A Dark Side of Mixing AI and Medicine
A Dark Side of Mixing AI and Medicine
If there's one concern about mixing artificial intelligence ('AI') and medicine, it's that it will over diagnose and lead to under and over treatment...
But another concern outside of specialized health care publications isn't getting much attention...
It's that unregulated AI is starting to be used as a tool in insurance pre-authorizations – in some cases denying insurance coverage for people who need it.
Nowhere is that more obvious than with Medicare Advantage's approach to authorizing nursing home stays after surgery or some other acute treatment.
Medicare Advantage is a popular option among Medicare recipients because it's cheaper and more inclusive than traditional Medicare. Think of it as a health maintenance organization ("HMO") that covers 31 million people, or roughly half of all Medicare recipients.
This gets us to our story...
An investigation by health care news site STAT shows how an AI-driven program from a small company called naviHealth – which is owne…