STAT April 14, 2022
Does the quest for high utilizers really help patients?
Health insurers and providers are increasingly using machine learning to flag the subset of patients likely to rack up the most costly hospitalizations, ideally so they can be funneled into preventive care programs and toward social services that can improve their health. But as Mohana reports, there’s no standard predictive method, which means they run the risk of excluding the highest need groups from preventive care. There’s also little agreement about the best way to get these homegrown algorithms into the hospital or payer workflow. In the absence of government or industry oversight, machine learning experts are calling for more oversight in cost prediction.
One example of how the tech is...
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