McKinsey: AI Could Handle Up to 22% of Outpatient Care
A McKinsey & Co. analysis published Sept. 28 estimates AI could perform the clinical work behind 16% to 22% of U.S. outpatient claims, representing roughly 2 billion to 3 billion claims and 13% to 19% of outpatient spending. The analysis draws on 2024 commercial, Medicare and Medicaid claims data. It suggests a substantial share of outpatient services across payer types, including Medicaid, involve tasks that current AI capabilities could technically automate. The report does not specify implementation timelines or payer-specific adoption plans.
Health plans and state Medicaid agencies evaluating AI-driven utilization management, prior authorization, or care delivery tools now have a benchmark for how much outpatient volume could be affected by automation.
Managed Care · Finance
You might also like