Hospitals Used AI to Inflate Medical Bills by Nearly $1,000,000,000: Report
Hospitals’ use of artificial intelligence tools hiked healthcare spending by nearly $1 billion over a two-year period, per a Blue Cross Blue Shield Association analysis released Thursday.
BCBSA’s new study shows that a major rise in patients being documented as having complex conditions led to $942 million in additional medical care costs for Blue Cross and Blue Shield (BCBS) companies between 2023 and 2025.
The study “raises concerns” that the widespread adoption of AI coding tools is driving higher healthcare spending in the U.S., which “ultimately puts pressure on premiums and out-of-pocket expenses for families, employers and taxpayers,” according to BCBSA’s report.
The research looked at secondary diagnoses such as anemia after major bowel surgery.
“If patients are truly sicker, we’d expect to see more treatment,” BCBSA Senior Vice President of Product and Data Science Luke Chalker said in a statement.
“For example, we’re seeing significantly more anemia diagnoses at these hospitals without a corresponding increase in transfusions.”
“The disconnect between diagnoses and treatment suggests that AI is identifying more billable conditions, not sicker patients,” Chalker continued.
The research shows that secondary diagnoses that shifted claims into a higher-reimbursement category comprised about $650 million of the increased costs for BCBS companies from 2023 to 2025.
“We know families are frustrated by the rising cost of healthcare, and we are committed to tackling the root causes of these higher prices,” BCBSA Senior Vice President of External Affairs David Merritt said.
“As families face higher healthcare costs, this research underscores the urgent need to better understand these AI tools and the role they may play in exacerbating the affordability crisis.”
Experts previously told the Daily Caller News Foundation that certain AI tools may contribute to rising healthcare costs over the next year.
Increasingly unaffordable health costs remain a key issue ahead of November’s midterms.
A NBC News survey released in September notably found that U.S. voters trust Democrats over Republicans on healthcare by 22 percentage points.
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