AI助力医保改革，提升可及性、降本增效、优化健康管理
AI-driven innovation in medicaid: enhancing access, cost efficiency, and population health management
- 用AI做预测分析与精准医疗，优化资源分配
- 提升护理协调效率，降低欺诈风险，改善患者结果
- 适合政策制定者与医疗系统管理者参考
美国医疗补助计划（Medicaid）正面临医疗成本快速上升、医疗服务可及性不均以及应对多样化人群健康需求的挑战。本文探讨人工智能（AI）在重塑 Medicaid 中的变革潜力，通过优化运营流程、改善患者治疗效果、降低医疗成本实现突破。研究聚焦于 AI 在预测分析、护理协调、欺诈检测和个性化医疗中的关键作用。基于先进数据模型的洞察，并针对 Medicaid 特有挑战，提出以公平医疗和公共健康改善为核心的 AI 驱动解决方案。研究强调亟需将 AI 融入 Medicaid 体系，以提升运营效率，构建更可及、更公平的全民医疗保障系统。
原文摘要 · Abstract (English)
The U.S. Medicaid program is experiencing critical challenges that include rapidly increasing healthcare costs, uneven care accessibility, and the challenge associated with addressing a varied set of population health needs. This paper investigates the transformative potential of Artificial Intelligence (AI) in reshaping Medicaid by streamlining operations, improving patient results, and lowering costs. We delve into the pivotal role of AI in predictive analytics, care coordination, the detection of fraud, and personalized medicine. By leveraging insights from advanced data models and addressing challenges particular to Medicaid, we put forward AI-driven solutions that prioritize equitable care and improved public health outcomes. This study underscores the urgency of integrating AI into Medicaid to not only improve operational effectiveness but also to create a more accessible and equitable healthcare system for all beneficiaries.
Thank you to arXiv for use of its open access interoperability. PaperDance 不是 arXiv 官方产品；中文卡片由大模型生成，请以原文为准。