Hospitals’ use of artificial intelligence tools as they submit insurance claims led to an additional $942 million in healthcare spending over a two-year period, according to an analysis by the Blue Cross Blue Shield Association.
The BCBSA analysis found “a sharp increase in patients being documented as having complex conditions,” but argued there is a “clear disconnect between [medical] coding and treatment,” as there’s “no evidence of corresponding change in care delivered.”
The New York Times pointed the analysis as just the latest sign that AI is contributing to an increase in healthcare costs. While battles between hospitals and insurers over treatments and payments are nothing new, the NYT said the use of AI on both sides seems to be making it worse.
First I was ready to jump in and go, yup AI’s fucking things up more… but I’m more confused on this. It sounds to me like AI is maybe, doing like bob in the incredibles. IE guiding providers through the obstacle course of meaningless hoops that are normally there so that they can deny as many claims as possible, by learning what loopholes insurance companies usually reject, and specifically coding and phrasing the claims to avoid the traps.
IE it’s most likely similar to the job application problem right now. IE companies basically trained AI to auto reject applications that came in on a bunch of arbitrary worthless metrics, thus cutting the pile of applications down by 90% before humans even start looking at it. Then applicants got AI tools that now specifically look for and phrase things specifically to target the searching AIs arbitrary filters, negating it useless. With the exception of the applicants that don’t use the tool, who just get fucked.