This viewpoint explores the role of artificial intelligence in improving decision-making processes for coverage and payment in health care.
Discussion of AI applications in health care decision-making
Analysis of historical coverage decisions made by humans
Exploration of gaps identified through AI disagreement
Highlights the potential for AI to reveal discrepancies in coverage rules
Suggests that AI can improve fairness and transparency in payment decisions
Indicates AI as a tool to support human representatives rather than replace them
Abstract
This Viewpoint discusses the use of artificial intelligence (AI) in health care to support coverage and payment decisions that historically have been made by human representatives.