
Managed Care 3.0: Rise of the Robots - scripthacker
https://thedeductible.com/2020/07/21/managed-care-3-0-rise-of-the-robots/
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scripthacker
Some detailed HMO history here, followed by lots of insider detail (parts 2
and 3) on how HMOs are using AI to dominate the healthcare system.

"Hospitals saw, in some cases, a doubling of claims denials or “repricing” in
just a 12 to 18-month period after 2016 based on these automated” reviews.
This surge of machine-driven denials played a major role in the mysterious 39%
plummet in hospital operating earnings"

