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Artificial Intelligence (AI) is making significant strides in healthcare, and its potential impact on the 340B Drug Pricing Program is becoming increasingly evident.
What can AI do for 340B?
AI offers innovative solutions that could streamline operations, improve compliance, and drive more effective decision-making within the program. It can manage compliance monitoring with a high level of precision, optimize split billing, more accurately identify patient eligibility, thereby maximizing savings. Moreover, AI-enhanced financial forecasting can help anticipate market trends, enabling timely adjustments to strategies.
A practical example
One example comes from a large health system that implemented AI tools across its multiple 340B covered entities. This organization struggled with time-consuming manual auditing processes and complex financial reporting systems. By leveraging AI, they eliminated 97% of manual auditing work, improved compliance through real-time auditing capabilities, and optimized drug savings.
What are the risks?
Despite these advantages, there are significant risks associated with AI implementation.
- Data privacy and security are paramount concerns, as AI systems handle sensitive health information.
- Moreover, AI models can introduce biases if not properly managed, leading to unfair outcomes.
- There’s also the risk of over-reliance on AI, where critical decisions are left to machines that may
not fully understand the complexities of healthcare environments.
These challenges highlight the need for cautious and thoughtful AI integration.
How to implement AI correctly?
For covered entities considering AI implementation, the approach should be strategic and
measured. It’s essential to start with a clear understanding of the specific needs and challenges
within the 340B program. Entities should invest in high-quality data management and ensure robust safeguards for privacy and security. Continuous monitoring and evaluation of AI systems are crucial to maintaining their effectiveness and ensuring they align with organizational goals. By balancing innovation with caution, covered entities can harness the power of AI while mitigating its risks.
Perry West is Solutions Engagement Director at Verity Solutions. He can be reached at pwest@verity340b.com.
