On Monday, Kaiser Permanente CEO Greg Adams took the stage at the American Hospital Association‘s Leadership Summit in Denver to make the case 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 appearance at the event, saying that Kaiser is using AI to automate staffing and clinical judgment calls without the input of the frontline nurses who would normally make them.
While Adams didn’t engage with the nurses directly, he did briefly address the demonstration before diving into his session.
“We’re in the middle of bargaining. They are concerned about AI and their ability to be involved in the decision making around AI. And I want them to know, because they may come in, that we’re fully committed to their being present to the work that we’re doing around AI, and we all must own that AI as a part of healthcare and a part of our future,” he declared.
Adams quickly went on to say that the Risant Health experiment is already paying off. Kaiser spun out 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 Health, both of which were acquired by Risant in 2024.
For instance, more than 70% of Geisinger’s physicians are using Kaiser’s value-based guidelines for primary care, Adams stated. He said that shift has freed up hundreds of specialty appointments and cut Geisinger’s length of stay by nearly 15% on a case-mix-adjusted basis, while emergency department boarding has dropped by half.
Adams credited an “intelligent triage” system for diverting patients who would have otherwise gone to the emergency department toward urgent care, primary care or virtual visits instead. Rather than eating into revenue, he argued the lower utilization has created capacity for more patients.
Adams linked the Risant strategy to a larger point about industry responsibility, telling the audience that health systems can no longer treat day-to-day operations and long-term transformation as separate choices.
“We don’t always get to choose the moment we lead,” he said, suggesting the current cost pressures on U.S. healthcare as proof that the time for incremental change has passed.
Outside in the 97-degree heat, Kaiser’s own nurses were making a different argument about what leading looks like.
About a dozen nurses represented by the California Nurses Association gathered to demonstrate outside the venue — there to protest Adams’ session as well as voice their concerns about the Kaiser’s AI strategy, which they said is designed to make nurses more replaceable.
“Kaiser is one of the biggest and most influential health care systems in the country,” said Natalie Rommel, a nurse at a Kaiser hospital in Roseville, California. “That’s the reason our CEO is speaking at this conference, and it’s the reason why we have to demand better from them as the nurses at the bedside in Kaiser facilities.”
Another nurse — Terah Deason, who works at a Kaiser hospital in Santa Rosa, California — expressed worry that AI is encroaching on nurses’ jobs.
“Kaiser is making billions and billions of dollars in profit, and they are investing a lot of that money into AI. The issue with that is that they’re using AI to determine all kinds of things that nurses would normally determine, such as how many nurses we need in a day on the floor. They’re using AI to assess how patients are actually feeling and what kind of treatment they’re going to get,” he declared. “Basically, the concern is that they’re going to use AI to start to replace 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 labor suppression strategy, arguing that the more Kaiser can position AI as capable of doing nurses’ jobs, the more “disposable” nurses become to the company.
The union isn’t taking a completely anti-AI stance, though, he noted.
“We do recognize that [AI] does have its uses. That there are times when it can be very useful in helping us, but we should be the one to determine how it’s used, and we should be the one to determine when it’s appropriate,” Deason remarked.
(You can watch Deason’s full interview here.)
In a statement emailed to MedCity News on Monday evening, Kaiser struck a similar 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 nurses, as clinicians, should have a voice in the use of AI and other evolving health care technologies in their practice, and we are committed to ensuring our nurses and other clinicians do so. We look forward to continuing those discussions directly through the collective bargaining process,” Kaiser’s statement read.
The gap between Adams’ stage and the demonstration outside is less about whether AI belongs in healthcare and more about who controls the terms of its use. It’s a tension that has surfaced elsewhere in healthcare recently, too.
This month, a former Mayo Clinic research operations director sued the health system, alleging she was demoted and fired after repeatedly raising concerns that Mayo’s AI projects were cutting corners on patient privacy and safety.
The two sagas beg the question: as AI moves faster into patient care, will the people closest to it have any real power to shape that shift?
Photo: Katie Adams, MedCity News
