Identifying the Common Steps ACOs Take to Reduce Low-Value Care
The American Journal of Managed Care recently published a paper, “ACOs With Risk-Bearing Experience Are Likely Taking Steps to Reduce Low-Value Medical Services”, detailing the traits commonly found among independent networks seeking to optimize medical services. A low-value medical service is a test or treatment that is over-used, redundant, or lacks meaningful benefits. It should be noted that tests and treatments should only be deemed unnecessary on a case-by-case basis as every patient is unique.
The authors primarily looked at predictive factors that indicated an ACO that would implement low-value care reduction strategies, as well as the relationship between the implementation of these strategies and quality and savings.
Innovista encourages our readers to review the full study, published by the American Journal of Managed Care, in order to gain a better understanding of the methods and processes utilized in the authors’ research. A link to the study can be found here, and directly below are Innovista’s Key Takeaways from the study.
- The Choosing Wisely campaign, run by the American Board of Internal Medicine (ABIM) Foundation, has prioritized “Advancing a national dialogue around avoiding unnecessary medical tests and treatments”. The mission of Choosing Wisely is to “promote conversations between clinicians and patients by helping patients choose care that is supported by evidence, not duplicative of other tests or procedures already received, free from harm, and truly necessary.” The Choosing Wisely campaign offers access to a library of medical services determined to be low value by various accredited organizations, such as the American Society for Clinical Pathology and the American Academy of Nursing.
- Identified ACOs took on average 3 steps to reduce low-value medical services:
- Educating physicians on low-value tests and procedures (82.5% of ACOs)
- Encouraging discussions between physicians and patients about appropriate care (73.7% of ACOs)
- Disseminating Choosing Wisely materials (68.4% of ACOs)
How can Innovista help?
Innovista Health Solutions offers targeted solutions designed to collect, analyze, and report on patient data in order to make these valuable insights easy to access for all contracted providers and practice administrators. Innovista stresses the importance of physician education and leadership when navigating value-based models. To assist in the provider-patient relationship and to further ensure appropriate and complete treatment in the primary care setting, Innovista offers a population health management platform, in conjunction with an EHR integration tool, to identify care gaps and prevent unnecessary medical costs and utilization. In addition, Innovista employs national clinical guidelines to identify low-value services, offer procedural benchmarks, provide standards for length of stay, and more. Innovistastaff applies these standards of practice when reviewing authorizations, thus directly impacting and reducing low-value medical services and effectively decreasing medical spend for our physician partners.
Innovista exists to help providers succeed in value-based care by developing strong relationships, delivering innovative solutions and driving exceptional performance. Strong dedication to improving patient outcomes drives Innovista to provide our physician partners with expert staffing, clinical programs, delegated services, and analytics capabilities optimized to drive effective change.
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