New analysis of low value care in the state looks at utilization and how it affected spending.
Coloradans received almost two million unnecessary healthcare services in 2021 which cost patients and payers approximately $134 million, according to a new report by the Center for Improving Value in Health Care (CIVHC).
Researchers examined claims from the Colorado All Payer Claims Database from 2017 to 2021 and used Milliman's MedInsight Health Waste Calculator to evaluate potentially low value services.
Of the 58 services analyzed, inappropriate opioid prescribing was at the top of the list for spending, accounting for 36% of all low value spending at $48 million.
That was followed by screening for Vitamin D deficiency at $12.4 million, prostate cancer screening at $6.6 million, imaging test for eye disease at $6.2 million, and coronary angiographies to assess risk in asymptomatic patients at $6 million.
"This most recent analysis puts crucial information into the hands of the people who need it most," Kristin Paulson, president and CEO of CIVHC, said in the press release. "Understanding the most frequent low value services occurring in Colorado and how much they cost can help health insurance companies, providers, and patients work together to improve care and lower costs."
The low value services evaluated cost $70 per instance on average, but some services like proton beam therapy for prostate cancer can cost almost $19,000 per procedure, the report stated.
Among payers, Medicaid and Child Health Plan Plus have the highest percent of spending on low value care, while top services by spending vary across payer type.
The report highlights that provider-focused and patient education interventions, as well as multi-stakeholder collaborations, have shown to have positive results to reduce low value care in other states.
"Initiatives are most effective when each unique low value care service is evaluated individually based on the patient diagnosis and history, patient expectations regarding treatment, and payment incentives," the report said.
Jay Asser is an associate editor for HealthLeaders.
KEY TAKEAWAYS
The Center for Improving Value in Health Care checked out Colorado claims and found unnecessary healthcare services cost patients and health insurers $134 million in 2021.
The top five services in terms of spending were inappropriate opioid prescribing, screening for Vitamin D, prostate cancer screening, imaging test for eye disease, and coronary angiographies.
Among payers, Medicaid and Child Health Plan Plus have the highest percent of spending on low value care, while top services by spending vary across payer type.