Overview:
A top concern highlighted by the survey was the increased use of AI decision-making systems.
The American Medical Association (AMA) recently released its 2024 AMA Prior Authorization Physician Survey, providing insight into the concerns and challenges surrounding prior authorization (PA) including issues with artificial intelligence (AI).
29% of Physicians: Prior Authorization Created Serious Adverse Events
Every year the AMA conducts the nationwide survey of 1,000 practicing physicians including 400 primary care and 600 specialists. This year’s findings reveal that the prior authorization process has a negative impact on care, frustrates physicians, and can increase costs for patients and time for physicians. Notably, according to the survey, “more than 1 in 4 physicians (29%) report that prior authorization has led to a serious adverse event for a patient in their care.”
Artificial Intelligence: What Could Possibly Go Wrong?
A top concern highlighted by the survey was the increased use of AI decision-making systems.
According to the survey, “61% of physicians report that they are concerned that augmented intelligence (AI) increases/will increase PA denial rates.” According to the press release, there are accusations that AI tools have produced denial rates 16 times higher than usual.
Furthermore, three in five physicians (61%) are also concerned that health plans’ use of AI is “exacerbating avoidable patient harms and escalating unnecessary waste now and into the future.”
AMA President Bruce A. Scott, M.D. commented, “Using AI-enabled tools to automatically deny more and more needed care is not the reform of prior authorization physicians and patients are calling for.”
Automated Decision System Deeply Flawed
Scott continued, “Emerging evidence shows that insurers use automated decision-making systems to create systematic batch denials with little or no human review, placing barriers between patients and necessary medical care. Medical decisions must be made by physicians and their patients without interference from unregulated and unsupervised AI technology.”
According to the AMA press release, “the AMA firmly believes that AI must augment decision-making; be referred to as ‘augmented intelligence,’ and not remove humans from patient care, coverage, or treatment.” Earlier this year the AMA’s Augmented Intelligence Research found that “nearly half of all physicians (49%) ranked oversight of payers’ use of AI in medical necessity determinations among the top three priorities for regulatory action.” Additionally, AMA policy has become increasingly focused on concerns with insurer use of AI.
