DeSantis criticizes AI’s role in rising healthcare costs

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(The Center Square) – Gov. Ron DeSantis criticized higher health insurance premiums Monday that are being driven by the use of AI tools in healthcare.

The governor’s comments came in response to a recent analysis of artificial intelligence tools used by insurance companies.

The report from the Blue Cross Blue Shield Association found a nearly $1 billion increase in healthcare spending for its companies between 2023 and 2025.

Approximately 6 million Floridians use Florida Blue, which is the state’s local licensee of Blue Cross Blue Shield.

The report warned that widely adopted AI coding tools are pushing up healthcare spending with no benefit to patients.

“Both Big Hospitals and Big Insurance are using AI tools to either seek more reimbursements or to deny more claims,” DeSantis said Monday. “The result: AI providers make a lot of money, individuals pay higher premiums and have more denials, and nobody gets healthier.”

More than 60% of hospital systems are incorporating AI technology to scan lab results and electronic records to find secondary diagnoses, leading to hospitals billing patient stays as more medically complex at an increasing rate, the report said.

However, these secondary diagnoses did not lead to evidence of a corresponding change in care, which means patients did not necessarily receive better care. What they did get was a higher-cost billing category.

Approximately 70% of the additional healthcare costs were tied to secondary diagnoses, representing over $650 million. According to the report, secondary diagnoses can increase reimbursements for hospitals.

“If patients are truly sicker, we'd expect to see more treatment,” said Luke Chalker, BCBSA’s senior vice president of product and data science. “For example, we're seeing significantly more anemia diagnoses at these hospitals without a corresponding increase in transfusions. The disconnect between diagnoses and treatment suggests that AI is identifying more billable conditions, not sicker patients.”

When asked about Florida passing a universal pricing law for healthcare providers, DeSantis said the state has done a version of that.

“When combined with a shared savings-style insurance plan — where the patient shares in the savings when choosing a better priced option — it can help save money,” the governor said.

This latest analysis highlights the rapid adoption rate of AI tools across different sectors. A recent McKinsey Global Survey found nearly 9 out of 10 respondents said their organizations were regularly using AI. The share of respondents saying their organizations are using AI in at least one business function increased from 78% to 88% in one year.

“As families face higher healthcare costs, this research underscores the urgent need to better understand these AI tools and the role they may play in exacerbating the affordability crisis,” said David Merritt, BCBSA’s senior vice president of external affairs.