LVCTF Newsletter | July 2021 Update - Value Based Insurance Design Health

New Alliance White Paper Describes Purchaser-Led Efforts to Improve Health Care Value

The Washington Health Alliance recently released a white paper summarizing the products of their initiative to inform and motivate purchaser action to improve the value of care for plan participants. Data analysis identified several high- and low-value improvement opportunities for purchasers, such as improved treatment of low back pain through non-opioid pain management alternatives.

Study Finds High Rates of Low-Value Care, But Hospitals Disagree

In a recent study published by the healthcare think tank, researchers stated that hospitals in the U.S. deliver a low-value test or procedure to an older adult every 80 seconds, harming thousands of patients. In response to these findings, the American Hospital Association published an official blog post stating that this study “attempts to make sweeping conclusions about hospital value” based on Medicare billing data which represents only a portion of hospitals’ patient populations and are not reflective of all the care hospitals provide. Read more here.

Racial Disparities in Low-Value Surgical Care and Surgery Scheduling in High-Volume Hospitals

A recent study aimed to better understand processes of care that contribute to racial disparities in clinical outcomes examined differences in the utilization of low‐value surgical care and surgical delays between non-Hispanic black women and non-Hispanic white women. Findings suggest that in high-volume hospitals, non-Hispanic black women have higher rates of delay, but are less likely to undergo low-value surgical procedures compared to non-Hispanic white women.

Adverse Events and Hospital-Acquired Conditions Associated With Potential Low-Value Care in Medicare Beneficiaries

In a recent study, researchers seek to determine the prevalence of adverse events associated with potential low-value procedures and the additional hospital length of stay (LOS) and costs. While hospital-acquired conditions were associated with only 1% of inpatients with a low-value procedure, researchers suggest that other dimensions of harm caused by low-value care – such as psychological and financial – should be studied moving forward.

Prioritizing High-Value, Equitable Care After the COVID-19 Shutdown: An Opportunity for a Healthcare Renaissance

In this article, AcademyHealth CEO Lisa Simpson and colleagues from the low-value care research community reflect on the opportunities and challenges facing healthcare systems as they reboot from COVID-19 shutdowns. Framing this moment as an opportunity to focus on providing patients with high-value, equitable care, authors share lessons learned from medical centers that have begun reopening: keep patients central; deliberately avoid low-value care; proactively address healthcare disparities; and reform to support high-value care delivery.

Three Key Considerations for Building Successful Health System Leader and Researcher Partnerships

In a convening hosted by AcademyHealth, the ABIM Foundation, and the Donaghue Foundation, stakeholders explored what it takes to build successful partnerships between health system leaders and researchers and how to deploy these partnerships to deliver high-value, equitable care. The key considerations that emerged include aligning priorities and timelines; employing a patient-centered approach; and developing champions among health system leaders and researchers. Read more here.

Association of Low-Value Care Exposure With Health Care Experience Ratings Among Patient Panels

As hospitals, insurance companies and policymakers seek to improve healthcare quality and reduce costs, one important metric used to assess clinicians hinges on how patients feel about their healthcare experience. While many healthcare providers and policymakers fear that increased pressure to please patients — and ensure high satisfaction ratings as a result — could lead to overuse of low-value care, recent JAMA research study finds no relationship between favorable patient ratings and exposure to more low-value care.

Use of Evidence and Technology to Improve Quality and Eliminate Low-Value Care

One-third of health care in the United States is wasted. Despite this recognition, solutions are sparse. In a recent AJMC article, Dr. Kenneth Cohen of Optum Care announced the Optimal Care model, a program designed to propel health care transformation through the use of evidence-based medicine, patient-centered technology, and outcomes reporting.

Webinar: Lessons from the Field: Building Organizational Resiliency to Deliver High-Value Care in the Time of COVID

In this webinar accompanying blog, Sarah Millender highlights lessons experts from across the healthcare field have learned about building organizational resilience, recovery, and capacity during COVID-19. She emphasizes the need to re-design our health systems around high-value care, equity, and more stable payment structures. (AcademyHealth Blog: S. Millender) (March 2021)

How Waste in Healthcare Can Be An Asset in APMs

There is a lot of avoidable waste in the basic delivery of care, but this waste is actually an asset for alternative payment models (APMs). Unlike the fee-for-service model that discourages eliminating waste and low-value care because it loses money, APMs can get paid to eliminate that same waste and improve healthcare quality, says health economist Michael Chernew, PhD, professor of healthcare policy at Harvard Medical School, and chair of MedPAC. In a timely interview with APG President and CEO Don Crane, Chernew talks about the premise of his recent JAMA article, “A Path Forward for Alternative Payment: Build a Portfolio Not a Garden.”

Tweet/Tiktok: Cardiac Clearance

Will Flanary, an ophthalmologist, writer, and comedian who moonlights in his free time as “Dr. Glaucomflecken,” has become a leading voice in ophthalmology and healthcare on social media. Blending humor with education, Dr. Glaucomflecken informs audiences on a wide range of topics – watch this TikTok for his take on unnecessary cardiac clearance prior to cataract surgery.