The Weekender: Shorting Envision, care assessments get automated + how tea got its name

‘The Weekender’ spotlights what you might have missed on BirdDog and why a few headlines from elsewhere matter for Tennessee.

From BirdDog


LifePoint: ‘Cast of thousands’ needed to tackle problems facing health, hospitals

‘Destiny’ brings indie pharmacy to Napier, alleviating the struggle for a ride to get an Rx

From Elsewhere


1. What happens when an algorithm cuts your health care

Colin Lecher, The Verge

Riveting piece that looks at the impact on people’s lives when Arkansas switched to an algorithm, in order to determine the number of hours per week someone would receive aide services, or caretaker payment, through Medicaid.

It highlights the surprise element when a program is abruptly transitioned from being human administered to calculated by code, and how case managers’ different approaches to evaluation can change the calculation.

Normally one should probably avoid the comment section, but on this piece someone points out that algorithms on the clinical side can help identify medical issues or problems within a facility and that the algorithm in question is used on the business side as a gateway to care.

The piece touches on the bias that can emerge in code because it’s written by people who may think about the problem from a certain perspective or be approaching the algorithm from a certain business-driven standpoint.

There is a waiting list for some long-term services and support programs for people with intellectual and physical disabilities in Tennessee. People with disabilities accounted for 10 percent of TennCare enrollees in 2016 and 35 percent of the costs that year, per the Sycamore Institute.

Other reads on bias in code:

Keeping Bias From Creeping Into Code, The Institute

Forget Killer Robots—Bias Is the Real AI Danger, MIT Technology Review


2. jim Chanos, known for his Enron takedown, fires off tons of new stocks that he’s betting against 

Matthew J. Belvedere, CNBC

Chanos is short Envision Healthcare (which merged with Nashville-based AmSurg and is the surviving entity), another health care company (Mednax), and two fast food companies, including the parent of Dunkin’ Donuts.

He told CNBC he went short on Envision in the middle of 2017, and that the health care companies could be using “deception or aggressive use of reimbursement.”

Shorting a stock means the investor thinks the company’s share price is overvalued because of its underlying business structure, and essentially bet that a correction or devaluation is on the horizon. Chanos gained notoriety for shorting Enron, then an energy behemoth whose fall was unimaginable.

Short sellers aren’t always right — or they could be too far ahead of the devaluation timeframe.

EmCare, a division of Envision that employs emergency medicine physicians, is under fire for balance bills — or the surprise bills patients receive when a doctor is out of network even though they could be at an in-network hospital. A team at Yale University found increased numbers of balance bills when hospitals entered into an agreement with EmCare.

Dirty Money,’ a limited run documentary series on Netflix by Oscar-winning filmmaker Alex Gibney, looked at an investor shorting drugmaker Valeant in an episode. It’s a series worth some couch time if you’re interested in diving into the Volkswagen diesel scandal or payday lending.

You might binge it.


3. Tea if by sea, cha if by land: Why the world only has two words for tea

Nikhil Sonnad, Quartz

No matter whether people use words that sound like ‘tea’ or ‘cha,’ for the beverage usually served on ice with lemon in the South, the words originated in China.

The Chinese character for tea had different pronunciations in different dialects, and how the tea was exported (by the Silk Road or by boat) influenced what traders called it when they arrived home.

Excerpt: “How they spread around the world offers a clear picture of how globalization worked before “globalization” was a term anybody used.”

This has a really cool map. •

Photo by Roos Oosterbroek on Unsplash

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