Of the nearly $3 trillion spent in the U.S. each year on healthcare, an estimated 10% to 30% of it is spent on low-value care.
In 2021, Colorado spent nearly $134 million on low-value care services, CBS News reported Nov. 9. That's the total spend by payers, patients and the state government combined.
According to a report from Denver-based nonprofit Center for Improving Value in Health Care, which collects healthcare data from insurers, spending on unnecessary procedures in Colorado averaged $71 per service — which can quickly add up.
A myriad of scenarios such as physicians commonly ordering CT scans for children with abdominal pain before actually assessing if one is necessary, requiring extensive follow-up or post-operative care, or patients themselves insisting on services that may not be a value-add to their care can all contribute, CBS reported.
But barriers can exist to some value-based interventions because "there is a culture of more is better," oftentimes in medicine, Mark Fendrick, MD, director of the University of Michigan Center for Value-Based Insurance Design told CBS.
In Colorado specifically, some efforts are underway to incentivize hospitals to reduce low value care. At Children's Colorado in Aurora, the hospital partnered with an insurance provider to reduce its rate of high-cost imaging services. At the end of the year, if the insurance provider saved money in that area, the hospital could receive a bonus, CBS reported.
A team overseeing quality at Children's Colorado also works across hospital departments to come up with catchy slogans for clinicians to remember to focus on reducing low-value care.
So far, it has been able to reduce imaging rates by 11% throughout the last 17 months.