New Report: Utilization and Spending on Low-Value Medical Care Across Four States
A new VBID Health report analyzes data from all payer claims databases (APCDs) from four states – Colorado, Connecticut, Utah, and Wisconsin – to quantify the utilization and spending on 48 specific low-value services by commercial payers in 2019. Key findings:
- In 2019, the four states spent more than $630M on the 48 low-value services measured.
- In Colorado, Connecticut, and Utah, patients paid nearly $100M out-of-pocket on the 48 LVC services.
- A substantial proportion of LVC expenditures was concentrated in high-volume services and those frequently used in low-value clinical settings.
Video: Reducing Low-Value Care to Improve Health Equity
In the United States, low-value health care disproportionately impacts communities of color. By incorporating equity and the diverse needs of underserved communities in the definition of low-value care, we can encourage progress towards addressing health disparities. Watch our latest video here.
Changes in Use of Low-Value Services During the COVID-19 Pandemic
A study in the American Journal of Managed Care reported that early in the COVID-19 pandemic, the use of low-value care services declined at a rate similar to the use of high-value services. However, the rebound of low-value services lagged behind high-value care, suggesting a role for clinical value in decision making as we emerge from the pandemic.
Hospital Overuse During COVID - How Many Older Adults Were Put at Risk for Unnecessary Procedures?
The Lown Institute has examined the use of 8 low-value procedures by hospitals during the COVID-19 pandemic. The services include stents for stable coronary disease, vertebroplasty for osteoporosis, hysterectomy for benign disease, spinal fusion for back pain, IVC filters, carotid endarterectomy, renal stents, and knee arthroscopy. Key takeaways are included below:
- Hospitals delivered more than 100K low-value procedures to Medicare beneficiaries between March and December 2020.
- Of these, almost half were unnecessary coronary stents, and approximately one-third were unnecessary back surgeries.
- Hospitals delivered low-value services to Medicare patients at rates similar to 2019.
- All hospitals on the U.S. News Honor Roll ranking overused coronary stents at a higher rate than the national average in 2020.
Cascade Services and Spending Following Breast MRI vs. Mammography Among Commercially Insured Women
The increasing use of breast MRI (Magnetic Resonance Imaging) screening, especially among women with low or average-risk for breast cancer, raises concerns about resulting mammary and extramammary cascades of uncertain value. Findings from a recent national study show that compared to women receiving mammography, breast MRI recipients had higher rates of downstream visits and services, as well as total and out-of-pocket spending. Read more here.