---
title: "Hospitals use AI to diagnose, and insurers are not pleased — Marsanne Studio AI watch"
description: "US hospitals and insurers are using AI against each other to justify or deny medical billing, with rising costs for patients."
url: "https://marsanne.studio/en/ai-watch/hospitals-use-ai-to-diagnose-and-insurers-are-not-fed736/"
lang: "en"
---

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Analysis · 6 October 2026

# Hospitals use AI to diagnose, and insurers are not pleased

Original title, in Spanish: “Los hospitales están utilizando IA para diagnosticar. Y a las aseguradoras no les está gustando nada”

**Publication**

Xataka (Spain)

**Author**

[Rubén Andrés](https://www.xataka.com/autor/ruben-andres)

**Published on**

6 October 2026 · read in the page structured data

## Summary

In the United States, hospitals and health insurers are each using AI at opposite ends of the medical billing chain, according to a New York Times report picked up by Xataka. Hospitals use software that analyses test results, medical notes and patient histories to justify more costly secondary diagnoses: the McLaren group in Michigan is reported to earn an extra million dollars in monthly revenue as a result. A report by the insurer BlueCross puts this additional cost at $942 million between 2023 and 2025, of which 70% is linked to secondary diagnoses that reclassify the admission. In response, insurers use AI to detect irregularities and deny more payments: UnitedHealthcare had already denied 22.7% of post-hospitalisation care requests in 2022, according to the US Senate. The consultancy Marsh forecasts an 8.2% rise in healthcare costs per employee in 2027.

Summary based on the full text of the article.

[Read the article on Xataka →](https://www.xataka.com/robotica-e-ia/hospitales-estan-utilizando-ia-para-diagnosticar-a-aseguradoras-no-les-esta-gustando-nada)

## Figures cited

-   942 millions of dollars
    
    Estimated additional spending from diagnoses of complex conditions in the US, 2023-2025
    
    United States, 2023-2025
    
    > « el número de pacientes diagnosticados con afecciones complejas parece haber supuesto un gasto adicional estimado de 942 millones de dólares en atención médica entre 2023 y 2025, provocando un aumento de las primas para las familias, los empleadores y los contribuyentes »
    
    Source: Informe de BlueCross
    
-   70 %
    
    Share of patients whose secondary diagnosis raised the billing category to a more costly level
    
    United States, Medicare patients, 2023-2025
    
    > « Cerca del 70% de esos pacientes venía de diagnósticos secundarios que subían el ingreso a una categoría más cara. »
    
    Source: Informe de BlueCross
    
-   1 million dollars per month
    
    Additional monthly revenue for the McLaren hospital group from using AI to manage diagnoses
    
    McLaren, Michigan, United States
    
    > « el grupo hospitalario McLaren que opera en Míchigan, ingresa un millón más al mes gracias al uso de IA en la gestión del diagnóstico de sus pacientes. »
    
    Source: The New York Times
    
-   22.7 %
    
    Denial rate of post-hospitalisation care requests by UnitedHealthcare under Medicare Advantage, 2022
    
    UnitedHealthcare, Medicare Advantage, United States, 2022
    
    > « El Senado de EEUU documentó que UnitedHealthcare denegaba en 2022 un 22,7% de las peticiones de cuidados tras el alta en Medicare Advantage. »
    
    Source: Senado de EE. UU.
    
-   8.2 %
    
    Forecast rise in healthcare costs borne by each employee in 2027
    
    United States, forecast for 2027
    
    > « La consultora sanitaria Marsh (antes Mercer) prevé que el coste de salud que deberá pagar cada empleado suba un 8,2 % en 2027, el mayor salto desde 2003. »
    
    Source: Marsh (anciennement Mercer)
    

## Classification

**Country**

United States

**Company size**

All sizes

**Industries**

Healthcare, pharmaceuticals, social care · Banking, insurance, asset management, finance departments

**Companies**

American Hospital Association (AHA) (cited), Marsh (study author), Peterson Health Technology Institute (study author), BlueCross (study author), McLaren (deploys AI), UnitedHealthcare (deploys AI)

**Keywords**

healthcare, health insurance, medical billing, AI diagnosis, reimbursement, hospitals

Entry written by Marsanne Studio from the cited article, with the help of an AI model (claude-sonnet-5). The rights to the article and its illustrations belong to Xataka and its author. Entry translated from French by Claude Sonnet 5.5.