AI & Healthcare + Open Enrollment Innovation

Janson Silvers  0:03  
Welcome to Healthcare Policy pop. I'm Janson Silvers, it's Tuesday, October 10 2023. Today's pop topics open enrollment season featuring an innovator trying to change the marketplace and AI in healthcare. Let's begin there. Jennifer Hinkel is managing partner at the data economics company, and says so far she sees AI falling into two buckets in healthcare. 

Jennifer Hinkel  0:27  
An example would be if you're inside a pharma company, and you're using an AI or LLM large language model, which is what like the chat GPT tool is that a lot of people are familiar with to do something like synthesize a bunch of papers to help you maybe write some copy, whether that's like marketing copy, or maybe to help you come up with ideas for a secondary data research protocol. 

Janson Silvers  0:49  
And the other bucket. 

Jennifer Hinkel  0:50  
On the other side, we have tools that are actually out there in the hands of patients, in some cases, clinicians as well. These are pretty scaled things that are using AI to generate interactions with patients, maybe they're using AI to generate direction for clinicians to practice. So I think that it really runs the gamut. And there's a lot of different nuances really in there about what kinds of tools how these are applied, etc. 

Janson Silvers  1:15  
Despite the uneasiness around the unknowns of AI, Hinkle says a lot will depend on the human who is using it. 

Jennifer Hinkel  1:22  
I mean, one of the things we know about these AI models is they're only as good as the data that's fed into them. You know, artificial intelligence, intelligence is a bit of a misnomer here. These are mostly predictive models that can be very sophisticated, but they're not really creating anything more intelligent than what a human would do. So they're just able to synthesize and kind of predict based on huge amounts of data. So if you don't give the right data in, where your data is limited and what's going in, you're gonna get a response out that is maybe not the same as what a human would do. 

Janson Silvers  1:54  
Hinkle adds that now is the right time for stakeholders to get involved on policies that will govern AI decades from now, 

Jennifer Hinkel  2:01  
What we don't want to see for example, is patient data used in models that then have a commercial application when the patient hasn't necessarily consented for their data to be used in commercial applications. So I think there are a lot of opportunities for like biopharma companies, and patient advocacy groups, others in the healthcare sector that have a policy footprint to help guide the rules and regulations and things that are going to determine how these AI tools can be deployed.

Janson Silvers  2:26  
Learn more about Henckels organization by using the link in the show notes.

Brad O'Neill is the president and Managing Director of the ICHRA shop. That stands for individual coverage, Health Reimbursement Arrangement. As we near open enrollment season, the  ICHRA  shop is a new way to purchase a plan to individualize the options for each person.

Brad O'Neill  2:52  
 I think that is changing the world, because we're actually getting what the employees want. They're making the choices of maybe I want an HSA, maybe I want a zero deductible claim. What do you got coming up what's in your medicine cabinet? You can give them all the technology in the world, but a live person who's trained, does the best. And I think that's changing the world of what employers want. They don't want to have the question of when Bob is going to go to the doctor and what's going on. They just want to know that they've given them money to get great benefits. 

Janson Silvers  3:22  
O'Neill says ekra is saving individuals money saving businesses money and teaching people. 

Brad O'Neill  3:28  
We're pointing them, we're educating them, we're changing the way that they've now bought health care for the past 20 years, right. So it's a slow burn, right? It's not going to be fast. But what we are going to see is overall, I think that this mechanism where it's bipartisan, both sides are kind of agreeing, this makes sense. 

Janson Silvers  3:46  
O'Neill says he wants businesses to do their business and INCRA can handle the insurance side of things. 

Brad O'Neill  3:53  
You know, I think employers especially today need to understand, you know, are they really in the insurance business? Did they want to be in the insurance business? Do they want to know this much about their employees? 

Janson Silvers  4:04  
Learn more about it grow by using the link in the show notes.

We wanted to share a couple stories related to both open enrollment and AI before we go today, the FDA is actually reopening the comment period on its paper about the use of AI in drug development. The original comment period ended on May 1, but now the comment period is being reopened for an additional 60 days. And finally today, a Kaiser Health News article lays out new federal rules for Medicare Advantage plans that will begin in January, CMS is hoping to rein in the use of algorithms in Medicare Advantage plans when it comes to coverage decisions. Patients rising now we'll be keeping a close eye on this as it develops and you can find links to both those stories in the show notes. That's all for today. We're back on Thursday for another health care policy pop, a resource of patients rising now. I'm Janson Silvers have a great day