In a new analysis of 1.3 million patients across the state who received a healthcare service considered to be commonly overused, the Washington Health Alliance found that nearly half of the patients received care that is considered low value, or wasteful. That overuse of care amounted to an estimated $282 million in unnecessary healthcare spending in one year.
The report, "First, Do No Harm: Calculating Health Care Waste in Washington State" used the MedInsight Health Waste Calculator, from the actuarial consulting firm Milliman, to produce an analysis of low-value healthcare services across the state. The services measured include 47 common tests, procedures and treatments that clinician-led national initiatives such as Choosing Wisely and the U.S. Preventive Services Task Force have determined are overused.
[Also: Low-value health services fuel $586 million in wasteful spending, Health Affairs study says]
Low-value healthcare services, sometimes cited as overuse or waste, refers to medical tests and procedures that have been shown to provide little benefit in certain clinical scenarios, and in many cases have the potential to cause physical, emotional or financial harm to patients. Preventing harm associated with the delivery of healthcare is essential to improving patient safety, and while the harm is not intentional, it is particularly troublesome when it results from tests, procedures and treatments that were unnecessary.
More than 45 percent of the healthcare services examined were determined to be of low value. About 1.3 million people received one of these 47 services; among them, almost half, 47.9 percent. received a low-value service.
Meanwhile, 36 percent of spending on the healthcare services examined went to low-value treatments and procedures. This amounts to an estimated $282 million in unnecessary spending.
And of the 47 treatments and services analyzed, 93 percent of overuse was attributed to just 11 common tests, procedures and treatments. These include such things as preoperative tests and lab studies prior to low-risk surgery; too-frequent cancer screenings; eye imaging tests for people without significant eye disease; annual EKG tests or cardiac screening for people with low risk of heart disease; and imaging for uncomplicated conditions such as low back pain.
Many areas of overuse are individually low cost, but when they are used in high volumes they add up to a significant amount of waste, the authors found.
To help reduce low-value care, physicians and patients should have conversations about appropriate medical care that is both necessary and evidence-based, the study found.
Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com