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Medicare might finally pay for AI that catches cancer earlier.
Right now, AI tools that can spot tumors months before human eyes can see them sit unused in hospitals across America.
Why? Medicare won’t pay for them.
But that could change. The bipartisan Health Tech Investment Act, now in Congress, proposes something radical: a 5-year reimbursement pathway for FDA-approved AI diagnostics. 🎯
Think about what this means:
• AI that detects pancreatic cancer 3 years early (Mayo Clinic’s tool)
• Algorithms diagnosing lung nodules in underserved communities with tools like Oatmeal Health that reduces false positives and false negitives
• Breast cancer screening that reduces false positives by 40%
• Heart conditions found on routine ECGs, years before symptoms
These tools exist TODAY. They’re FDA-approved. They work.
But without reimbursement codes, hospitals can’t afford to use them. It’s like having a fire extinguisher you can’t unlock.
The proposed solution is elegant: Give these AI tools temporary payment codes for 5 years. Collect real-world cost and outcome data. Then set permanent rates based on actual value delivered.
Here’s what makes this different from past attempts:
1. Bipartisan support (rare in healthcare)
2. Specific focus on add-on diagnostics
3. Clear 5-year data collection period
4. Addresses the “reimbursement valley of death”
For imaging centers and FQHCs, this changes everything. You could finally justify AI investments with predictable revenue streams.
For patients? Earlier detection saves lives. Period.
The biggest risk? Congress moving too slowly while patients wait.
Every month of delay means missed diagnoses that AI could have caught. We’re literally legislating at the speed of disease progression.
Healthcare executives, here’s your moment: Contact your representatives. Support this bill. Your future capacity to deliver cutting-edge care depends on payment models catching up to technology.
The technology is ready. The evidence is clear. Now we need the political will.
♻️ Repost if Medicare should pay for AI that saves lives
👉 Follow me, Jonathan Govette, for daily, real-time updates on healthcare technology and business news. LinkedIn Profile: https://www.linkedin.com/in/jonathangovette/
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Author:
CEO/Co-Founder @ Oatmeal Health | AI Lung Cancer Screening | Almost Became a Doctor | Engineer | Follow to Share What I’ve Learned Along the Way
I help patients get the care they need earlier, preventing late-stage cancer.
That’s been the throughline across three companies and almost 20 years in healthcare. At ReferralMD, we fixed broken referral networks so patients didn’t fall through the cracks. At Oatmeal Health, it’s lung cancer: building the diagnostic and screening infrastructure so the 85% of cases caught too late get caught early instead.
Today as CEO of Oatmeal Health, I lead a team embedding AI into radiology workflows to turn routine lung CT scans into reimbursable cancer risk assessments. We partner with FQHCs to reach underserved communities, and with health systems and payers to make early detection economically sustainable. Think HeartFlow or Cleerly, but for lungs.
Between companies, I advised at Techstars and Plug and Play, mentoring founders building in digital health. That experience shaped how I think about what separates companies that ship from companies that stall: distribution, reimbursement, and clinical trust, not just technology.
I’m a CancerX alumnus, a 3x healthcare founder, and someone who believes the biggest problems in cancer aren’t scientific. They’re operational.
We’re hiring mission-driven builders at Oatmeal Health. If you want to work on something that matters, reach out.
When I’m not working, I’m traveling, mentoring, and keeping up with one very energetic husky. 🐾
Substack – The Oatmeal Bite:
Millions of patients get less care because of who they are, where they live, or how they look. I’m fighting to change that. CEO @OatmealHealth, a startup built for the underserved. The Oatmeal Bite: intel for clinicians, investors, and advocates.
Jonathan Govette
CEO of Oatmeal Health
Substack:
https://oatmealhealthjonathangovette.substack.com/
