The Washington Health Alliance last month released a report citing that approximately $341 million was wasted on superfluous healthcare tests and treatments in Washington state during a one-year period.
The report examined 48 measures of common medical tests and treatments, and ultimately discovered that 47 percent of performed medical services were found to be wasteful. Additionally, of the 2 million patients receiving the services examined, more than 1 million received care considered low-value.
“Nationally, experts agree that about one-quarter to one-third of what we spend on healthcare in this country is waste,” Susanne Dade, deputy director of the Washington Health Alliance, said in a statement. “This includes patients receiving unnecessary medications, tests, and procedures that have been shown to have little benefit under certain clinical conditions and that create the very real potential for harm to patients — physical, emotional, and financial. Based on our results for Washington state, the Alliance’s report underscores that waste in healthcare is a significant problem that is impacting millions of people and costing billions of dollars nationwide every year. “
The conundrum of these redundant tests and treatments is a burden on providers; insurance companies; employers; and, of course, patients.
One Eastside organization is working to reduce this waste through a clinically integrated network, or CIN, known as the Eastside Health Network (EHN).
Established in early 2017, this organization merges behemoth medical centers like Overlake Hospital and Clinics, Snoqualmie Valley Hospital, and EvergreenHealth with small- to medium-sized private practice providers across the Eastside to create an interconnected continuum of care.
How does this work?
“I’ll be fictional patient David, and I’m not feeling so great,” explained EHN’s Executive Director David LaMarche. “I go see my primary care doctor, with whom I have a relationship, and he (runs some tests) and says, ‘That knee looks pretty bad; you’re probably going to have to go see a surgeon for this.’ I get sent to a surgeon, and (she) redraws the labs and says, ‘Let’s get some imaging,’ which you already had done at your primary care doctor’s office — it sounds crazy, but it’s not uncommon.”
Suddenly, a small two- or three-person private practice medical clinic that has been family-owned for several decades can view lab results performed by the orthopedic surgeon, oncologist, or other specialist from places like EvergreenHealth. And vice versa.
This integrated network, like the one established by EHN, is not just a benefit to the patient, but to the hospitals and private practitioners, as well.
For Overlake Hospital and Clinics, the EHN has “amplified our ability to deliver the highest-quality care, as measured by outcomes and patient safety at a lower cost than some other systems in the region,” said Overlake CEO J. Michael Marsh. “If you have a well-coordinated system of care, you are able to provide higher quality at a lower cost, and that’s, at its core, what EHN’s purpose is.”
EHN has more than 1,430 providers in its network. Of those, more than 60 percent are independent providers not employed by one of the three hospital systems who benefit as well.
“(Operating a private practice is) a ton of work,” said LaMarche. “Their pay has stagnated, their work has increased, and the intensity of their administrative burden has increased. It’s really hard on those folks. That is why virtually all of the primary care (providers) — that are not employed by competitors like Virginia Mason, University of Washington, or Providence — are in our network.”
LaMarche said it is his personal mission to continue to bring in more private practice providers while continuing to improve patient care.
“It’s having a sense of community,” he said. “I feel like it buoys us, and it gives us some encouragement to persevere into the mission or goal that we’re called into, which for them is providing care in what is a complex and challenging environment.”