Incentives, Equilibria, and the Limits of Healthcare AI: A Game-Theoretic Perspective

arXiv cs.AI / 4/1/2026

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Key Points

  • The paper examines why healthcare AI deployments may fail to deliver expected system-level improvements when incentives and risk allocation are not changed.
  • It classifies AI technologies into three archetypes—effort reduction, increased observability, and mechanism-level incentive change—and argues each affects system behavior differently.
  • Using a stylized inpatient capacity signaling scenario with minimal game-theoretic reasoning, it concludes that task optimization alone typically cannot alter outcomes if incentives remain unchanged.
  • The analysis suggests that only interventions reshaping risk allocation can plausibly change stable equilibria in healthcare systems, with direct implications for leadership decisions and procurement strategies.

Abstract

Artificial intelligence (AI) is widely promoted as a promising technological response to healthcare capacity and productivity pressures. Deployment of AI systems carries significant costs including ongoing costs of monitoring and whether optimism of a deus ex machina solution is well-placed is unclear. This paper proposes three archetypal AI technology types: AI for effort reduction, AI to increase observability, and mechanism-level incentive change AI. Using a stylised inpatient capacity signalling example and minimal game-theoretic reasoning, it argues that task optimisation alone is unlikely to change system outcomes when incentives are unchanged. The analysis highlights why only interventions that reshape risk allocation can plausibly shift stable system-level behaviour, and outlines implications for healthcare leadership and procurement.