Generalist medical AI reimbursement challenges and opportunities.

Mahajan, Arjun; Powell, Dylan · NPJ Digit Med · 2025

review · Level V

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Abstract

Generalist AI systems in healthcare can handle multiple complex clinical tasks, unlike narrow AI tools that perform isolated functions. However, current payment systems struggle to capture the value of these integrated capabilities. We examine potential solutions, including value-based and tiered structures, balancing innovation, equitable access, continuous performance evaluation, and cost-effectiveness to realize generalist AI’s transformative potential.