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Special Issue: Early Impacts of AI in Healthcare

ABOUT THE JOURNAL

Current Issue:

We solicited papers to address timely topics at the forefront of discussions and decision-making in health management research, policy, education, and practice. This issue addresses the incorporation of AI into healthcare systems and clinical care and the impacts of its adoption amid lingering administrative and operational complexities.

AI IN HEALTHCARE: EARLY WINS, NEW CHALLENGES

New Research

The Emerging Risk of AI-Enabled Healthcare Fraud

Elman Amador Medina, Steven Gong, Dashiell Miner, Lauren Bilbo, Klara Klarowicz, Sergio Mavridis, David Scheinker, Stefanos Zenios, and Kevin Schulman, Stanford University

The structural complexity of U.S. healthcare and the lack of market governance have led to significant lags in the response to emerging AI-enabled fraud. The authors propose a new technical framework that could lead to proactive fraud prevention.

New Research

AI Adoption and Hospital Performance: Evidence from 2,979 U.S. Hospitals

Serdar Aydin, Gokhan Agac, Ramshah Mona Eliza, Tomia Sheares, Zachary Roberts, and Chad Kuchvalek, Georgia State University

The study found that hospital-level AI adoption is positively associated with operational efficiency and patient volume. Its link to financial performance varies.

Literature Analysis

AI as Administrative Infrastructure: Reducing Waste and Expanding the Feasible Frontier of Cost, Access, and Quality

Bryn M.C. Rediger, Boston University, Questrom School of Business

This analysis draws on published estimates of administrative waste, prior authorization burden, and emerging evidence from AI-enabled claims validation and utilization management tools.

Literature Analysis

The CARE Framework: A Pathway for AI Command Centers to Streamline Hospital Operations in the United States

Ron Varghese, Robbins Institute for Health Policy & Leadership, Baylor University

Interconnected systems that use real-time data to enhance patient flow, resource utilization, and care quality, can bring structure and foresight to every level of hospital management.

Case Study

Operational Effectiveness of AI-Assisted Targeted Intervention System Design in Healthcare: Reducing 30-Day Readmission Rates for Diabetes Patients

Amanda Wong, Tanzina Khan, Melissa Florus, Milagros Ramos, Miguel Rodriguez, Yi Zhuang, and Tolga Aydinliyim, Zicklin School of Business, Baruch College, CUNY

The operational value of AI in healthcare lies not in prediction capabilities, but in effectively using AI-generated data to prioritize and allocate scarce post-discharge resources.

Perspective

When AI Becomes Extra Work: Redesigning Clinical Decision Support Without Clinician Burnout

Kalgi Modi, Johns Hopkins University, Carey Business School

Using AI-enabled clinical decision-support systems without changing workflows, decision authority, and governance structures, can raise cognitive and administrative workload.

OPERATIONAL EFFICIENCY

New Research

The State of Payer and Provider Contracting: Challenges and Opportunities

Brooke Shearon, Kristine Burnaska, and Erin Weber, DataSpring, powered by CAQH; Brooke Istvan and Kevin Schulman, Stanford University

Modernizing contracting with standardized, structured, and more digital approaches could reduce administrative burden and better support value-based care.

New Research

The Growth in Healthcare Administrators since 2004 in the United States

Becca Nelson, Margaret C Nikolov, Kevin Schulman, Stanford University

The changes in the healthcare market since the passage of the Affordable Care Act has led to a significant growth in the number of administrators and in the ratio of the number of administrators per physician.

Policy Research

From Infrastructure to Impact: Operationalizing India’s Ayushman Bharat Digital Mission

Alekhya Kommuru and Divyansh Agarwal, Stanford University

In 2021, India built the infrastructure for a federated digital health ecosystem at a scale no comparable country has achieved. Generating clinical value is the tough part.

TEACHING HEALTH MANAGEMENT

Perspective

New Book: “Concise Introduction to Healthcare Management”

Lawton Robert Burns, The Wharton School, University of Pennsylvania

Rob Burns introduces his latest book, which discusses healthcare management using approaches designed to appeal to executives, healthcare professionals, and students.

Case Study

Regi’s ‘Innovating in Healthcare’ Cases: Southern California Permanente Medical Group’s Care Transformation Office

Regina (Regi) Herzlinger, the first woman tenured and chaired at Harvard Business School, is the Nancy McPherson Professor of Business Administration at HBS. “Regi’s ‘Innovating in Healthcare’ Cases,” a regular HMPI feature, highlights teaching materials focused on healthcare innovation. In this issue, we focus on “Southern California Permanente Medical Group: The Care Transformation Office (CTO) – Scaling Integrated Value-Based Care Through Strategic IT-Clinical Partnerships.” Read more.

SUBMIT YOUR PAPER

Word from the Editors

Kevin Schulman, BAHM President & HMPI Editor-in-Chief; Professor of Medicine, Stanford University: It has been a pleasure to help develop this issue of HMPI. The papers address some of the opportunities and challenges with the advent of emerging AI technologies for healthcare. As these articles make clear, connecting the technology and our triple aim of cost, quality and access will be a challenge over the next several years. It's exciting to think about the technology: machine learning based predictive models, large-language models (LLMs) – an exciting advance on the concept of foundation models. And now we’re seeing the emergence of agentic transactions where AI can perform tasks spanning clinical and administrative processes. Bill Gates has said that automation applied to efficient business processes will magnify the efficiency. But he also warned that the converse is true: applying AI to inefficient business processes will magnify the inefficiency. These observations really frame the findings from the papers in this issue and provide a roadmap for the hard work ahead. In the end, it's not a question of whether AI has the potential to transform the delivery of healthcare. It cannot by itself. It will be up to all of us in healthcare leadership roles to use this extraordinary opportunity to address the affordability crisis in American healthcare.

Upcoming Issues

July 14, 2026

October 13, 2026

January 19, 2027

Call For Papers

Escalating costs, private equity, AI, workforce challenges, continued access and care inequities. These are among the topics we will continue to explore from strategic, operational, and policy perspectives. We invite research papers, analyses, and commentaries that offer actionable insights and / or solutions, while contributing to engaging discussions in the classroom.

Please send submissions and questions to Managing Editor Kirsten Gallagher.

News

BU Questrom Essay Wins Inaugural HMPI Contest

The paper entitled "AI as Administrative Infrastructure: Reducing Waste and Enabling Value-Based Care,” won first place in the inaugural Will Mitchell Student Essay Contest. Authored by Bryn Rediger, the essay was published in this issue of HMPI and was one of several submissions focused on ways AI can be used to improve health system operations and patient care. The late editor of HMPI, Will Mitchell was a strategic management expert and mentor who was passionate about innovative health management ideas. This new contest honors his vision and legacy.

BAHM Case Competition Focuses on Price Transparency

This year’s BAHM Case Competition, sponsored by The HEAL Network, gave health management MBA students a forum to showcase their solutions to challenges around medical price transparency. Students also engaged with leaders shaping U.S. healthcare policy at institutions including the U.S. Congress, the White House Council of Economic Advisers, the Centers for Medicare & Medicaid Services, the Department of Health and Human Services, and PhRMA. Learn more.

HMPI Precedents Thinking Article Cited in New Model Published by JAMA

Kevin Schulman et.al's work published in HMPI, Applying Precedents Thinking to the Intractable Problem of Transaction Costs in Healthcare, was cited in a recently published Perspective in JAMA Network. The JAMA article outlines a new outcome-aligned payment approach for chronic care that incorporates precedents thinking into the model design. The CMS Innovation Center recently announced the 10-year Advancing Chronic Care With Effective, Scalable Solutions (ACCESS) model beginning July 2026, part of CMS’s broader efforts to modernize the U.S. care infrastructure and digital health ecosystem.