Who’ll pay for AI in health care? 3 trends to watch in 2026

The healthcare industry is preparing for a debate on how to incorporate and compensate for clinical artificial intelligence (AI) adoption.
FDA has authorized 1,357 AI-enabled medical devices, but few of these are covered by insurance.
Experts like Ateev Mehrotra suggest focusing AI improvements on clinician productivity and efficiency to indirectly affect payment.
The American Medical Association (AMA) is considering new reimbursement codes for AI, especially those not requiring physician input.
Centers for Medicare and Medicaid Services (CMS) and medical societies are working on payment models for AI, potentially years away.
Specific use cases show varied payment models: coronary plaque analysis reimbursed by Medicare at a high rate, while AI in mammography mostly relies on self-pay.
Some health systems use value-based approaches to implement AI tools without direct insurance reimbursement, prioritizing efficiency and outcomes.

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