AHIP study points to decline in healthcare overuse

While overuse of certain diagnostic procedures is still high among those who have employer-sponsored insurance, it declined consistently in recent years--a positive sign for cost-conscious payers, according to a study from America's Health Insurance Plans (AHIP).

The study looked at three specific diagnostic procedures--bone density scans, cancer antigen 125 blood tests and electrocardiograph--and found that the national rate of potential overuse for these services decreased between 2008 and 2013. The total national spending associated with the potential overuse of all three procedures in the population with employer-sponsored insurance totaled $154 million in 2013, and payers are working with clinicians to get that number even lower, the report says.

In a Q&A article posted on the trade group's website, AHIP Senior Vice President of Private Market Innovations Aparna Higgins said insurers are playing an important role in helping clinicians reduce overuse. "Health plans' efforts in promoting evidence-based medicine are likely contributing to a clearer understanding by clinicians of when it is appropriate to use certain tests and procedures," he said.

The provider side also wants to play a role in reducing healthcare overuse, American College of Physicians Executive Vice President and CEO Steve Weinberger in the article. Eliminating the overuse of healthcare services, he said, could greatly decrease wasteful spending, which would make insuring people less expensive.

One such collaborative effort to reduce healthcare overuse is the Choosing Wisely campaign. However, a study published last fall pointed out that further interventions may be needed in order to get physicians to implement the campaign's recommendations in their practices.

To learn more:
- here is the study
- read the article

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