CMS Launches AI Challenges for Predicting Unplanned Hospital, SNF Admissions 

The Centers for Medicare & Medicaid Services announced last week the launch of a three-stage challenge designed to encourage the use of artificial intelligence (AI) in health care.

As part of the challenge, participants will be tasked with using AI to better predict unplanned hospital and skilled nursing facility admissions — already a key focus for many home health providers. Broadly, the initiative is also yet another example of policymakers trying to shift health care into the home and away from institutional settings.

While a market exists for AI tools, use is not particularly heavy among home health providers, AlayaCare founder and CEO Adrian Schauer told Home Health Care News.


“I don’t think it’s very prevalent,” he said. “You see pilot projects here and there. [AI] is often used as a marketing tool, with some of our clients going to referral sources and saying, ‘Hey, by the way, did you know I’m using software to manage patients and predict readmissions?’”

Canada-based AlayaCare is a cloud-based home care software platform with more than 250 clients across the U.S., Canada, Australia, the Middle East and Asia. The company has raised a total of $23 million since launching roughly five years ago.

AlayaCare’s offerings include a remote patient monitoring application with a built-in deep-learning model that predicts hospital readmissions and ER visits for chronically ill patients.


In general, the rise of value-based payment arrangements and models will be key to driving broader use of AI in care delivery, Schauer said.

“You need some flavor of an outcome-based or value-based reimbursement scheme for the incentives to be in place to invest in these types of tools,” he said. “If you’re paid purely on a fee-for-service or per-visit basis, you’re motivated to leverage AI … is limited.”

CMS is partnering with the American Academy of Family Physicians and the Laura and John Arnold Foundation for its AI challenge. Together, they’ll award up to $1.65 million to selected participants during the challenge’s three stages.

The initial launch stages will run from March 2019 through June 2019.

AI-powered technology in health care is primed for a massive expansion across the globe over the next few years, a 2018 report from market foresight advisory firm ABI Research found. The number of monitoring devices capturing patient data for AI purposes totaled about 53,000 in 2017.

ABI Research projects that figure to grow to 3.1 million by 2021.

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