How CT can save $162 million in healthcare waste

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An analysis of Connecticut’s commercial insurance markets finds we spent $9.45 per person per month on wasteful low-value care in 2019, according to a new report by VBID Health. Of the $162 million total, $24.5 million was from patient out-of-pocket costs.

Low-value care provides no or minimal benefit to patients and is an important driver of rising healthcare costs. There is a growing understanding that whether care is low-value depends on for whom and when the care is provided. Too often, initiatives to lower healthcare costs are indiscriminate, targeting both wasteful and necessary care, resulting in harm to patient outcomes and system efficiency. States are at the forefront of efforts to lower costs and improve health by reducing low-value care, freeing up resources to expand access to high-value, evidence-driven care. VBID Health has tools for states and employers to reduce the use of low-value care.

Of Connecticut’s total low-value spending, 45% was concentrated on ten services. Leading the list were preoperative baseline labs, annual resting EKGs, and imaging tests for eye disease. There was considerable overlap in the top ten lists between states.

In the VBID Health study, All-Payer Claims Database information from CT’s Office of Health Strategy was analyzed by Millman’s proprietary Health Waste Calculator. The analysis used allowed costs for 48 measures of low-value care based on evidence-based recommendations and clinical guidelines. The estimates are likely to be conservative as the researchers selected services to minimize misclassification. In this report and a prior one, VBID Health has analyzed low-value care for eight states including Connecticut.