Overuse is a chronic problem in the health care system. As much as 30 percent of health care spending is used for services, treatments and procedures that do not contribute to better health and that can expose a patient to both additional health risks and enormous costs.
The problem of overuse has multiple causes
- A fee-for-service system that pays the medical provider, regardless of the value of the test, encourages medical providers to design business models based on volume of care given instead of quality or health outcome.
- Consumers often equate more treatment with better treatment and assume that higher price is a proxy for higher quality.
- Benefit designs don’t encourage consumers to make smarter health care choices and support a “more is better” attitude.
Areas of focus
The Alliance is focused on five areas of activity to reduce overuse of care in Washington.
- Reduce avoidable use of emergency room (ER) services, whether in hospital-based or free-standing ERs.
- Reduce avoidable 30-day (all cause) hospital readmissions.
- Reduce the rate of elective, preference-sensitive procedures.
- Reduce the rate of non-evidence based testing and services with a focus on the clinical topics profiled in the Choosing Wisely ® campaign.
- Reduce unwarranted variation in resource use and intensity of care during episodes of care that include hospitalizations.