Financial incentives for patients may expedite AI use in healthcare, according to new research from Johns Hopkins University.
The study, conducted by researchers from Johns Hopkins University’s Carey Business School and School of Medicine, found that patients were more likely to opt for AI-based healthcare screenings and think more favorably about its effectiveness in medical settings when the copay was waived for the service.
The researchers led a study in which patients were presented either with clinical scenarios where a copay was required or scenarios where the copay was waived. This approach enabled the researchers to test how a copay waiver might affect patients’ perceptions of AI-based medical screenings and decisions on whether to use medical AI for their own care.
The screening at the heart of the study targets diabetic retinopathy, a complication of diabetes and the leading cause of blindness among working-age U.S. adults. Autonomous AI tools that can diagnose the disease from retinal images, without an on-site eye specialist, are already cleared by the U.S. Food and Drug Administration and in clinical use.
Study participants were presented with a primary-care scenario in which they were due for an annual diabetic eye screening, and an autonomous AI tool was available as an alternative to the traditional diagnostic exam with an eye care professional. More than 80% of participants opted for the AI tool when the copay was waived, compared to 43% who chose AI when the copay was not waived.
“We rarely hear people talk about the cost of getting AI-enabled health care, but we will soon,” said Tinglong Dai, a co-author of the study and the Bernard T. Ferrari Professor at the Carey Business School. “At Johns Hopkins, we want to uncover the impact now, because cost is becoming a decisive factor in whether patients accept AI in their care.”
“We rarely hear people talk about the cost of getting AI-enabled health care, but we will soon,” said Tinglong Dai, a co-author of the study and the Bernard T. Ferrari Professor at the Carey Business School. “At Johns Hopkins, we want to uncover the impact now, because cost is becoming a decisive factor in whether patients accept AI in their care.”
Not only did more participants opt for the AI screening when there was no copay, but participants also perceived the AI as more effective.
“When the copay was waived, patients perceived the autonomous medical AI as more effective and were more likely to opt for the AI,” said Haiyang Yang, a co-author of the study, associate professor, and academic director of the Master’s in Management program at the Carey Business School. “Well-designed incentives will accelerate patients’ AI usage. The key is to identify the appropriate design for each medical AI context.”
The caveat is that the patients who chose AI over a traditional screening with a human professional were far more likely to seek reconfirmation from their eye doctor after getting their results, regardless of whether the results were normal or abnormal.
“Human oversight is clearly important to patients when it comes to AI use in medical care,” said Risa Wolf, a co-author of the study and an associate professor of pediatrics at Johns Hopkins Medicine with a joint appointment at the Carey Business School. “AI might be able to provide patients results, but they still want to hear from a medical professional to verify those results.”
According to the researchers, when it comes to AI integration in medicine, it’s crucial to address the persistent preferences for provider follow-up and verification, even when AI results are normal.
“Patient comfort needs to remain a priority as AI is integrated into the healthcare system,” said Dai. “While AI screening can save patients and doctors time and money, it’s important to patients that their providers review and further validate what AI tells them.”
The study, recently accepted for publication in the journal npj Digital Medicine, included 248 U.S. adults with type 1 diabetes, recruited online between August and December 2024.
