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Items tagged with: algorithm


How UnitedHealth’s Playbook for Limiting #MentalHealth Coverage Puts Countless Americans’ Treatment at Risk

United used an #algorithm system to identify #patients who it determined were getting too much #therapy and then limited coverage. It was deemed illegal in three states, but similar practices persist due to a patchwork of #regulation.

#News #Healthcare #Health #Insurance #UnitedHealth #Medicaid #Government

propub.li/3Ogrfow


“Not Medically Necessary”: Inside the Company Helping America’s Biggest #Health Insurers Deny Coverage for Care

When companies like Aetna or UnitedHealthcare want to rein in costs, they turn to #EviCore, whose business model depends on turning down payments for #care recommended by #doctors for their #patients.

propublica.org/article/evicore…

#News #Insurance #Algorithm #AI #Healthcare