The proliferation of separate AI tools for providers (upcoding, auth requests) and payers (denials, downcoding) will lead to automated conflict. This friction could worsen administrative burdens rather than easing them, creating a high-speed, zero-sum game played by algorithms.
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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.
Using AI to generate content without adding human context simply transfers the intellectual effort to the recipient. This creates rework, confusion, and can damage professional relationships, explaining the low ROI seen in many AI initiatives.
The next evolution in personalized medicine will be interoperability between personal and clinical AIs. A patient's AI, rich with daily context, will interface with their doctor's AI, trained on clinical data, to create a shared understanding before the human consultation begins.
A major unsolved problem for MCP server providers is the lack of a feedback mechanism. When an AI agent uses a tool, the provider often doesn't know if the outcome was successful for the end-user. This "black box" makes iterating and improving the tools nearly impossible.
Managing human identities is already complex, but the rise of AI agents communicating with systems will multiply this challenge exponentially. Organizations must prepare for managing thousands of "machine identities" with granular permissions, making robust identity management a critical prerequisite for the AI era.
Recent security breaches (e.g., Gainsight/Drift on Salesforce) signal a shift. As AI agents access more data, incumbents can leverage security concerns to block third-party apps and promote their own integrated solutions, effectively using security as a competitive weapon.
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.
Organizations must urgently develop policies for AI agents, which take action on a user's behalf. This is not a future problem. Agents are already being integrated into common business tools like ChatGPT, Microsoft Copilot, and Salesforce, creating new risks that existing generative AI policies do not cover.
To improve the quality and accuracy of an AI agent's output, spawn multiple sub-agents with competing or adversarial roles. For example, a code review agent finds bugs, while several "auditor" agents check for false positives, resulting in a more reliable final analysis.
Unlike traditional SaaS where high switching costs prevent price wars, the AI market faces a unique threat. The portability of prompts and reliance on interchangeable models could enable rapid commoditization. A price war could be "terrifying" and "brutal" for the entire ecosystem, posing a significant downside risk.
