They are calling it a health care waste calculator, but it seems more like a canine trained to sniff out low-value care in large claims databases.
Milliman and VBID Health have a developed tool called MedInsight that can go through a claims database and find 47 presumably wasteful tests and procedures, according to Modern Healthcare. That list is derived from the Choosing Wisely measures.
The Virginia Center on Health Innovation and the Washington Health Alliance have used the tool, the magazine reported earlier this month.
The Washington alliance issued a report late last year that said that among two million commercially and Medicaid insured patients, $341 million was spent on unnecessary health care from mid-2016 through mid-2017. Most (92%) of the wasteful services were low cost, the magazine reported. The top three "drivers" are on the usual suspect list of low-value care: opioid medications for low-back pain, antibiotics for upper respiratory and ear infections, and ECGs for cardiac screening in low-risk patients.
Milliman is now processing data for Maine and Colorado. Modern Healthcare also said it is scheduled to publish a report with Rand about wasteful services (and spending) among Medicare beneficiaries.