Please boost so anyone in the US with #MedicareAdvantage or any #UnitedHealthcare plans, including #Optum and #NaviHealth can read this article on the algorithms they use to deny your care and what it takes to fight back. #HCR4US #HealthcareIsAHumanRight

https://kffhealthnews.org/news/podcast/attack-of-the-medicare-machines/

"In a class action lawsuit filed Tuesday, plaintiffs argued the payer prematurely cut payments for MA [Medicare Advantage] beneficiaries’ ... #Humana [reportedly] based the cuts on the AI model’s 'rigid and unrealistic predictions for recovery' — not doctors’ recommendations — despite knowing the model’s estimations were often 'highly inaccurate.'
"...another suit [pending] against #UnitedHealth and nH’s owner, #NaviHealth."

Courtesy of Yahoo and HealthCare Dive https://finance.yahoo.com/news/humana-used-algorithm-deny-care-105455153.html

#UnitedHealth uses #AI model with 90% error rate to deny care, #lawsuit alleges
For the largest #healthinsurer in the #US, AI's error rate is like a feature, not a bug. 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 but over 90 percent of the #insurance denials are reversed on appeal. https://arstechnica.com/health/2023/11/ai-with-90-error-rate-forces-elderly-out-of-rehab-nursing-homes-suit-claims/

#UnitedHealthcare uses #naviHealth care mgmt bought in 2020 2 help make coverage decisions. Proprietary “nH Predict” tool sifts thru M of #medicalrecords to match patients w similar #diagnoses & characteristics. Based on these comparisons #algorithm anticipates what kind of care specific patient will need, 4 how long and predicts patient’s date of discharge which coincides w insurer cuts off coverage even if the patient needs further treatment #Medicare would provide. https://kffhealthnews.org/news/article/biden-administration-software-algorithms-medicare-advantage/

“Denied by AI: How Medicare Advantage plans use algorithms to cut off care for seniors in need”

“STAT is investigating denials and appeals in Medicare Advantage, and the role that technology plays in those decisions. If you have an experience with Medicare Advantage denials, please share your story with us.”

#MedicareAdvantage #Medicare #healthInsurance #artificialIntelligence #AI #algorithms #SecurityHealthPlan #NaviHealth #UnitedHealthGroup #UnitedHealthcareAdvantage

https://www.statnews.com/2023/03/13/medicare-advantage-plans-denial-artificial-intelligence/

This is a good one 😡
Insurance companies using artificial intelligence (AI) to cut off care!

#medicare #medicareadvantage #artificialintelligence #ai #authorization #algorithm #algorithms #NaviHealth @STAT
https://www.statnews.com/2023/03/13/medicare-advantage-plans-denial-artificial-intelligence/