- Unnecessary Utilization in CO Leads to $134M in Healthcare Spending
- NAHPC Releases Call to Action for Employers to Address Conflicts in the PBM Industry
- The AI Powered Future of Healthcare is ‘Right Now’: What CEOs Think of AI
- Incorporating Value-Based Decisions in Breast Cancer Treatment Algorithms
- In Value-Based Oncology, Who Decides When Less is More?
- Key Principles for Effective Use of Behavior Substitution to De-Implement Low-Value Care
- “Choosing Wisely” Interventions Can Reduce Antibiotic Overuse at Safety-Net Hospitals
- Choosing Wisely and the Climate Crisis: A Role for Physicians
- High-Risk Medication Use Lower Among Medicare Advantage Beneficiaries
- Choosing Wisely Consumer Questions and Shared-Decision Making Video Intervention
According to an analysis from the Center for Improving Value in Health Care (CIVHC), delivery of approximately 2M unnecessary healthcare services in Colorado in 2021 resulted in a staggering $134 million in wasteful spending. The analysis identifies specific areas of unnecessary utilization, including imaging tests, low-value diagnostic procedures, and unnecessary emergency department visits. By targeting these areas and implementing interventions to reduce unnecessary utilization, healthcare providers and payers have the potential to generate substantial cost savings and improve the overall efficiency of healthcare delivery in Colorado.
The National Alliance of Healthcare Purchaser Coalitions released a comprehensive report outlining a strategic approach to tackle low-value healthcare in the complex world of pharmacy benefit management (PBM). The playbook sheds light on industry misalignment and self-dealing, and provides insights on flawed negotiation processes, including coverage of high-cost, low-value drugs that have less expensive OTC alternatives.
In the rapidly evolving healthcare landscape, artificial intelligence (AI) is gaining significant attention from CEOs and industry leaders as a potential solution to address low-value care. AI technologies have the power to revolutionize care by optimizing resource allocation, improving decision-making, and reducing costs associated with unnecessary interventions. While AI offers great promise, healthcare leaders also emphasize the importance of maintaining the human connection and addressing potential biases. Read more here.
A recent study finds that a significant proportion of breast cancer patients receive low-value care, such as unnecessary imaging tests and surgeries. Authors emphasize the importance of integrating value-based decision-making into treatment algorithms to ensure that patients receive the most effective and cost-efficient care, reducing the burden of low-value interventions in breast cancer management.
A recent AJMC article discusses low-value care in oncology and the challenges it presents in the context of value-based payment reform. The article raises concerns about how the shift from fee-for-service to bundled payments may impact shared decision-making and patient-centered care. It also highlights the increasing financial burden of cancer treatment and the need to control costs. Additionally, authors emphasize the importance of considering patient-reported outcomes, the full cycle of care costs, and the nuances of value when making treatment decisions.
Recent frameworks provide guidance for developing and investigating de-implementation of low-value care interventions; yet little attention has been devoted to identifying what strategies are most effective for de-implementation. In this commentary, authors present six essential principles for effectively replacing low-value care practices with high-value alternatives, highlighting the need for clear communication, education, and support for healthcare providers and patients to facilitate behavior change and improve the quality and value of healthcare delivery.
Inappropriately prescribed antibiotics account for 25-50% of all U.S. antibiotic prescriptions. Overuse of antibiotics contributes to low-value care and can lead to adverse effects, including antibiotic resistance. By implementing Choosing Wisely interventions, healthcare providers can promote appropriate antibiotic use, educate patients about the risks and benefits, and ultimately reduce the prevalence of unnecessary antibiotic prescriptions, improving patient outcomes and preserving the effectiveness of these important medications. Read more here.
Authors of BMJ Viewpoint state that unnecessary medical tests, treatments, and procedures not only contribute to rising healthcare costs and potential harm to patients, but also have a significant environmental impact. By promoting the principles of Choosing Wisely, clinicians can play a crucial role in reducing low-value care, minimizing healthcare-related carbon emissions, and fostering a more sustainable healthcare system that benefits both patients and the planet.
New JAMA Network Open study reveals that Medicare Advantage beneficiaries have lower rates of high-risk medication use compared to those enrolled in traditional Medicare fee-for-service plans. This finding indicates that Medicare Advantage plans may be more effective in promoting safer medication practices and reducing potential risks associated with certain medications. Read more.