Denied by AI: How Medicare Advantage plans use algorithms to cut off care for seniors in need
Denied by AI: How Medicare Advantage plans use algorithms to cut off care for seniors in need
A STAT investigation found artificial intelligence is driving Medicare Advantage denials to new heights, cutting off care for seniors.
This is part 1 of an ongoing investigative series.
An algorithm, not a doctor, predicted a rapid recovery for Frances Walter, an 85-year-old Wisconsin woman with a shattered left shoulder and an allergy to pain medicine. In 16.6 days, it estimated, she would be ready to leave her nursing home.
On the 17th day, her Medicare Advantage insurer, Security Health Plan, followed the algorithm and cut off payment for her care, concluding she was ready to return to the apartment where she lived alone. Meanwhile, medical notes in June 2019 showed Walter’s pain was maxing out the scales and that she could not dress herself, go to the bathroom, or even push a walker without help.
- Part 2: Denied By AI: How UnitedHealth's acquisition of a popular Medicare Advantage algorithm sparked internal dissent over denied care
- Part 3: Denied By AI: UnitedHealth pushed employees to follow an algorithm to cut off Medicare patients' rehab care
- Part 4: Denied By AI: UnitedHealth used secret rules to restrict rehab care for seriously ill Medicare Advantage patients
You're viewing a single thread.
Dan McQuillan has been warning about this since forever, to the point where I would've assumed that he'd be referenced if not interviewed int his article, though he wasn't. Here's a pretty short one from him. His basic argument is that AI is best understood as algorithmic Thatcherism, in which they'll silicon-wash the same austerity politics that neoliberalism has been feeding us forever.
AI is being used as a means of diverting blame from humans onto a black box. It's not inherently bad of itself, but the current hype around it is allowing it to be used in ways it shouldn't be.
Somehow I missed this piece, thanks for sharing — as someone whose family used to be miners, I'll never pass up an opportunity to bitch about Thatcher