PwC Says AI Could Lift Healthcare Costs 9% by 2027 as Billing Codes Intensify
Updated
Updated · Fortune · Jun 12
PwC Says AI Could Lift Healthcare Costs 9% by 2027 as Billing Codes Intensify
2 articles · Updated · Fortune · Jun 12
Summary
A new 60-page PwC report says AI is one of five forces that could keep U.S. healthcare cost growth at 9% in 2027, matching this year’s fastest pace since 2010-11.
AI note-taking tools are capturing more diagnostic detail, letting hospitals bill higher-severity codes even when the care delivered does not materially change.
Blue Cross Blue Shield found acute posthemorrhagic anemia coding in maternity admissions rose to 12.3% from 4% between 2022 and 2025, while blood transfusion rates barely moved.
An audit of the hospital system with the sharpest increase found fewer than 20% of those cases met clinical criteria, and BCBS said coding intensity added $22 million to maternity spending over three years.
PwC still said labor and supply expenses remain bigger overall cost drivers, though AI could eventually lower costs through administrative automation and earlier diagnosis.
While AI inflates US medical bills, could it create near-zero-cost healthcare for the rest of the world?
As hospitals and insurers wage an AI arms race over billing, how can patients avoid becoming casualties?
Is AI the villain in rising healthcare costs, or is it just exposing a fundamentally broken system?
U.S. Healthcare Costs to See Highest Increase in 20 Years: 2027 Projections, Causes, and Solutions
Overview
U.S. healthcare costs are projected to rise sharply in 2027, affecting both employer-sponsored and individual markets, including Affordable Care Act plans. This increase is creating immediate challenges for health plans and self-funded employers. Regulatory changes, especially under the No Surprises Act, are adding complexity, as providers are winning most arbitration cases, leading to higher reimbursement rates that insurers must pay. These higher rates are driving up overall costs. Additionally, if enhanced ACA subsidies expire, individuals could face even greater financial pressures, making healthcare less affordable for many Americans.