Reimbursement
How Cástulo de la Rocha Built an Affordable Health Care Empire
Follow this author to personalize your feed and get instant alerts. Follow Go to your personalized feed WHY FOLLOW? Smart Alerts: Get notified about major news as it happens. When Cástulo de la Rocha arrived at the East LA Barrio Free Clinic in 1977, he had just moved back from Berkeley, where he'd gone to law school. "I pulled up in my old beat-up Volkswagen. I had long hair for sure, holes in my pants and things like that. So a very typical hippie," he recalls.
Disentangling Misreporting from Genuine Adaptation in Strategic Settings: ACausal Approach
In settings where ML models are used to inform the allocation of resources, agents affected by the allocation decisions might have an incentive to strategically change their features to secure better outcomes. While prior work has studied strategic responses broadly, disentangling misreporting from genuine adaptation remains a fundamental challenge. In this paper, we propose a causally-motivated approach to identify and quantify how much an agent misreports on average by distinguishing deceptive changes in their features from genuine adaptation. Our key insight is that, unlike genuine adaptation, misreported features do not causally affect downstream variables (i.e., causal descendants). We exploit this asymmetry by comparing the causal effect of misreported features on their causal descendants as derived from manipulated datasets against those from unmanipulated datasets. We formally prove identifiability of the misreporting rate and characterize the variance of our estimator. We empirically validate our theoretical results using a semi-synthetic and real Medicare dataset with misreported data, demonstrating that our approach can be employed to identify misreporting in real-world scenarios.
Strategic Feature Selection
Kaur, Jivat Neet, Patil, Pratik, Shanmugam, Divya, Pierson, Emma, Jordan, Michael I., Haghtalab, Nika, Jagadeesan, Meena, Alaa, Ahmed, Wang, Serena
When algorithmic predictors inform resource allocation in high-stakes domains such as healthcare, these predictors must account for strategic manipulation of input features. The typical solution is to redesign the predictor itself to explicitly account for strategic interactions. In practice, however, decision makers are often constrained to adjusting coarser levers within existing prediction pipelines. For example, healthcare organizations often select which features to exclude based on perceived manipulability, while using standard regularization procedures to shrink the coefficients of retained features. In this work, we initiate a formal study of strategic classification through feature selection and its interaction with ridge regularization. Our main finding is that excluding individual features based on their manipulability alone is generally suboptimal. We provide a fine-grained characterization of the performance of a feature subset under optimal regularization, yielding new insights for policy design. Motivated by this characterization, we develop a practical algorithm for jointly choosing the feature set and the level of ridge regularization. Through a real-world case study on a healthcare payments benchmark, we illustrate how our algorithm can guide the design of coarse policy levers in practice. Our results provide a principled, practical framework for mitigating the effects of strategic behavior in algorithmic decision-making systems.