Monday, Kaiser Permanente CEO Greg Adams took the stage during the American Hospital Associationin Denver to demonstrate that his organization is cracking the code on value-based care. Outside the Colorado Convention Center, a group of Kaiser nurses gathered to protest his presence at the event, saying Kaiser is using AI to automate staffing and clinical judgment calls without input from the front-line nurses who would normally make them.
Although Adams did not engage directly with the nurses, he spoke briefly during the demonstration before launching into his session.
“We’re in the middle of negotiations. They’re concerned about AI and their ability to participate in decision-making around AI. And I want them to know, because they might step up, that we are fully committed to having them be present in the work that we’re doing around AI, and that we all need to consider that AI is part of health care and part of our future,” he said.
Adams quickly went on to say that the Health Risant the experience is already bearing fruit. Kaiser created Risant in 2023 as a vehicle designed to acquire and operate nonprofit health systems under its value-based care models. Kaiser’s models have since been exported to Geisinger And Cone healthboth acquired by Risant in 2024.
For example, more than 70 percent of Geisinger physicians use Kaiser’s values-based guidelines for primary care, Adams said. He said the change freed up hundreds of specialty appointments and reduced Geisinger’s length of stay by nearly 15% on a case mix-adjusted basis, while emergency room boarding was cut in half.
Adams credited a “smart triage” system for diverting patients who otherwise would have gone to the emergency room to urgent care, primary care or virtual visits. Rather than eating into revenue, he argued that the lower usage created capacity to accommodate more patients.
Adams tied Risant’s strategy to a broader point about industry responsibility, telling the audience that health systems can no longer treat daily operations and long-term transformation as separate choices.
“We don’t always get to choose when we take the lead,” he said, suggesting that current health care cost pressures in the United States are proof that the time for incremental change is over.
Outside, in 97-degree heat, Kaiser’s own nurses were making a different argument about what leadership looks like.
About a dozen nurses represented by the California Nurses Association gathered to demonstrate outside the venue — to protest Adams’ session and to voice concerns about Kaiser’s AI strategy, which they say aims to make nurses more replaceable.
“Kaiser is one of the largest and most influential health systems in the country,” said Natalie Rommel, a nurse at a Kaiser hospital in Roseville, California. “That’s why our CEO is speaking at this conference, and that’s why we must demand better of them as bedside nurses at Kaiser facilities.”
Another nurse, Terah Deason, who works at a Kaiser hospital in Santa Rosa, California, said she is concerned that AI is encroaching on nurses’ work.
“Kaiser makes billions and billions of dollars in profit, and they are investing a lot of that money into AI. The problem is that they’re using AI to determine all sorts of things that nurses would normally determine, like how many nurses we need in the field each day. “They use AI to assess how patients are actually feeling and what type of treatment they are going to receive,” he said. “The bottom line is that they’re going to use AI to start replacing us.”
As a member of the Northern California bargaining team currently negotiating a new contract, he said nurses are pushing for contract language that gives them a say in how AI is deployed.
Deason also suggested that AI adoption could be part of a work elimination strategy, arguing that the more Kaiser can position AI as capable of doing nurses’ work, the more “disposable” nurses become to the company.
The union is not taking a completely anti-AI stance, however, he noted.
“We recognize that [AI] has its usefulness. There are times when it can be very useful in helping us, but we should be the ones determining how it is used, and we should be the ones determining when it is appropriate,” Deason remarked.
(You can watch Deason’s full interview here.)
In a statement emailed to MedCité News On Monday night, Kaiser struck the same tone as Adams. The health system said it values its nurses and is engaged in ongoing negotiations with the union, including conversations about the evolving use of AI in clinical workflows.
“We believe that nurses, as clinicians, should have a say in the use of AI and other evolving health care technologies in their practice, and we are committed to ensuring that our nurses and other clinicians do so. We look forward to continuing these discussions directly through the collective bargaining process,” Kaiser’s statement said.
The gap between Adams’ scene and the demonstration outside is less about AI’s place in health care than about who controls the conditions of its use. It’s also a tension that has emerged recently elsewhere in the health care sector.
This month, a former Mayo Clinic director of research operations continued the health systemalleging she was demoted and fired after repeatedly expressing concerns that Mayo’s AI plans were undercutting patient privacy and safety.
Both sagas raise the question: As AI becomes more quickly established in patient care, will the people closest to it have real power to shape this change?
Photo: Katie Adams, MedCity News