nH Predict post-acute care predictions

Page published: June 2023 | Last updated: September 2025 nH Predict is an A I -powered software system that predicts how much post-acute care a patient should need , including when they should be discharged from hospital. It does this b y sifting through millions of medical records to match patients with similar diagnoses and characteristics, including age, gender, living situation, preexisting health conditions and other factors. Based on these comparisons, the algorithm anticipates what kind of care a specific patient will need and for how long. The system was developed by health technology company N aviHealth and first deplo yed in the US healthcare system in 2023. NaviHeath was acquired by US-based health insurance company UnitedHealth Group in 2020. nH Predict has raised significant concerns regarding how it is used and its impact on patients and the US healthcare system: Inaccuracy. Reports indicate that the NH Predict algorithm has a 90 percent error rate , leading to inaccurate predictions about patient care needs. This high level of inaccuracy can result in patients receiving inadequate care or being prematurely discharged from medical facilities. Automation bias. Clinicians have reported instances where decisions made by the algorithm contradict and overrride their professional assessments, potentially compromising patient safety. Coverage denials. The algorithm has been implicated as algorithmic cover in the premature termination of payments for necessary medical treatment, particularly for elderly and disabled patients. This can force patients to pay out-of-pocket for care that should be covered by insurance. Discrimination and health inequities. The algorithm may perpetuate or exacerbate existing health disparities, particularly among marginalised groups. By not fully considering social determinants of health or individual patient circumstances, NH Predict risks making biased decisions that disproportionately affect vulnerable populations. Psychological impacts on patients. The uncertainty and stress caused by unexpected coverage denials can have a significant psychological toll on patients and their families, particularly when they are already dealing with serious health issues. December 2023. Humana sued for using AI to unfairly deny health insurance to elderly patients November 2023. nH Predict accused of having a 90 percent error rate March 2023. Investigation: nH Predict used to deny Medicare Advantage benefits

Organisation involved

Humana; CVS Health/Aetna; Priority Health; Security Health Plan; Select Medical; UnitedHealth Group

Product, system or model

nH Predict

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