Application

Deploying Counterfactual Intelligence

U.S. insurers face soaring costs from total knee arthroplasty (TKA), yet up to one-third of patients experience little to no improvement after surgery, leading to wasteful spending, patient dissatisfaction, and poor outcomes.[15][16]

Predictive Decision Support

  • Delivers individualized counterfactual predictions showing outcomes with surgery versus conservative care.
  • Achieves ~93% AUC accuracy on real-world pre- and post-operative data, ready for clinical deployment.
  • Generates SHAP-based explanations to meet transparency, auditability, and fairness requirements.[22]
  • Aligns with CMS’s 2025 prior authorization final rule, which mandates evidence-based, patient-specific justification for orthopedic procedures.[17]

Optimizes Orthopedic Workflow

  • Prioritizes “hot-lead” OA patients so surgical teams focus on members most likely to achieve meaningful benefit.
  • Improves OR throughput and surgical ROI by elevating high-benefit cases—critical as CMS requires KOOS Jr. outcomes for reimbursement tracking.[18][19]
  • Reduces low-value specialist visits by steering low-benefit patients away from unnecessary imaging and consults.

Boosts Conservative Care Pathways

  • Redirects low-benefit patients toward GLP-1-based weight management programs proven to improve OA outcomes.[20][21]
  • Promotes structured physical therapy and lifestyle programs that delay surgical need.
  • Delivers AI-personalized education where patients compare surgical versus non-surgical benefit, powered by SHAP explanations.[22]
  • Empowers shared decision-making that reduces regret and unnecessary interventions.[23]

For Payers

Reduced spend on low-benefit TKA surgeries, fewer downstream costs, and transparent ROI tracking.

For Providers

Higher outcome metrics, optimized OR utilization, and avoidance of poor-value care episodes.

For Patients

Clearer choices, fewer unnecessary surgeries, and improved access to alternatives that deliver meaningful improvement.

Next: Impact