It turns out health care spending does not directly correlate to “healthiness”

An algorithm widely used to allocate health care resources among patient populations has demonstrated significant racial bias. Researchers of the algorithm revealed that patients who self-identified as black, when compared to equally sick white people, were assigned lower risk scores. The result was that health care decisions treated these patients as healthier than their white counterparts, meaning they were less likely to receive personalized care. That means that under this algorithm an average black patient has to be sicker than the average white patient to receive the same level of care.

How can this be? There are several reasons behind this including historical racial bias, and reliance on cost prediction to make health care decisions.

Much of the US health care system is based on algorithms developed to allocate resources among groups of people. One such algorithm relied largely on the basis of health care costs accrued in one year. On the surface this appears a reasonable basis for developing risk scores, as with greater health care needs comes greater cost. A deeper dive into the data, though, shows that less money is spent on black patients with the same level of need as white patients; approximately $1,800 less per year. This resulted in the number of black patients identified for extra care being reduced by half.

The error in the algorithm speaks to a larger concern: that less money spent on care does not necessarily mean the patient, or that patient population, is healthier. The algorithm developers fell into the trap of believing that health care cost is an effective proxy for health. The researchers further speculate that the disparity in quality of care is due to systemic racism, direct discrimination by health care providers or distrust of the health care system.

The researchers found that tweaking a few components of the algorithm, meant to step away from relying on health care costs to determine need, reduced bias dramatically.

What does this mean for you and I? While we assume that our well being is at the forefront of the medical care recommendations made to us, there is a substantial financial factor in the background that, it appears, leads trusting patients away from quality, effective care, and continues to perpetuate racial biases and economic disparities.  

Read more here: Millions of black people affected by racial bias in health-care algorithms