Primary care is facing a collision of two trends: a growing patient population with more chronic disease, and a workforce that will be short 85,000 to 90,000 physicians within a decade.

In this episode, David Carmouche, M.D., executive vice president and chief medical and commercial officer at Lumeris — and a newly appointed member of the HHS Healthcare Advisory Committee — joins Medical Economics Senior Editor Richard Payerchin to discuss what AI can realistically do about that.

Music Credits:
Higher Self by Cephas - stock.adobe.com
A Textbook Example by Skip Peck - stock.adobe.com

Editor's note: Episode timestamps and transcript produced using AI tools.

0:00 – 0:25 | Sponsor message Copic medical liability insurance.

0:25 – 0:42 | Cold open Dr. Carmouche previews the episode's closing message: as physicians, we're meant to be lifelong learners — and this is an exciting time to shape how AI gets deployed in health care.

0:42 – 1:49 | Introduction Austin Littrell introduces the episode and previews the conversation with Dr. Carmouche.

1:49 – 5:16 | Dr. Carmouche's background Richard Payerchin invites Dr. Carmouche to introduce himself. He traces a career that moved from independent primary care practice to Blue Cross Blue Shield of Louisiana, Ochsner Health, Walmart Health and now Lumeris — 30 years of experience across payer, provider and retail health settings.

5:16 – 8:16 | The tipping point — and what AI is actually for Dr. Carmouche describes the collision driving the primary care crisis: unprecedented patient need meeting a shrinking workforce. He argues AI's role is to extend the human workforce and reduce cognitive load — summarized in his core design principle: make the right thing the easy thing.

8:16 – 11:29 | Value-based care's promise and execution failures Dr. Carmouche explains Medicare's two main value-based care models — ACOs and Medicare Advantage — and why the concept is right but the execution has consistently missed the mark. Most physicians feel managed to the wrong things: care gaps, AWVs and risk codes rather than keeping patients healthy.

11:29 – 15:10 | What AI-enabled continuous care could look like Dr. Carmouche lays out a vision of AI as a continuous presence between office visits — monitoring patients using EHR, pharmacy, HIE and consumer data, alerting physicians when someone is going off track and adjusting visit frequency based on real-time patient status rather than arbitrary scheduling.

15:10 – 15:56 | P2 Management Minute Keith Reynolds shares practice management tips and invites listeners to submit their own workflow ideas.

15:56 – 21:42 | Repatriating specialty care back to primary care Richard raises the growing burden of chronic disease management falling to primary care. Dr. Carmouche addresses the specialty referral problem directly — including a health system where 30% of cardiology appointments are filled with hypertension patients — and describes how AI-enabled clinical decision support could help primary care physicians manage more complex conditions and reduce unnecessary specialist referrals.

21:42 – 23:53 | The Wolters Kluwer partnership and automated clinical decision support Dr. Carmouche describes a partnership with Wolters Kluwer and UpToDate to automate the connection between patient data and evidence-based guidance — presenting clinicians with personalized, guideline-directed treatment recommendations at the point of care without requiring them to manually query the tool.

23:53 – 28:05 | Who pays for the technology — and can everyone access it? Dr. Carmouche addresses the cost and access challenges around remote monitoring devices, distinguishing between high-tech connected options and low-tech alternatives like a $39 Omron blood pressure cuff paired with AI text communication. The key challenge isn't the device — it's closing the loop back to a prescribing clinician.

28:05 – 31:02 | Advice for physicians still on the sidelines Dr. Carmouche says skepticism is okay — but burying your head in the sand is not. He encourages even the most reluctant physicians to read about AI, explore free online primers and stay curious, while also urging caution about placing AI directly between physician and patient without requiring proof points first.

31:02 – 32:22 | Closing remarks and outro Payerchin wraps the interview. Littrell thanks listeners and reminds the audience to subscribe and visit MedicalEconomics.com and PhysiciansPractice.com.

S1 Ep151: Make the right thing the easy thing, with David Carmouche, M.D., of Lumeris

Off the Chart: A Business of Medicine Podcast

S1 Ep151: Make the right thing the easy thing, with David Carmouche, M.D., of Lumeris