The title of the article on arstechnica comes from the following quote, a few paragraphs in
Though few patients appeal coverage denials generally, when UnitedHealth members appeal denials based on nH Predict estimates—through internal appeals processes or through the federal Administrative Law Judge proceedings—over 90 percent of the denials are reversed, the lawsuit claims. This makes it obvious that the algorithm is wrongly denying coverage, it argues.
While they are correct that error rate applies to the number of misclassified cases (denied when it should not have been), it’s only 90 percent of the denials which are appealed which are overturned. As stated in the quote above, few patients appeal their coverage denials, so it is possible the error rate is much lower as presumably the denials which are not appealed would not be overturned at the same rate.
A minor quibble about the original title:
The title of the article on arstechnica comes from the following quote, a few paragraphs in
While they are correct that error rate applies to the number of misclassified cases (denied when it should not have been), it’s only 90 percent of the denials which are appealed which are overturned. As stated in the quote above, few patients appeal their coverage denials, so it is possible the error rate is much lower as presumably the denials which are not appealed would not be overturned at the same rate.
Your comment is true but I can’t help think of the Orphan Crushing Machine.
My analogy: 90% of orphans who ask to not be crushed are released from the machine. Presumably the ones who did not ask would not have been released.
(The fact that health coverage can be denied at all is the real problem, not that they’re heavy handed about doing it.)
Who are you who are so wise in the ways of science?