Sep 25, 2026 · 7 min · 10 segments
Hospital A I added nearly a billion dollars in charges. Nobody got sicker. Run time: 7:28 In today's episode: Blue Cross: hospital AI added $942 million in chargesVA picks Abridge for ambient AI…
Start with the money.
The Blue Cross Blue Shield Association analyzed its own members' inpatient claims this week.
Between 2024 and 2025, rising coding intensity added about $942 million in cost compared with 2023.
$653 million of that traced to secondary conditions, the extra diagnoses that sit alongside the main reason a patient was admitted.
Over the same stretch, the share of blue members' inpatient claims billed as complex rose from roughly 37% to about 40%.
What did not change, the association says, is the care.
Their medical executive put it flatly.
The tools named are ambient listening scribes and lab data mining.
Here's the mechanism.
One documented comorbidity can push a claim into a higher weighted payment tier without a single order changing.
The scribe is not inventing anything.
It captures what was genuinely said in the room and what was said is not the same as what was treated.
Signal with an asterisk.
This is an insurer's own analysis, not a peer-reviewed study.
And insurers have an obvious interest in lower payouts.
But it covers three years of real bills.
Start with the money.
The Blue Cross Blue Shield Association analyzed its own members' inpatient claims this week.
Between 2024 and 2025, rising coding intensity added about $942 million in cost compared with 2023.
$653 million of that traced to secondary conditions, the extra diagnoses that sit alongside the main reason a patient was admitted.
Over the same stretch, the share of blue members' inpatient claims billed as complex rose from roughly 37% to about 40%.
What did not change, the association says, is the care.
Their medical executive put it flatly.
The tools named are ambient listening scribes and lab data mining.
Here's the mechanism.
One documented comorbidity can push a claim into a higher weighted payment tier without a single order changing.
The scribe is not inventing anything.
It captures what was genuinely said in the room and what was said is not the same as what was treated.
Signal with an asterisk.
This is an insurer's own analysis, not a peer-reviewed study.
And insurers have an obvious interest in lower payouts.
But it covers three years of real bills.
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