New study links AI coding tools to higher hospital costs

The Blue Cross Blue Shield Association (BCBSA) has released a study examining how hospitals’ use of artificial intelligence coding tools may affect healthcare costs. It found that as hospitals implement these tools, more patients are being classified as having complex medical conditions, even when the care they receive has not significantly changed.

What the study found

AI coding tools can identify additional diagnoses in medical records that may allow hospitals to bill at higher rates. According to the study, these higher classifications are occurring without evidence that patients are sicker or receiving more treatment. Researchers estimate the practice added nearly $1 billion in healthcare costs over the past two years.

Why it matters

Higher hospital charges can increase overall healthcare spending and add pressure to healthcare costs for employers and members. The findings offer important context for conversations about affordability and the factors contributing to rising medical costs.