UnitedHealth uses AI model with 90% error rate to deny care, lawsuit alleges | For the largest health insurer in the US, AI’s error rate is like a feature, not a bug::For the largest health insurer in the US, AI’s error rate is like a feature, not a bug.
For-profit health insurance just makes no sense. This is the expected behavior of a for-profit insurance system.
Ah it would be nice if the government actually took care of it’s citizens health. At least the government is taking care of corporate profits though.
Current america reminds me of america under british rule before independence. Or at least how I have seen it being portrayed.
99% it’s not AI, it is just an old school linear model, the one they have been using for decades, implemented on Excel, that they now call AI.
I know people working in insurance…
It’s what they trained the AI on. The AI wasn’t to help the insured’s situation. It’s so they can employ fewer agents.
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Yeah but ummm free market. You can switch to one of 2 or 3 other health insurance companies with their own distinct AI death panel.
I don’t get why I need a middleman between me and my doctor! As a person who comes from a 3rd world country that has universal healthcare, this sounds insane to me.
Yep it’s insane. Healthcare shouldn’t be a for-profit business FFS.
They better be careful! The court could issue a judgement of up to $100,000 to cover all the lives they have destroyed. That’ll show 'em!
Unfortunately I’ve never known a insurance company in the business of paying out claims. It’s always seemed to be in their best interests to pay out at little as possible.
You can imagine the lengths they go to do this as it’s great for their bottom line. Adding this mentality to things beyond physical things like human healthcare seems scary to me.
As messed up at times government run things can be I’m still glad for universal health care in my country not being a profit center for those running it.
Hey Insurance Co., hire me as your AI specialist. Here’s some sample code for your new version:
if (ChanceDisGuyGonnaSueMe less than 0.2) { DenyInsuranceClaim(); return; } NormalClaimsProcess();Guys, this guys code is garbage, let me double your profits here:
if (ChanceDisGuyGonnaSueMe less than 0.4) { DenyInsuranceClaim(); return; } NormalClaimsProcess();
Oh good. My wife’s employer, who we both get insurance through, just switched to United Healthcare. Although I’m sure Anthem is using the same bullshit AI software.
At least I’m not on Medicare. Those people sound really fucked.
We may have the same employer.
In addition to switching companies, my employer is also bragging about a new health plan with $0 monthly cost to the employee, while being completely silent on that new plan covering absolutely nothing aside from virtual appointments through an app sponsored by the insurance company.Probably not. This is a public library. They really had no choice because they just couldn’t afford Anthem anymore. My wife is an administrator and helped decide on UHC because it offered the best package for what they could afford to pay. Our copays have still gone up, but it was either that or a much shittier plan. It’s not a $0 cost plan either, because public library budgets aren’t exactly massive.
So I don’t blame them and my wife for switching to UHC. Their hands were pretty much tied. They want to do right with their employees and they aren’t trying to make a profit.
That health insurance companies exist at all is the problem.
This is the best summary I could come up with:
The investigation’s findings stem from internal documents and communications the outlet obtained, as well as interviews with former employees of NaviHealth, the UnitedHealth subsidiary that developed the AI algorithm called nH Predict.
The algorithm estimates how much post-acute care a patient on a Medicare Advantage Plan will need after an acute injury, illness, or event, like a fall or a stroke.
It’s unclear how nH Predict works exactly, but it reportedly estimates post-acute care by pulling information from a database containing medical cases from 6 million patients.
NaviHealth case managers plug in certain information about a given patient—including age, living situation, and physical functions—and the AI algorithm spits out estimates based on similar patients in the database.
But Lynch noted to Stat that the algorithm doesn’t account for many relevant factors in a patient’s health and recovery time, including comorbidities and things that occur during stays, like if they develop pneumonia while in the hospital or catch COVID-19 in a nursing home.
Since UnitedHealth acquired NaviHealth in 2020, former employees told Stat that the company’s focus shifted from patient advocacy to performance metrics and keeping post-acute care as short and lean as possible.
The original article contains 669 words, the summary contains 193 words. Saved 71%. I’m a bot and I’m open source!
