StartUp Health NOW Podcast
How Two Founders Are Using AI to Tackle Wasteful Healthcare Spending
Nov 30, 2023
The podcast discusses the issue of wasteful spending in healthcare and introduces two founders using AI to tackle the problem. They delve into the alarming amount of wasteful spending in healthcare, highlight examples of redundant care and unethical billing practices. The conversation focuses on how AI algorithms can identify and reduce wasteful spending, the role of audits and automating record review with AI.
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Quick takeaways
- Up to 30% of healthcare spending, equivalent to $1.2 trillion annually in the US, is wasteful, with examples including redundant care, billing practices, and lack of proper modifiers on claims.
- HealthCostIQ and hindsight, two StartUp Health founders, are using AI technology to address wasteful spending in healthcare by identifying inefficiencies, fraudulent claims, and instances of abuse within health plans.
Deep dives
The Problem of Wasteful Spending in Healthcare
Wasteful spending in healthcare is a major problem, with studies showing that up to 30% of all healthcare spending, equivalent to $1.2 trillion annually in the US, is considered wasteful. Redundant and unnecessary care, billing practices like bundling procedures to increase reimbursement, and lack of proper modifiers on claims are examples of wasteful spending. StartUp Health founders Jude Odu from HealthCostIQ and Panaki Dasgupta from hindsight are tackling this issue through advances in AI technology, which can identify wasteful practices, potentially fraudulent claims, and instances of abuse and waste within health plans.
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