Friday, October 28, 2011

United HealthCare in New York to Disclose More Data Used to Justify Premium Increases–But You Can Almost Bet We Won’t See the Algorithms That Create the Data

This is getting to be such a hot topic today as you can no longer 100% rely on math to prove accuracy as with algorithmic formulas it can be marketed, flawed, you name it.  This is great that consumers will have additional access but think of the marketing too, it’s done to help them have consumers feel that they somehow deserve and needs these increases.  The marketeers of the web are getting smarter all the time. 

Even in the financial industry, people want to see those algorithms to find out how reports and analytics are calculated and this for good reason as you can’t touch, see or feel one of them, much less talk to one and the algorithms work on servers 24/7 every day making decisions and providing information on your computer screen.  Most of them are good guidance for decision making processes but again we have those created for profit and it’s hard sometimes to tell the difference.  This brings me around once again to my favorite NYU professor and his talk about “Numbers don’t lie, but people do”. Not saying that anyone is lying here but when you look back at the 15 year lawsuit to where doctors were paid less based on the United data base for out of networks services, this tells us to ask questions and to not assume when it comes to math and algorithms, in other words ask questions and ask about the math as 15 years of payments on flawed data was a long time before the math issues were finally resolved with the low balling rates that were used and that the other insurers also subscribed to.

“Numbers Don’t Lie, But People Do”–Radio Interview from Charles Siefe–Journalists Take Note, He Addresses How Marketing And Bogus Statistics Are Sources of Problems That Mislead the Public & Government

If you need a reminder on skewed numbers and algorithms, here’s the case that was settled in 2010 due to the work of Andrew Cuomo.  He found the flawed data so when more information comes available we need to ask questions and not be naïve and gullible.  BD

AMA Announced Settlement of Class Action Suit of $350 Million with Ingenix (United Healthcare)
Ingenix Data Base Has Some Long Reaching Legal Tentacles with Aetna, Blue Cross, Blue Shield, Humana

ALBANY, N.Y. — New York's largest health insurance company agreed Tuesday to publicly disclose more data used to justify premium increases.

The agreement with UnitedHealth Group is part of a statewide effort by state Financial Services Superintendent Benjamin Lawsky to make rate increase filings public for review by policy holders and consumer advocates. That could result in reducing the number of requested hikes and provide a better chance for consumers to challenge the requests.

Lawsky is now seeking greater disclosure from all companies operating in the state.

"We got here and said, 'This is crazy,'" Lawsky told The Associated Press. "We are supposed to be getting comment from consumers and they don't understand what's in the filing.

http://online.wsj.com/article/AP1f19c82204f44201bab80ad73fdc8933.html

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