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Watch: As AI Makes More Health Coverage Decisions, the Risks to Patients Grow

April 10, 2026
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Watch: As AI Makes More Health Coverage Decisions, the Risks to Patients Grow
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That Discount at the Pharmacy Counter May Pack Hidden Costs

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Darius Tahir and Hannah Norman, KFF Well being Information

This yr, executives from practically each main medical health insurance firm made the identical declaration in calls with Wall Road analysts: Utilizing synthetic intelligence to make protection choices would assist save them cash.

Even the Trump administration is testing AI’s usefulness in managing the prior authorization course of for the Medicare program, in addition to searching for to override AI regulation by states.

However class motion lawsuits have accused insurers of utilizing AI to wrongfully withhold remedy. And new analysis from Stanford College outlines the dangers of coaching AI on a present system rife with wrongful denials.

“There’s a world by which utilizing AI might make that worse, or no less than replicate a nasty human system, as a result of the information that it could be coaching on is from that dangerous human system,” stated Michelle Mello, a co-author of the research.

Though, Mello stated, the analysis workforce discovered “actual positives alongside the dangers.”

On this video produced by KFF Well being Information’ Hannah Norman, Darius Tahir, a correspondent masking well being know-how, explains.

You’ll be able to learn Tahir’s current protection of AI’s use by well being insurers under:

KFF Well being Information is a nationwide newsroom that produces in-depth journalism about well being points and is likely one of the core working applications at KFF—an unbiased supply of well being coverage analysis, polling, and journalism. Study extra about KFF.

See also  Hacking at UnitedHealth Unit Cripples a Swath of the US Health System: What to Know

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It’s essential to notice, not every thing on kffhealthnews.org is offered for republishing. If a narrative is labeled “All Rights Reserved,” we can not grant permission to republish that merchandise.

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Tags: CoverageDecisionsGrowHealthPatientsRisksWatch

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