In this issue:
  • Washington State Health Waste Calculator™ Analysis
  • Effect of a Peer Comparison & Educational Intervention on Medical Test Conversation Quality
  • Overtreatment and Associated Risk Factors Among Multi-Morbid Older Pts with Diabetes
  • Audit and Feedback to Reduce Unwarranted Clinical Variation at Scale
  • Industry Payments to Physicians Linked to Use of LVC Among Cancer Patients
  • Reducing Low-Value Care in Oncology
Washington State Health Waste Calculator™ Analysis

An analysis of the last 3 years shows that Washington’s health care system has wasted over $125 million on approximately 800,000 low-value or unnecessary services and cases, ranging from inappropriate tests to harmful opioid prescriptions. The funds lost to healthcare waste could provide full insurance for over 2,000 Washington families. The Alliance emphasizes the importance of addressing overuse, underuse, and misuse of healthcare services to enhance equity, quality, and access.

Effect of a Peer Comparison and Educational Intervention on Medical Test Conversation Quality – A Randomized Control Trial

A JAMA Network Open study investigates the impact of a peer comparison and educational intervention on the quality of medical test discussions. The study reveals that such interventions significantly improve the quality of conversations surrounding medical tests. This underscores the potential of targeted educational strategies to enhance the effectiveness of patient-physician communication, ensuring more informed and comprehensive discussions about medical tests.

Overtreatment and Associated Risk Factors Among Multi-morbid Older Patients with Diabetes

A recent JAGS study delves into the issue of overtreatment in older individuals managing diabetes and multiple health conditions. The study identifies that overtreatment, such as excessive medication use, is prevalent among this demographic. It highlights the importance of tailored, patient-centered approaches to diabetes management in older adults, emphasizing the need to balance treatment intensity with individual health circumstances to avoid potential risks associated with overtreatment.

Audit and Feedback to Reduce Unwarranted Clinical Variation at Scale: A Realist Study of Implementation Strategy Mechanisms

This study investigates the effectiveness of audit and feedback mechanisms in addressing clinical variation. Findings indicate that tailoring feedback to specific contexts and employing a multifaceted approach are pivotal for successfully tackling issues of underuse, overuse, or misuse of services. Authors emphasize the need for personalized, context-specific interventions to drive impactful changes in healthcare quality.

Industry Payments to Physicians Linked to Use of Some Non-Recommended and Low-Value Drugs Among Cancer Patients

A recent BMJ study delves into the impact of financial relationships on prescription choices. Key findings underscore a correlation between industry payments to physicians and the utilization of certain non-recommended and low-value drugs in cancer treatment. The study prompts a critical reevaluation of industry interactions to ensure patient are aligns with evidence-based practices, emphasizing the importance of mitigating potential conflicts of interest in medical decision-making. Read more here.

Reducing Low-Value Care in Oncology

Low-value care in oncology encompasses various aspects, with two common forms being over diagnosis and overtreatment of cancer, as well as aggressive end-of-life cancer care. As a follow-up to to the Center for Medicare & Medicaid Innovation’s (CMMI) Oncology Care Model, CMMI is launching the Enhancing Oncology Model pilot. In this article, authors discuss the importance of decision-support tools and prior authorization within the complex process of de-implementation.

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