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LAS VEGAS — CMS wants to deploy artificial intelligence tools to Medicare beneficiaries to help them navigate their care, CMS officials said Thursday at the HIMSS conference.
The agency already uses this technology to detect fraud. But CMS also hopes to put technology in the hands of patients, both to help older adults and to I hope to bring down increase in health spendingwhich continues to outpace the rest of the economy.
“The fundamental problem right now is that other sectors of the U.S. economy have grown and been deflationary through their use of technology,” CMS Administrator Dr. Mehmet Oz said during a panel discussion. “Health care has remained inflationary. »
The federal government wants to introduce AI agents, or AI systems that can act more autonomously, to Medicare beneficiaries to help them find doctors or choose Medicare Advantage plans, Oz said. That tool should be available “when we’re done with this administration,” he said.
The biggest challenge is that Medicare beneficiaries don’t trust AI, Oz noted.
Only 31% of Medicare enrollees aged 65 and older trust AI “a lot” or “a fair amount” to access medical records and provide personalized health advice, according to a survey published last year by health policy researcher KFF.
“No one explained to them why this would transform their lives for the better,” Oz said. “It seems like a tool that we use to let them know or to help hospitals solve problems, but not necessarily their problems. »
An objective of CMS Health Technology Ecosystem — an initiative launched last year which aims to facilitate data exchange through partnerships with the private sector and increase the availability of digital health tools – is about expanding access to conversational AI to help patients navigate care and discuss their health, Amy Gleason, acting administrator of US DOGE and senior advisor to CMS, said during the panel.
Some companies that signed the Health Tech Ecosystem pledge have started launching AI chatbots dedicated to health queries, she noted. For example, OpenAI launched its tool in Januaryand Microsoft announced its Copilot Health assistant this week.
Always, misuse of AI chatbots could pose a risk to patients, given that the tools can provide false or misleading information, experts say. Research into OpenAI’s consumer health tool published last month revealed the chatbot cases often undertriagedby failing to send patients to the emergency room for serious health problems such as impending respiratory failure.
Hallucinations are a concern, but doctors can also make mistakes, Gleason said.
“The same thing will happen with AI, and they are the stupidest today than they will ever be,” she said. “So I think we need to embrace that and help people understand how much it can help them.”
The Trump administration has also used AI in health care to help CMS detect fraud, said Kimberly Brandt, the agency’s chief operating officer and deputy administrator.
Fraud has become a major priority for the Trump administration, which last month ended $259 million in Minnesota Medicaid funds over what he called unsubstantiated and potentially fraudulent claims. The agency also imposes a six-month moratorium on Medicare enrollment for some durable medical equipment suppliersas part of its anti-fraud efforts.
CMS used an algorithm trained on legacy Medicare providers against whom the agency took enforcement action, and tested new providers enrolling in the program against these bad actors, Brandt said.
“We wanted to use AI to really help us uncover where the problems are,” she said.