Thursday, April 11, 2024

Counting the cost when AI replaces doctors

The ideas and innovators shaping health care
Apr 11, 2024 View in browser
 
Future Pulse

By Daniel Payne, Erin Schumaker and Carmen Paun

WASHINGTON WATCH

Marsha Blackburn

Blackburn says Congress needs to think about how to pay for AI in health care. | Greg Nash-Pool/Getty Images

Congress isn’t just looking to create rules governing artificial intelligence in health care — it’s also considering how it might pay for the tech.

Senators working on Medicare payment reforms are keeping AI in mind as they rethink the way health care is funded.

“How Medicare reimburses providers for AI utilization will be at the forefront of the conversation that my colleagues and I will have in the working group,” Sen. Marsha Blackburn (R-Tenn.) said in remarks at an event on AI sponsored by the American Enterprise Institute, a conservative think tank. “From diagnostic support to predictive analysis, AI holds significant potential in transforming patient care and operational efficiency.”

That thinking has some precedent: CMS already reimburses for some AI devices for services once performed by clinicians. Should that trend continue, tech companies could show new interest in the adjustments Congress makes to how much Medicare pays doctors or for the AI systems replacing them.

That matters not only for the businesses developing AI products but also for the larger health system’s willingness to adopt the technology.

It’s been an industry focus for some time.

“There’s a direct link between product adoption in health care and obtaining CMS reimbursement,” John Bertrand, CEO of health AI company Digital Diagnostics, told Daniel last year.

But he acknowledged that the question could be perplexing.

“How do you value what an algorithm is doing when the entire system is based off how much provider time has been allocated to the task?” he asked.

 

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This is where we explore the ideas and innovators shaping health care.

Mexico’s president, Andrés Manuel López Obrador, has declared 19 feral cats that roam his presidential palace “living fixed assets,” which means the government will have to take care of them forever, AP reports.

Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@politico.com, Daniel Payne at dpayne@politico.com, Ruth Reader at rreader@politico.com or Erin Schumaker at eschumaker@politico.com.

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SAFETY CHECK

The downtown Los Angeles skyline is seen as traffic passes on the Route 2 Freeway Wednesday, April 28, 2010. Six in 10 Americans - about 175 million people - are living in places where air pollution often reaches dangerous levels, despite progress in reducing particle pollution, the American Lung Association said in a report released Wednesday. The Los Angeles area had the nation's worst ozone pollution. (AP Photo/Reed Saxon)

Traditionally, government has focused more on outdoor air quality than indoor. | AP

ARPA-H wants to “revolutionize public health” with smart buildings to detect airborne health threats, like respiratory viruses.

That’s according to Jessica Green, program manager for BREATHE, or Building Resilient Environments for Air and Total Health, an initiative the high-risk, high-reward Advanced Research Projects Agency for Health announced Wednesday.

The agency seeks proposals for projects that advance smart-building technology, which is currently more associated with comfort and energy efficiency than airborne threats.

The goal: To assess, measure and report air quality in real time, address those problems and ultimately drive down disease transmission.

That could mean adding extra ventilation or disinfecting the air to reduce airborne pathogens and allergens. “Even though Americans spend 90 percent of their lives indoors, we do more to monitor and reduce health threats from the air we breathe outside than we do inside,” Green said in a statement. “As we experienced through the pandemic, having the ability to monitor, track, and improve the air we breathe indoors is urgently needed.”

Why it matters: Airborne pathogens and allergens are especially dangerous for vulnerable people, such as kids, elderly adults and people with weakened immune systems.

Cleaner indoor air can reduce allergens and exposure to respiratory illnesses like the flu and Covid-19, according to the Centers for Disease Control and Prevention.

What's next? ARPA-H wants proposals in three technical areas: air biosensors, respiratory risk assessment software and optimized building controls.

The agency encourages developers, data analysts, software developers, property management firms, building automation system providers, health care systems, hospital networks, long-term care facility operators and others to apply.

A proposer’s day, for learning about the application process and ARPA-H's vision for the program, is May 2 in Oakland, California. Registration for the hybrid event closes April 30.

 

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WORLD VIEW

Leonardo Dominguez Gomez, field researcher with the New York City Department of Health, holds up drug tests used to detect the presence of fentanyl and xylazine.

Public health agencies are deploying tests for xylazine, the horse tranquilizer dealers are mixing with illicit fentanyl and other drugs. | Angela Weiss/AFP via Getty Images

The horse tranquilizer xylazine, which is showing up more often in combination with illicit fentanyl in the U.S., has reached the U.K., POLITICO’s Rory O’Neill reports from London.

New research from King’s College London published in JAMA Network Open on Wednesday found that the drug, also known as Tranq, is turning up in fake marijuana vapes and knock-off codeine and Valium pills there.

Eleven deaths were tied to xylazine in the U.K. between December 2022 and August 2023, according to the research. That’s considerably lower than in the U.S., which recorded nearly 3,500 overdose deaths involving xylazine in 2021. But it’s enough to ring alarm bells across the Atlantic about a similar crisis.

“Urgent action is needed to protect both people who use heroin and the wider population of people who use drugs from its acute and chronic health harms,” the study said.

Caroline Copeland, who co-authored the study, said she wants to see cheap test strips made available, while health care providers should be aware that chronic skin ulcers are a sign of intravenous xylazine use.

Her co-author, Adam Holland of the University of Bristol, said the growing threat from xylazine reinforced the need to look again at how punitive drug laws impede treatment. “We need to expand the range of harm reduction interventions available for people who use drugs, including drug checking and overdose prevention centers, to give them the opportunities they need to stay safe,” Holland said in a statement.

When the U.S. launched a global coalition to address synthetic drug threats last year, Secretary of State Antony Blinken warned countries that the U.S. was the “canary in the coal mine” for fentanyl and potentially other synthetic drugs, calling on other nations to work together to stop more people across the world from exposure, and addiction, to them.

A year ago, the White House Office of National Drug Control Policy designated the combination of fentanyl and xylazine — known as Tranq Dope — as an emerging public health threat and, in November, outlined a plan to respond, which includes improving testing and data collection and developing standards for prevention, harm reduction and treatment, among other goals.

 

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