EmpiricalRequires evidence

Automation applied to an adversarial administrative process raises activity rather than cutting cost, a failure mode distinct from Goodhart capture: PHTI (Oct 2026) reports that for prior authorization, "insurers and vendors have not yet reported evidence that AI reduces the average cost per claim after factoring in the cost of the AI solution", and that because each side automates its own half, "AI designed to optimize each side of the transaction makes the overall process more activity-intensive, rather than more efficient." The structural cause cited is unaddressed variation: across four major US insurers more than 5,000 procedure codes require prior authorization and only 3% of those codes require it across all four payers. Evidence grade: absence of reported evidence is weaker than evidence of absence, and PHTI is reporting what workshop participants said they had not measured.

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