September 27, 2026
AI is already affecting medical bills: insurers tally $942 million
Blue Cross Blue Shield Association linked $942 million in additional costs to AI from 2023 to 2025. The share of hospitalizations coded as complex rose from 37% in early 2023 to 40% by the end of 2025.
Previously, 37% of hospitalizations were coded as complex. By the end of 2025, the share had risen to 40%. BCBSA attributed $653 million of the increase to secondary diagnoses: they added 55 thousand complex cases at an average cost of $11 thousand.
A signal for AI. More than 60% of hospital systems use AI to identify secondary diagnoses in lab results and electronic patient records. One such diagnosis can move a case into a higher-cost payment category. BCBSA’s calculation is based on insurance claims rather than patient medical records.
The American Hospital Association disputes BCBSA’s conclusion, attributing the increased complexity of cases to an aging patient population and the shift of less complex care to outpatient settings.
