Insurers Blame Hospitals’ Use Of AI, ‘Aggressive’ Coding For Price Spikes
Health insurers are ready to fight fire with fire, as they cite the overzealous uses of AI in billing and coding for the surge in claims that are cutting into their profits. Other news looks at a class-action lawsuit by nurses and doctors in Montana, racial disparities in maternal care, and more.
Stat:
Insurers Say They’ll Deploy More AI To Combat ‘Aggressive’ Coding By Hospitals
Health insurance companies are fighting fire with fire as they combat rising medical costs they say are being driven up, in part, by artificial intelligence. Large private insurers have continued to call out purportedly overzealous coding and billing as a source of ballooning health care costs. In particular, some have blamed the use of AI tools for some of the surge in claims from health care providers that have cut into their profits. (Palmer, 10/31)
More health industry news —
Montana Free Press:
Nurses, Doctor Sue Montana Recovery Program In Class-Action Lawsuit
A group of Montana doctors and nurses is suing the national company that runs a rigorous, often mandatory monitoring program for health care providers grappling with addiction. The case is the latest instance of public criticism about how the state-mandated program for more than 60,000 medical licensees operates. (Silvers, 10/30)
Newsweek:
New Orleans Nurses Announce Three-Day Strike In November
Nurses at University Medical Center New Orleans (UMCNO) announced Thursday that they will hold a three-day strike in November over staff retention concerns amid ongoing contract negotiations. This is the fifth time nurses at this hospital have gone on strike since contract negotiations began. Rose Cutropia, a nurse in the post-anesthesia care unit, told Newsweek that recruitment and retention are critical because UMCNO is the only Level 1 trauma center in the region. (Giella, 10/30)
Mississippi Today:
Mississippi Opens Long-Term Pediatric Medical Center For Youth With Complex Medical Conditions
Mississippi’s first skilled pediatric medical center celebrated its opening Tuesday with a ribbon cutting in Jackson. The Alyce G. Clarke Center for Medically Fragile Children will provide long-term care for patients younger than 19 years old with complex medical conditions and training for others’ families to care for them at home. It is a part of Children’s of Mississippi, the pediatric arm of the University of Mississippi Medical Center. (Dilworth, 10/30)
The New York Times:
Marthe Gautier, 96, Dies; Had Key Role In Down Syndrome Breakthrough
Dr. Marthe Gautier, a physician and researcher who had a major role in identifying the cause of Down syndrome but whose achievement was undermined when a male colleague took credit for her work, died on April 30, 2022. She was 96. (Grady, 10/30)
KFF Health News:
A Bite, A Bill, And A Bureaucratic Chill In Winning Halloween Haikus
Nearly 100 health care-themed haikus crept into our inbox this Halloween. See the winning poems and top runners-up from KFF Health News’ seventh annual Halloween haiku contest, illustrated by Oona Zenda. The judges’ favorites were inspired by tick migration, Medicaid work requirements, and rising copays. (10/31)
On race and health care —
Word In Black:
Why Do We Believe Organ Donation Conspiracies?
Organs aren’t “harvested” or “kept on ice.” But countering mistrust and misinformation in the Black community isn’t easy. (Durham, 10/29)
Word In Black:
He’s A Legendary Transplant Surgeon. At 88, His Work Isn’t Done
Dr. Clive O. Callender fought racism in medicine and built a movement that saved thousands of Black lives. (Durham, 10/22)
The CT Mirror:
How One CT Clinic Is Addressing Racial Disparities In Maternal Care
Monique Rainford has built a decades-long career as an obstetrician. But, for the last ten years, she’s been grappling with how the traditional health system she’s been a part of has failed to adequately serve Black mothers and babies. (Golvala, 10/30)
KFF Health News:
Better Treatments Buoy Multiple-Myeloma Patients, Bound By Research Cuts And Racial Disparities
For more than a year, Diane Hunter, now 72, had been experiencing vague symptoms — pain in her spine and hips, nausea, exhaustion, thirst, and frequent urination. Her primary care physician had ruled out diabetes before finally chalking up her ailments to getting older. But months of intense back pain eventually landed her in the emergency room, where a doctor suggested that Hunter might have multiple myeloma. Hunter’s first question was, “What is that?” (Newsome, 10/31)
