STAT+: Blue Cross Blue Shield says data back up claim that AI is driving up medical bills

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Source: STAT News

Original: https://www.statnews.com/2026/03/09/bcbs-study-hospitals-use-ai-upcoding-drive-u...

Published: Mon, 09 Mar 2026 08:30:00 +0000

Blue Cross Blue Shield says new data analysis confirms how AI coding is driving up healthcare costs. Research by BCBSA and BHI suggests that AI-enabled billing in hospitals leads to higher costs by increasing the number of diagnoses without appropriate treatment. These AI coding tools create a disconnect between diagnoses and actual treatment, which increases overall spending. Blue Cross Blue Shield of Michigan uses AI to predict 12-month claims costs and identify drivers of rising costs. The firm plans to save $600 million over three years thanks to AI tools like ContractsGPT and SecureGPT to reduce administrative expenses. AI also helps identify risks of chronic diseases, such as chronic kidney disease or prediabetes, enabling early intervention. Blue Shield of California has achieved efficiencies of 25% to 50% when combining AI with human expertise in call processing. These findings raise concerns about cost sustainability in healthcare.