New Statewide Pilot in Virginia Aims to Reduce Low-Value Care, Decrease Costs and Patient Harm

As the conversation around the use of unnecessary medical services that increase both costs and potential patient harm continues, Virginia is taking steps to tackle low-value care. The Virginia Center for Health Innovation (VCHI) is receiving a $2.2 million grant from Arnold Ventures to launch a 3-year statewide pilot to reduce the use of low-value care in the Commonwealth, announced Daniel Carey, MD, the Virginia secretary of health and human services, at the University of Michigan’s Value-Based Insurance Design Summit.

VCHI will work with 6 Virginia health systems and 3 clinically integrated networks to form a large-scale health system learning community targeting 7 low-value care measures.

Virginia and VCHI have been identifying, measuring, and reporting on the use of unnecessary and low-value medical services, and found that, in 2017, 2.07 million unnecessary services cost $747 million.

“This pilot will take us on the next step…on our journey from our previous work,” Carey said. The plan is to create more available resources for high-value care by eliminating low-value care, he added.

The pilot will focus on reducing provider-driven sources of low-value care, such as unnecessary diagnostic and imaging services for low-risk patients before low-risk surgery. Each of the participating health systems has committed to establishing a leadership team, and they will be receiving quarterly reports from the Virginia All-Payer Claims Database and Milliman on how every clinician in the system performs on the 7 measures.

“What they do with it is up to them,” said Beth Bortz, president and chief executive officer of VCHI, but VCHI will track what they do and how they differ in their approaches of responding to the information.

In addition to partnering with the physicians, the pilot includes the launch of an employer task force with the goal of increasing employer knowledge and engaging them in actions they can take in employer communication, benefit design, and more, explained Bortz. The task force will include employers, the Virginia Chamber of Commerce, and the Virginia Business Coalition.

According to Bortz, VCHI felt it was important that at the same time the provider community works to drive down low-value care, that the employer community supports that work.

“We get started as of tomorrow,” Bortz said. “And by next year, hopefully, we’ll have some exciting results to share with you.”