Amid Hype, Experts Debate AI’s Impact on Health Insurance

Hype of artificial intelligence reached new heights in 2023, and the health care industry was no exception to that trend. Health insurance firms have been among the first organizations to deploy previous generations of big data tools at scale, and in turn, AI is set to proliferate among health insurers in the near future. How AI adoption will actually impact health insurance operations and finances is an open question.

Some insiders, like Moody’s Investors Service analysts, expect health insurers to reap dramatic operational and financial benefits by deploying AI. Other experts disagree, including a group of Stanford University researchers who published a Nov. 16 op-ed in JAMA arguing that due to the extreme complexity of medical administration in the U.S., AI using large language models (LLMs) “might exacerbate billing challenges for physicians” and could lead to additional challenges of filed claims by carriers.

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Peter Johnson

Peter Johnson

Peter has worked as a journalist since 2011 and has covered health care since 2020. At AIS Health, Peter covers trends in finance, business and policy that affect the health insurance and pharma sectors. For Health Plan Weekly, he covers all aspects of the U.S. health insurance sector, including employer-sponsored insurance, Medicaid managed care, Medicare Advantage and the Affordable Care Act individual marketplaces. In Radar on Drug Benefits, Peter covers the operations of (and conflicts between) pharmacy benefit managers and pharmaceutical manufacturers, with a particular focus on pricing dynamics and market access. Before joining AIS Health, Peter covered transportation, public safety and local government for various outlets in Seattle, his hometown and current place of residence. He graduated with a B.A. from Colby College.

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