11:40Machine-translated from Azerbaijani by AIRead in Azerbaijani
Study: AI in hospitals increased insurance costs by AZN 1.6 billion
The Blue Cross Blue Shield Association has estimated that the use of artificial intelligence (AI) in hospitals increased medical insurance costs. According to an analysis covering 2024 and 2025, it generated an additional $942 million in costs. That is approximately AZN 1.6 billion. The organization represents 31 independent insurance companies and covers more than 100 million people.
Hospitals use AI tools to review medical records and transcribe what is said during patient visits. In addition to the primary complaint, the systems can identify other illnesses and complications. A human specialist may overlook such details while reviewing numerous documents. In the US, reimbursement depends on the number and complexity of diagnoses. Therefore, more diagnoses also mean higher costs. The analysis showed a sharp increase in the number of patients diagnosed with complex illnesses. However, there was no corresponding increase in treatment or the volume of medical services. The organization concluded that patients had not become more seriously ill. Instead, more health problems were added to records to seek higher reimbursement. At the same time, detecting additional problems early may benefit patients' health.
Insurance companies have also begun using AI to review payment claims submitted by hospitals. The systems assess whether a diagnosis is accurate and whether treatment was actually necessary. As a result, AI tools used by hospitals and insurers cross-check the same payment claim. This process may increase spending on computer systems and administration. The additional cost may then be passed on to patients through higher insurance premiums. Abridge founder Shiv Rao acknowledged that conflict between AI systems could create an undesirable future. At the same time, he believes that properly implementing the technology could reduce tensions and costs between the parties. Luke Chalker, the organization's vice president of product and data science, declined to call the situation a war. In his view, insurers are currently bearing the main loss.
Hospitals use AI tools to review medical records and transcribe what is said during patient visits. In addition to the primary complaint, the systems can identify other illnesses and complications. A human specialist may overlook such details while reviewing numerous documents. In the US, reimbursement depends on the number and complexity of diagnoses. Therefore, more diagnoses also mean higher costs. The analysis showed a sharp increase in the number of patients diagnosed with complex illnesses. However, there was no corresponding increase in treatment or the volume of medical services. The organization concluded that patients had not become more seriously ill. Instead, more health problems were added to records to seek higher reimbursement. At the same time, detecting additional problems early may benefit patients' health. Insurance companies have also begun using AI to review payment claims submitted by hospitals. The systems assess whether a diagnosis is accurate and whether treatment was actually necessary. As a result, AI tools used by hospitals and insurers cross-check the same payment claim. This process may increase spending on computer systems and administration. The additional cost may then be passed on to patients through higher insurance premiums. Abridge founder Shiv Rao acknowledged that conflict between AI systems could create an undesirable future. At the same time, he believes that properly implementing the technology could reduce tensions and costs between the parties. Luke Chalker, the organization's vice president of product and data science, declined to call the situation a war. In his view, insurers are currently bearing the main loss.