674
submitted 1 year ago by L4s@lemmy.world to c/technology@lemmy.world

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.

you are viewing a single comment's thread
view the rest of the comments
[-] autotldr@lemmings.world 4 points 1 year ago

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!

this post was submitted on 17 Nov 2023
674 points (99.4% liked)

Technology

60012 readers
2634 users here now

This is a most excellent place for technology news and articles.


Our Rules


  1. Follow the lemmy.world rules.
  2. Only tech related content.
  3. Be excellent to each another!
  4. Mod approved content bots can post up to 10 articles per day.
  5. Threads asking for personal tech support may be deleted.
  6. Politics threads may be removed.
  7. No memes allowed as posts, OK to post as comments.
  8. Only approved bots from the list below, to ask if your bot can be added please contact us.
  9. Check for duplicates before posting, duplicates may be removed

Approved Bots


founded 2 years ago
MODERATORS