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Patient has an eye test at Venice Family Clinic in Venice, California, June 25, 2009.
Your new insurance advocate is AI
Health insurers are routinely using artificial intelligence and algorithms to evaluate insurance claims, but now the tables have turned. Doctors are increasingly turning to generative AI to write appeals for prior authorizations and to fight insurance denials.
A survey from the American Medical Association found doctors and their staff spend an average of 12 hours a week dealing with such denials, which insurance companies routinely issue, even in serious cases including cancer and HIV/AIDS care. Now, with the help of HIPAA-compliant apps like Doximity GPT, physicians can use the power of AI to generate persuasive reply letters, citing all the relevant medical research they need, in minutes.
One physician even told the New York Times that he tells the bot to make his letters four times longer: “If you’re going to put all kinds of barriers up for my patients, then when I fire back, I’m going to make it very time-consuming.”
So the next time you find yourself annoyed by a glitchy AI chatbot customer service, just remember, AI might help you get lifesaving drugs one day.
Graphic Truth: Motherhood can wait
Women in wealthy countries are increasingly waiting to have children. What gives? Well, a complex array of factors are fueling this trend, but financial concerns appear to be a central cause.
A recent poll in Canada, for example, found that 55% of Canadians between the ages of 18 to 34 pointed to the housing crisis as affecting their decision and timing about when to start a family.
In the US, child care costs are a growing concern across the country. Meanwhile, the US remains on a short list of countries that do not guarantee paid parental leave. Have economic conditions made it more difficult to have children? We’d love to hear your thoughts. Write to us here.
Graphic Truth: Hospital bed decline
They made their bed – and were forced to lie in it.
At the start of the pandemic, G7 countries were plagued by a huge uptick in hospital admissions – and the shocking reality that hospital beds had been on a 50-year decline. Four years later, these countries have still not reversed the downward spiral.
In the US, over the last five decades, care has shifted away from inpatient hospital settings and to outpatient services to cut costs. The decrease has also been intentional. In 1974, the government began an initiative to directly cut the number of hospital beds, believing in a rule calledRoemer's Law, which said that “a hospital bed built would be a hospital bed filled,” thus driving up costs.
However, the US’s free-market healthcare system still provides more hospital beds per capita than the government-dominated system in Canada. According to the Canadian Institute for Health Information, Ontario has just one intensive-care bed for every 800 residents, giving it no surge capacity. Michael Decter, the former chair of the Health Council of Canada told theCBC that because Canada’s system is public, “we tend to ration everything.”
Across the G7, governments have reduced hospital capacity to cut costs and because advances in medical care have decreased the amount of time patients spend in hospitals. However, older people – who are more likely to spend time in hospital – are also taking up an increasing share of G7 populations. The result is higher wait times, lower surge capacity, and worsening patient care.
An adult female Anopheles mosquito bites a human body to begin its blood meal at Tehatta, West Bengal; India on 24/02/2023.
Djibouti goes high-tech to take a bite out of malaria
The coastal country of Djibouti, one of the smallest by population in Africa, has a big problem in a tiny package: An invasive species of mosquito from the Indian subcontinent has driven malaria rates through the roof, so the government on Thursday released thousands of genetically modified bugs in a bid to save thousands of lives.
How deadly is the disease? Malaria has probably killed more human beings over the sweep of history than any other single infectious disease, and African governments have been fighting for decades to eliminate it. Djibouti darn near made it: In 2012, the country recorded just 27 cases.
But since then, an invasive species has arrived. Unlike the mosquitoes indigenous to most of Africa, the new bugs thrive in urban environments and bite during the day, making them impossible to avoid. In 2020, over 70,000 people contracted malaria — one in every 15 Djiboutians — of whom 190 died. The invasive bugs are spreading to important cities in Ethiopia and Kenya, and have been found as far away as Lagos, Nigeria, a metropolis of over 15 million.
Fight bugs with bugs: Working with scientists at US firm Oxitec, Djibouti released thousands of genetically modified versions of the invasive mosquitos whose female offspring die quickly. Since only females of the species bite humans, the hope is reducing their number will reduce human exposure.
Similar programs in Brazil met with astonishing success, driving down the population of dengue-carrying mosquitoes by 96%, a model later copied by Panama and the Cayman Islands. We’re watching Djibouti’s plan with great hope.
Graphic Truth: Infant mortality in the OECD
American parents are more than four times as likely as their peers in Estonia to lose a baby during or shortly after birth. It is one of the most devastating human experiences – and a key indicator of a country’s development. After all, if even the most vulnerable babies survive, the healthcare system must be doing something right. By that metric, the US looks more like Chile or Slovakia than the global superpower it is.
And it’s not just babies who are more at risk in the US. A study from the Commonwealth Foundation found that American mothers are twice as likely to die during or shortly after childbirth than their Canadian peers, and more than 10 times as likely as women in New Zealand.
Part of the problem comes down to a shortage of care for expectant mothers. The US has about 15 gynecologists per 1,000 live births, compared to 54 in the UK and 78 in Sweden. That means less attentive care during and after pregnancy, which can lead to early warnings going overlooked.
DNA Helix.
CRISPR gets an AI upgrade
CRISPR, the gene-editing method that won two female scientists the 2020 Nobel Prize in Chemistry, may soon get infused with artificial intelligence. One Northern California startup called Profluent is expected to present its new paper at a gene-editing conference next month, which describes its work using AI to analyze biological data and create new gene-editing systems.
As one professor explained to the New York Times, it’s a departure from how CRISPR typically does gene replacement. Instead of altering genes based on discoveries in nature, the startup instead uses novel methods surfaced by its AI. “They have never existed on Earth,” University of California, San Francisco professor James Fraser said. “The system has learned from nature to create them, but they are new.”
Gene-editing is rife with ethical quandaries, such as questions around modifying human embryos, which could be exacerbated by the rise of AI. Still, CRISPR provides hope: it could provide cures to countless diseases and is already providing innovative new treatments for sickle-cell anemia.
Profluent also chose to open-source one of its gene editors, OpenCRISPR-1, though the underlying AI will stay under wraps, the company said.
Half the world can’t access healthcare. How can the World Bank help?
Billions of individual tragedies come together to hold back development in some of the world's most fragile countries, and that’s where the World Bank has a role to play. Monique Vledder runs the Global Health Practice at the World Bank, and she sat down with GZERO’s Tony Maciulis at a Global Stage event for the institution’s annual Spring Meetings.GZERO’s Tony Maciulis met with the World Bank’s Director of Infrastructure for West Africa Franz Drees-Gross, to discuss the project's details.
She announced ambitious goals to start tackling the problem: “We are planning to reach, with our financing and our programs, 1.5 billion people over the next five years with quality health services,” she says, expanding the World Bank’s geographic footprint in healthcare to target vulnerable countries and build capacity in their healthcare systems.
For more of our 2024 IMF/World Bank Spring Meetings coverage, visit Glogal Stage.
A man uses a chatbot in this illustration photo.
Get AI out of my health care
You fall and break an arm. Doctors set the break and send you to rehab. It’s pricy, but insurance should take care of it, so you submit your claim – only to be denied. Was it a claims examiner who rejected it? Or AI?
On Feb. 6, the US government sent a memo to certain Medicare insurers clarifying that no, they cannot use artificial intelligence to deny claims. While machine-learning algorithms can be used to assist them in making determinations, an algorithm alone cannot be the basis for denying care.
This memo, sent by the Centers for Medicare & Medicaid Services, follows lawsuits against health insurers for allegedly using AI to erroneously deny deserved care to patients. United Healthcare and Humana have each been sued by patients claiming the companies used the AI model nH Predict nefariously — a model they claim has a 90% error rate. It’s a clear and present danger of the technology at a time when many regulators and critics are focusing on far-off threats of AI.
CMS also said it’s concerned about the propensity for algorithms to “exacerbate discrimination and bias” and said the onus is on insurers to make sure these models comply with the Affordable Care Act’s anti-discrimination requirements. And it’s not just the federal government: A number of states including New York and California have issued warnings to insurance companies to ensure their own algorithms aren’t discriminatory.