the AI debate
Data versus doctors: Insides the algorithm disputes at NaviHealth
An algorithm was overriding clinicians' recommendations that intensely ill Medicare patients, many of them older or disabled, stay in care. And while employees raised alarms in 2021 about the growing disconnect, some say the disparity between data and doctors' advice continues.
With an investigation out today, STAT's Casey Ross and Bob Herman revisit the algorithm dispute they first reported and delved into when tension began to fester at NaviHealth, now owned by Optum.
As Casey and Bob write, the company's turmoil is a powerful example of the potential dark side of artificial intelligence and its incursion into health care. Dive into the story.
opioid crisis
Biden's emerging tranq plan
The White House on Tuesday unveiled a new plan for addressing the increasing presence of xylazine, a veterinary tranquilizer increasingly mixed into illicit opioids like fentanyl, amid the country's drug crisis, STAT's Lev Facher reports.
Since xylazine is not an opioid, it does not respond to naloxone, the medication used to reverse opioid overdoses. So while xylazine is known to suppress breathing and cause unconsciousness, it has no antidote.
There are six initial pillars to the White House plan including testing, research, data collection, disrupting the xylazine supply, and developing evidence-based treatment and harm reduction practices. But more could come: White House Office of National Drug Control Policy Director Rahul Gupta said the government will "explore" adding xylazine to the list of medications scheduled under the Controlled Substances Act. More from Lev.
Medicare
Medicare to balance 340B books with multibillion-dollar fix
The agency plans to send $9 billion to more than 1,600 hospitals in the 340B drug discount program after the Supreme Court found the program underpaid them for prescription drugs. It's not all rosy: Medicare is going to pay for the fix in part by slashing hospital payments for other services by 0.5% over the next 16 years, D.C.D. co-writer Rachel Cohrs wrote late Friday.
The trouble started when the Trump administration in 2018 began underpaying the program, which is controversial with Republicans. The court ultimately ruled that change illegal, delivering the Biden administration a nearly $10 billion bill to balance.
Medicare proposed Friday to do that by calculating how much each underpaid hospital should have been reimbursed by Medicare, subtracting the amount Medicare actually paid, and then paying that remaining amount in a one-time lump-sum payment. Read more from Rachel on the plan and hospitals' reactions.
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