5 ms·

It’s a bit sad that there’s nothing in this post about actually wanting to improve patient care, but instead make money for hospitals and “enhance metrics.”

dangerlibrary 1y ago
It's called upcoding. It's been happening with or without AI or SV's help for well over 40 years. [0] Interestingly, whistleblowers can recoup a big chunk of the recovered funds in a False Claims Act suit when medical providers do this to defraud Medicaid / Medicare [1]. Could be a lucrative long-term play if you get employed at a company whose sole purpose is helping hospital chains bill for care that an AI thinks may have been provided. [0] https://pmc.ncbi.nlm.nih.gov/articles/PMC10759668/ https://pmc.ncbi.nlm.nih.gov/articles/PMC10759668/ [1] https://en.wikipedia.org/wiki/False_Claims_Act_of_1863 https://en.wikipedia.org/wiki/False_Claims_Act_of_1863
xyst 1y ago
American healthcare in a nutshell. All of these startups in the healthcare industry focusing on "upcoding", "dealing with insurance" would go bust if private health insurance no longer existed or at least existed in a much much smaller role.
justin_sdx 1y ago
Our models don't only suggest up-coding possibilities, but also chart quality improvements! As a result, patient's charts become more accurate, allowing for potentially better patient care in subsequent visits. Also, the hospitals being able to bill more accurately allows them to have more resources to invest in patient care, and when you consider that a lot of hospitals operate on 1-3% profit margins while health insurance companies operate on a sometimes exponentially higher %, it's actually one of my favorite aspects of what we're building here. To each their own though ¯\_(ツ)_/¯
- numeromancer 1y ago
  "allows them to have more resources to invest in patient care" LOL
  - rgzz 1y ago
    lmao even
- dogtorwoof 1y ago
  I wish you just never replied, this explanation somehow makes me feel even worse :(
  - justin_sdx 1y ago
    Mind if I ask a very non-defensive "how come"? The logic in the comment you're responding to is legitimately the way I think about one of the impacts our products have re: patients.
deleted 1y ago
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Kanishka345 1y ago
I can relate to this reaction for a variety of startups. I still am interested in working for these light mission or neutral mission startups, rather than crypto or something empty, but I wish we had a lot of deep mission startups to choose from. I blame the diluted mission problem on VC + hypergrowth. If more startups could focus on less aggressive capital and growth goals and let the founders dream more, I think we would all be more excited.

dangerlibrary 1y ago

It's called upcoding. It's been happening with or without AI or SV's help for well over 40 years. [0] Interestingly, whistleblowers can recoup a big chunk of the recovered funds in a False Claims Act suit when medical providers do this to defraud Medicaid / Medicare [1]. Could be a lucrative long-term play if you get employed at a company whose sole purpose is helping hospital chains bill for care that an AI thinks may have been provided. [0] https://pmc.ncbi.nlm.nih.gov/articles/PMC10759668/ https://pmc.ncbi.nlm.nih.gov/articles/PMC10759668/ [1] https://en.wikipedia.org/wiki/False_Claims_Act_of_1863 https://en.wikipedia.org/wiki/False_Claims_Act_of_1863

xyst 1y ago

American healthcare in a nutshell. All of these startups in the healthcare industry focusing on "upcoding", "dealing with insurance" would go bust if private health insurance no longer existed or at least existed in a much much smaller role.

justin_sdx 1y ago

Our models don't only suggest up-coding possibilities, but also chart quality improvements! As a result, patient's charts become more accurate, allowing for potentially better patient care in subsequent visits. Also, the hospitals being able to bill more accurately allows them to have more resources to invest in patient care, and when you consider that a lot of hospitals operate on 1-3% profit margins while health insurance companies operate on a sometimes exponentially higher %, it's actually one of my favorite aspects of what we're building here. To each their own though ¯\_(ツ)_/¯

numeromancer 1y ago
"allows them to have more resources to invest in patient care" LOL
- rgzz 1y ago
  lmao even
dogtorwoof 1y ago
I wish you just never replied, this explanation somehow makes me feel even worse :(
- justin_sdx 1y ago
  Mind if I ask a very non-defensive "how come"? The logic in the comment you're responding to is legitimately the way I think about one of the impacts our products have re: patients.

deleted 1y ago

[deleted]

Kanishka345 1y ago

I can relate to this reaction for a variety of startups. I still am interested in working for these light mission or neutral mission startups, rather than crypto or something empty, but I wish we had a lot of deep mission startups to choose from. I blame the diluted mission problem on VC + hypergrowth. If more startups could focus on less aggressive capital and growth goals and let the founders dream more, I think we would all be more excited.