AIs (LLMs) are now being used in hospitals…

The American Hospital Association is pushing back on a Blue Cross Blue Shield Association report that linked hospitals’ growing use of artificial intelligence-enabled documentation tools to higher healthcare spending, arguing the analysis does not prove AI is driving improper billing.

The Blue Cross Blue Shield Association estimated that coding-related changes resulted in $942 million in additional spending for participating Blue plans between 2023 and 2025 as hospitals increasingly classified patients as having more complex conditions.

But the AHA said Monday that the analysis lacks critical context and does not establish that hospitals incorrectly coded patients or that AI tools were responsible for the changes.

“The central question is not whether hospitals are reporting more diagnoses,” the AHA said. “The question is whether the patient’s medical record supports those diagnoses.”

Full article, HERE from Fox News.

Anybody want to bet the LLMs are using the IF/THEN matrix to ‘add’ diagnoses to patients?

For those who may not be familiar with it, IF/THEN is a use case where you get the IF (say a specific diagnosis) and the THEN says if the patient has ‘this’, it must also have ‘that’, e.g. the second diagnosis…

This is basic programming, and I can easily see this being done by the LLMs since they are being used to ‘ensure’ the hospitals are making a profit…

Other than the Shrine Hospitals and St. Jude, I cannot think of a hospital these days that isn’t a profit center…

sigh…