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Denied by AI: How Medicare Advantage plans use algorithms to cut off care for seniors in need (archive.ph)

submitted 4 months ago* (last edited 4 months ago) by [email protected] to c/[email protected]

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This is part 1 of an ongoing investigative series.

An algorithm, not a doctor, predicted a rapid recovery for Frances Walter, an 85-year-old Wisconsin woman with a shattered left shoulder and an allergy to pain medicine. In 16.6 days, it estimated, she would be ready to leave her nursing home.

On the 17th day, her Medicare Advantage insurer, Security Health Plan, followed the algorithm and cut off payment for her care, concluding she was ready to return to the apartment where she lived alone. Meanwhile, medical notes in June 2019 showed Walter’s pain was maxing out the scales and that she could not dress herself, go to the bathroom, or even push a walker without help.

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[–] [email protected] 4 points 4 months ago (7 children)

Not all algorithms are AI

[–] [email protected] 4 points 4 months ago (5 children)

At this point I wouldn't be surprised to see people calling something as basic as a bash script that adds 2 numbers AI due to lack of actual understanding of what AI is.

[–] [email protected] 3 points 4 months ago (2 children)

there are rice cookers and other appliances that advertise ai features with no explanation, and when you take them apart they are literally the same as the standard version.

[–] Gsus4 2 points 4 months ago

Some weigh the clothes and adjust the wash time or prolong the centrifuge cycle if the clothes are still too wet (not sure if this is using the scale or the water flow)...BOOM comes with AI now :D at this point we need certification labels to end this bullshit.

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