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Artificial intelligence in Medicare: utilization, spending, and access to AI-enabled clinical software.

Anna Zink¹, Claire Boone, Karen E Joynt Maddox

¹University of Chicago Booth School of Business, 5807 S Woodlawn Ave, Chicago, IL 60637.

The American Journal of Managed Care

|May 31, 2024

Summary

Medicare reimbursement for AI-enabled CT fractional flow reserve (FFRCT) saw rapid growth, primarily among well-resourced hospitals and specialists. This trend highlights the need to monitor AI tool adoption for equitable patient access.

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Area of Science:

Cardiovascular Medicine
Health Informatics
Medical Economics

Background:

In 2018, Medicare introduced reimbursement for CT fractional flow reserve (FFRCT), the first AI-enabled clinical software for diagnosing coronary artery disease.
Understanding the adoption patterns of such technologies is crucial for assessing their impact on healthcare delivery and patient outcomes.

Purpose of the Study:

To quantify Medicare utilization and spending on FFRCT from 2018 to 2022.
To characterize the hospitals, clinicians, and patients adopting FFRCT technology.

Main Methods:

Analysis of 100% Medicare fee-for-service claims data.
Comparison of FFRCT-adopting vs. non-adopting entities (hospitals, clinicians) and patients.
Assessment of annual trends in FFRCT utilization and spending.

Main Results:

FFRCT billing volume increased over 11-fold between 2018 and 2022.
Adopting hospitals were larger, part of health systems, nonprofit, and profitable.
Adopting clinicians were more likely to be cardiac specialists in larger practices.
FFRCT patients were more likely to be male, White, and less likely to have Medicaid or disability benefits.

Conclusions:

The initial 5-year diffusion of FFRCT was concentrated among well-resourced healthcare providers.
Monitoring the spread of AI-enabled clinical software is essential to ensure equitable access to these diagnostic tools.