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美国人工智能医保支付的经验及启示

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目的:总结美国医疗保险和医疗补助服务中心对人工智能予以支付的主要做法和经验,为我国制定医保支付政策提供参考.方法:基于文献研究法,系统梳理美国医保对人工智能的支付机制和典型案例.结果:美国针对住院、门诊和医生服务中使用的人工智能技术建立4种额外支付机制,设定明晰的纳入和支付标准,促进了人工智能的临床使用.结论:建议我国建立对人工智能的医保支付机制,重点考量人工智能的临床获益,警惕过度使用人工智能技术.
The Experience and Implications of the Artificial Intelligence Payment in the US.
Objective:To summarize the main practices and experiences of the Centers for Medicare&Medicaid Services in the US.to pay for artificial intelligence(AI),which can provide references for the formulation of health insurance payment policies in China.Methods:Based on the literature study,it systematically analyzed the payment mechanism and typical cases of AI pay-ment in the US.Results:The US.has established four payment mechanisms for AI used in inpatient,outpatient and physician ser-vices,and set clear criteria for inclusion and payment,which has facilitated the clinical use of AI.Conclusion:It is suggested that China establish the payment mechanism for AI,focus on the clinical benefits of AI,and be alert of the overuse of AI.

health insurance paymentartificial intelligenceUS

俞纯璐、陈文、张璐莹

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复旦大学公共卫生学院 上海 200032

医保支付 人工智能 美国

国家自然科学基金面上项目上海市浦江人才计划

7237404921PJC024

2024

中国卫生经济
中国卫生经济学会,卫生部卫生经济研究所

中国卫生经济

CSTPCDCHSSCD北大核心
影响因子:1.524
ISSN:1003-0743
年,卷(期):2024.43(7)