The new Medicare 'Access' code for AI in chronic care is priced too low to be profitable if humans are kept in the loop. This clever incentive design forces providers to adopt genuine AI-driven leverage rather than simply relabeling human effort, a first for healthcare technology.

Contrary to expectations, professions that are typically slow to adopt new technology (medicine, law) are showing massive enthusiasm for AI. This is because it directly addresses their core need to reason with and manage large volumes of unstructured data, improving their daily work.

Hospitals are adopting a phased approach to AI. They start with commercially ready, low-risk, non-clinical applications like RCM. This allows them to build an internal 'AI muscle'—developing frameworks and expertise—before expanding into more sensitive, higher-stakes areas like patient engagement and clinical decision support.

The friction of navigating insurance and pharmacies is so high that chronic disease patients often give up, skipping tests or medications and directly worsening their health. AI can automate these tedious tasks, removing the barriers that lead to non-compliance and poor health outcomes.

An effective AI strategy in healthcare is not limited to consumer-facing assistants. A critical focus is building tools to augment the clinicians themselves. An AI 'assistant' for doctors to surface information and guide decisions scales expertise and improves care quality from the inside out.

While AI has vast potential, its most immediate and successful entry point is automating prior authorizations. This administrative bottleneck is considered an 'easy win' because it's non-patient-facing, has a clear ROI, and sits at the front of treatment, leading to natural and rapid adoption.

An "AI arms race" is underway where stakeholders apply AI to broken, adversarial processes. The true transformation comes from reinventing these workflows entirely, such as moving to real-time payment adjudication where trust is pre-established, thus eliminating the core conflict that AI is currently used to fight over.

Chronic disease patients face a cascade of interconnected problems: pre-authorizations, pharmacy stockouts, and incomprehensible insurance rules. AI's potential lies in acting as an intelligent agent to navigate this complex, fragmented system on behalf of the patient, reducing waste and improving outcomes.

Unlike the top-down, regulated rollout of EHRs, the rapid uptake of AI in healthcare is an organic, bottom-up movement. It's driven by frontline workers like pharmacists who face critical staffing shortages and need tools to manage overwhelming workloads, pulling technology in out of necessity.