McKnight's March 14, 2023
Artificial intelligence is partly to blame for increasing Medicare Advantage denials, especially among beneficiaries in need of skilled nursing care, a new report finds.
An investigation published by STAT News Monday accused insurers of using “unregulated predictive algorithms, under the guise of scientific rigor, to pinpoint the precise moment when they can plausibly cut off payment for an older patient’s treatment.”
The report, based on court documents and extensive interviews, comes as the federal government tries to reduce the number of pre-authorization and other denials to address a spate of consumer complaints. It also follows a February study in the Journal of Applied Gerontology that showed ageism has been designed into some AI tools.
The increasing use of artificial intelligence...
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