Feds rein in AI tools for Medicare Advantage plans
Plus: The daily routine of the best hitter in the MLB playoffs
Good morning and happy Friday. Welcome to the Friday Pulse Check from Fulcrum Strategies. I am traveling today and thus have an abbreviated version of our weekly e-newsletter for you.
In the news:
Feds rein in predictive tools for Medicare Advantage plans
UnitedHealthcare (UNH 0.00%↑) has been using a computerized tool to predict what patient outcomes are after certain diagnoses. KFF Health News talked to one patient who learned that her Medicare Advantage plan would no longer cover her cancer treatment because “she was well enough to go home;” she could barely walk a few feet at the time. The Centers for Medicare and Medicaid Services has rightly said that that is unacceptable and that real humans need to be evaluating patient circumstances, not computers. Read more from KFF Health News.
Other articles of interest:
The Daily Routine of the Best Hitter in the MLB Playoffs - InsideHook
Aetna received an estimated $25.5M in Medicare Advantage overpayments - Becker’s Payer Issues
LIVE CVS stock price: CVS 0.00%↑
Why Walmart isn't partnering with hospitals — yet - Becker’s Health IT
Opinion: Pulling the Plug (Again?) on Short-Term - American Enterprise Institute
California Watch: What to know about the largest healthcare workers strike in history - CNN
Medicare Advantage
The FLATLINING Podcast from Fulcrum Strategies
This week on the podcast, Ron and I took a good amount of time to talk about Medicare Advantage. Open enrollment is just around the corner so we decided to take a look at what changes have taken place over the years and the new trend of promotional partnerships between retail chains and some of these plans.
Listen now wherever you get your podcasts or listen on YouTube. Subscribe to the FLATLINING Podcast on Apple Podcasts, Spotify, the iHeartRadio app, Amazon Music, Google Podcasts, Stitcher, Pandora, TuneIn, and Audible.
Have a good weekend,
Matthew