Are You Providing Unnecessary Care?

Many health care entities provide some level of unnecessary or low-value care.

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A recent study from John Hopkins University analyzed data to scrutinize unnecessary and low-value care.

What did they find?

Interestingly, the study found that unnecessary and low-value care occurred most at health systems with:

  • Fewer employed primary care physicians
  • Higher bed counts
  • Investor owned

The study ranked a variety of hospitals.

Low-value care included:

  • Abdominal CT scans with and without contrast and spinal fusions for back pain
  • Pap smears for women over age 65
  • and more.

How can you make sure you are providing high-value care at your healthcare entity?

First, make sure your compliance plan is up to date.

While working on your compliance plan, look for areas of improvements.

Staff often know before physicians where potential issues may be.

Make sure to have open communication with all staff, so that they feel comfortable raising concerns.

It is also essential to have anonymous reporting set up. This way, staff can bring any problems to your attention, without worries of retribution.

You also want to make sure to have open communication with patients. Fully understanding patient histories, issues, and concerns can prevent potentially low-value care from occurring. Look at the ways you interact with patients and see if there is any room to improve. If a patient calls with questions, can they talk to a physician? Can they message through a portal or app?

Finally, audit your billing. This can help find any low-value or unnecessary services that are being provided. We recommend working with your healthcare attorney to audit charts.

We help our clients prepare audits so that they can find and address any issues. We also help our clients train their staff on any problems that were identified in the audit.

If you have questions as to how to best protect your practice and avoid unnecessary or low-value services, contact us today.

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Do you need help with updating your Business Associate Agreement or negotiating contracts with third-party vendors?  We can help. Contact Rickard & Associates today!

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