Tag: cost-control

Tragedy, Reform, and the State of Health Care – A Look at UnitedHealth Group

Marc
Health Care

A Shocking Loss That Shook a Nation The murder of Brian Thompson, the CEO of UnitedHealth Group’s UnitedHealthcare division, stunned the country in December 2024. Thompson, a 50-year-old husband and father of two, was fatally shot while walking to a company meeting in New York City. It was a crime that not only horrified his colleagues and family but also put a harsh spotlight on the broader frustrations with the U.S. health care industry. The accused, Luigi Mangione, reportedly had grievances about systemic issues in the health care system. He…

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The Impact of AI on Medicare Advantage Claims Denials

Angela Linders
Medicare Advantage Claims Denials

A Growing Concern for Healthcare Providers In recent years, the integration of artificial intelligence (AI) in the healthcare sector has sparked significant debate, especially concerning its role in Medicare Advantage claims denials. As hospitals face mounting administrative burdens, the use of AI by insurance companies has been scrutinized for potentially prioritizing cost-saving measures over patient care. The Rise of AI in Insurance Between 2019 and 2022, insurance companies like UnitedHealthcare, Humana, and CVS began increasingly employing AI tools to automate the prior authorization process. These technologies, while designed to streamline…

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