The non-profit Virginia Center for Health Innovation has received a $2.2 million grant from Arnold Ventures to launch a statewide pilot to reduce the provision of low-value healthcare in Virginia.
Low-value healthcare includes medical tests and procedures that have been shown to add little or no benefit in particular clinical circumstances and can lead to potential harm and a higher total cost of care for patients.
“As a physician and as governor, ensuring that all Virginians have access to quality-based healthcare has always been my top priority,” said Gov. Ralph Northam. “With this generous grant from Arnold Ventures and the work of the Virginia Center for Health Innovation, we’ll be able to ensure that more patients in Virginia are getting the right care in the appropriate setting.”
In 2012, the American Board for Internal Medicine’s Choosing Wisely® initiative identified more than 550 tests and procedures that should be questioned by providers and patients. After looking at 42 of these measures and using 2017 claims data for five million Virginians from Virginia’s All-Player Claims Database and the Milliman MedInsight Health Waste Calculator, VCHI identified 2.07 million unnecessary services costing $747 million.
“Reducing low-value care will require a collaborative, data-informed process, and we know there is work that needs to be done,” said Secretary of Health and Human Resources Daniel Carey, M.D. “Virginia’s health care community has come together through this partnership to commit themselves to serving patients through better care and better value.”
VCHI will employ a two-part strategy to first reduce seven sources of provider-driven low-value care and then to prioritize a next set of consumer-driven measures for phase two. The first part of the strategy calls for the creation of a large-scale health system learning community. This learning community will engage six health systems and three clinically integrated networks representing over 900 practice sites from four regions of Virginia. The second part of the strategy involves the formation of an employer task force on low-value health care.
“At VCHI, our mission is to accelerate the adoption of value-driven healthcare,” said Chas Rhoades, Chair of the VCHI Board of Directors and CEO of Gist Healthcare. “While much of the industry has focused almost exclusively on increasing the provision of high-value care—preventive services such as cancer screenings and immunizations, better chronic disease care, addressing the social determinants of health—we also recognize that we can achieve better value by reducing the provision of medical tests and procedures that clinical researchers and frontline physicians have identified as unnecessary and potentially harmful. Over time, we have worked with our data partners to identify and measure this low-value care and now, with the help of Virginia’s health systems, physicians, employers, and state government, we are ready to take significant steps to help reduce it.”
“It is our quality of data and data analytics that really set us apart,” said Beth Bortz, President and CEO of VCHI. “Access to Virginia’s All-Payer Claims database (APCD) and use of the Milliman MedInsight Health Waste Calculator made it possible for us to see where our opportunities for improvement lie.”
“VCHI’s collaboration makes plain the solid commitment of health care providers, employers and Virginia’s government to identify and reduce low-value care,”said Michael T. Lundberg, Virginia Health Information’s Executive Director. “Coupling their enthusiasm with the power of Virginia’s APCD makes for a potent combination of strong will and actionable healthcare metrics. The APCD continues to increase in value thanks to legislation passed this year by the Virginia General Assembly. Stakeholders worked with legislators to expand the type and amount of healthcare information collected, publicly reported, and which can support efforts to provide the right care, at the right place, and at the right cost.”
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