How can HASC member hospitals play a meaningful role in curbing non-value added treatments, thereby helping to eliminate some duplicative costs, wasted services, and clinical complications so often associated with these treatments?

The American Hospital Association (AHA) recently presented a five-pronged approach with suggestions on achieving this goal. Critical steps include:

• Provide medical staff with appropriate, relevant education around comparative effectiveness data, evidence-based clinical protocols, and benchmark comparative utilization data.
• Engage physicians and staff responsible for measuring and improving hospital quality in the discussion of non-value added treatments.
• Promote specialty society guidelines at medical staff department meetings.
• Lead the development of community-wide electronic health record systems to increase care coordination and reduce duplicative testing.
• Get the community involved in raising the collective conscience on non-value added treatments.

Researchers estimate that nearly 30 percent of Medicare’s costs could be saved without negatively affecting health outcomes; and that in just six categories outlined in an article in the Journal of the American Medical Association building on the work of the Dartmouth Atlas of Healthcare and others, opportunity of savings exceeds 20 percent of total healthcare expenditures.  That’s an estimated total of as much as $248 billion! As much as hospitals may want to be on board, practical obstacles may block the way. For example, taking away 20 percent of a hospital’s ancillary revenue and 20 percent of a hospital’s occupancy closes doors, thereby making the effort to lower ancillary utilization a tough sell.

On the clinical side, medical staff utilization review and peer review structures are already in place, but physicians still have a difficult time keeping up with the latest studies and clinical protocols.  Not to mention, patient demand for the “latest and greatest” and incessant direct-to-customer advertising by pharmaceutical companies and medical device manufactures. Our patients and communities must be informed about key quality issues and engaged in the appropriateness of the care they receive.

Despite these and other difficulties, the campaign to eliminate non-value added treatments is an important strategy to implement, especially in light of the Affordable Care Act. It also aligns with AHA’s top four must-do strategies for hospitals, outlined in Hospitals and Care Systems of the Future (September 2011):

• Aligning hospitals, physicians, and other providers across the continuum of care
• Utilizing evidence-based practices to improve quality and patient safety
• Improving efficiency through productivity and financial management
• Developing integrated information systems

Eliminating non-value added treatments is a huge opportunity to reduce unnecessary costs without sacrificing quality, safety or patient experience. Can your hospital get on board with taking steps to eliminate non-value added treatments? What perceived current benefits would you be willing to give up to promote inpatient oriented rather than physician office oriented patient care?