What happens when you take two of the most popular topics being discussed in collections today — healthcare debt and artificial intelligence — and you put them together? There is a concern that hospitals are using third-parties that are deploying artificial intelligence tools and algorithms to make decisions about charity care and financial eligibility for patients, which could potentially limit access to those programs and cause problems for the healthcare providers as well as companies that attempt to collect on the accounts, according to an article and an editorial that were published last week in JAMA Internal Medicine.
Why it matters: AI is already embedded in revenue cycle management for many hospitals, helping them streamline billing and collections. However, there is growing worry that these technologies might prioritize hospital revenues over patient care. As highlighted by Christopher Goodman and Kelsey Chalmers, AI tools could either alleviate or exacerbate the nation’s medical debt crisis, depending on how they’re deployed.
- The good: When used ethically, AI can proactively screen patients for financial assistance, ensuring that those in need receive charity care without navigating complicated application processes. For example, some hospitals use AI tools that automatically qualify patients for free care based on income and other factors.
- The bad: On the flip side, some AI-driven tools identify patients’ “propensity to pay,” encouraging hospitals to pursue collections even from those who might qualify for assistance. This use of AI risks turning healthcare institutions into aggressive collectors rather than care providers.
The bottom line: As AI becomes more integral to hospital billing and collections, its use needs regulation and oversight to prevent potential harm. Industry experts are calling for greater transparency, clearer financial assistance policies, and national standards for charity care programs to ensure AI is used to protect patients, not push them further into debt.
