The 2019 health plan open-enrollment season is kicking off for many Rhode Island employers. Each year the rising cost of health care takes its toll on employer budgets, placing an ever-increasing financial burden on employers and their employees.
We usually assume our health care dollars are spent appropriately and only when truly needed. Yet, studies show that this is not always the case.
According to the National Academy of Medicine, approximately $765 billion in health care spending in the U.S. is wasted on unneeded tests, medications and procedures. Even more disturbing, NAM estimates 30,000 avoidable deaths each year are attributed to this overly aggressive care.
No state is immune to overspending, and that includes Rhode Island.
“In our own recent study of one Rhode Island-based employer’s health care spending,” said Shannon Shallcross, CEO of East Greenwich-based BetaXAnalytics, “We looked at several specific categories of low-value care. Out of everyone who received care in these categories, half of these people received at least one test or service that would be considered unnecessary. And these wasteful services accounted for 15.5 percent of spending in these care categories.”
Research has identified the following causes of low-value care:
• Pressure from patients often drove doctors to prescribe unnecessary care due to fear of losing patients to other practices or of lawsuits.
• Lack of evidence-based tools to support a doctor-patient dialogue about treatment options.
• Patients are sometimes uncomfortable asking their doctors questions.
The good news is that employers can take immediate action to reduce wasteful health care spending and keep their employees safe from harm. That is why the Rhode Island Business Group on Health partnered with ABIMF to promote Choosing Wisely, an international campaign developed by ABIMF and active in 20 countries around the world.
The Choosing Wisely campaign promotes productive conversations between patients and doctor – conversations that research shows produce the right level of care and go a long way toward eliminating tests, procedures and medication that provide little, if any, benefit. The core of the campaign is educating patients in how to spark these essential conversations through asking their doctors five basic questions:
• Do I really need this test or procedure?
• What are the risks and side effects?
• Are there simpler, safer options?
• What happens if I don’t do anything?
• How much does it cost? (Will my insurance pay for it?)
Asking the five questions will give employees and their family members this critical information for making wise choices about their health care.
Encouraging doctor-patient communication to employees and their family is particularly urgent, not only to reduce wasteful spending but to keep employees safe from harm. The major cause of the opioid epidemic, for example, is the overprescribing of opioid-based pain relievers such as oxycodone. This can be accomplished by getting more Rhode Island businesses to adopt the proven “Choosing Wisely” approach.
RIBGH is asking Rhode Island employers to join the Choosing Wisely-RI campaign, which is free of charge and available to all Rhode Island employers in all industries. The campaign also offers access to the Choosing Wisely cellphone app, evidence-based educational materials, and more than 550 recommendations developed by ABIMF and their specialty boards. The materials are available online and can be easily distributed to all employees.
Employers are also invited to attend the RIBGH Annual Health Care Summit “Low Value Care Next Steps,” on Oct. 5 from 7:30 a.m. to noon at the Providence Marriott Downtown, 1 Orms Street, Providence, that will highlight how other states have reduced wasteful spending of health care dollars incorporating Choosing Wisely. Visit www.ribgh.org.
Joanne Bilotta is campaign manager for the Rhode Island Business Group on Health’s Choosing Wisely-RI campaign.