Utah has a robust All Payer Claims Database (APCD), which makes it a great candidate for the Milliman Waste Calculator, a tool which will allow us to identify overprescription of low-value healthcare, a first step in order to decrease our healthcare expenditures. The Milliman Waste Calculator is an analytical tool to provide actionable data around health care quality, efficiency and effectiveness. This tool combs through state APCD data to identify areas of high spending in low value care, searching for 44 preselected low value frequently prescribed services.
Identifying the frequency of low value care can help providers redirect resources to high value, evidence based care in determining appropriate screenings, medication, and treatments to prescribe. By extrapolating data, it can be determined which practices in medicine have become routine that in themselves are not costly, but spread across an entire population, add up and yield little to no value to the health of the patient.
What does HB 195 Identifying Wasteful Healthcare Spending do?
Alters the Utah Code to say that the Department of Health will contract with other organizations to identify wasteful spending practices in the Utah health care system. It will report the results of the analysis annually. The Department or a third party contracted organization will analyze the data in the report to create an annual report that makes recommendations in the areas of consumer/employer/payer/medical delivery action. The Department will submit the report to HHS Interim Committee by November 1 each year. Learn more about the Milliman Waste Calculator here.
Ask members of the Health and Human Services Committee and ask them to support HB 195 as a way to reduce healthcare spending and improve outcomes.
Suggested Talking Points (please remember to PERSONALIZE your email – why does this issue matter to you?)
- Return on Investment: In 2014, the Commonwealth of Virginia used the Milliman tool to discover $586 million in wasteful spending. Results showed low-value low-cost procedures being used 2x more than high-value high-cost procedures.
- Improve Utah: Wasteful spending has costly penalties (e.g. rise in premiums.) that can increase patient risk of harm and mistrust of the healthcare system. Less wasteful spending improves efficiency and healthcare consumer outcomes, and better utilizes tax dollars.
Be sure to write your brief email in the box on the right BEFORE clicking send. Thank you for taking action!