  • More access to state-of-the-art care in traditionally underserved areas, like rural settings

  • Reduced physician workloads

  • More efficient devices which improve clinical workflows and increase patients seen

  • Fewer re-scans and reduced radiation exposure 

FUTURE OF AI IN HEALTHCARE

MITA believes that medical imaging AI will continue to modernize U.S. healthcare at an exponential rate. Providers can reap the benefits of improved workflows, but both public and private payers need a clear and consistent reimbursement structure before AI potential can be unleashed.