“Overuse and underuse are now a central part of the conversation about fixing health care. Ten years ago, if you brought it up, people looked at you funny. Today, it’s widely acknowledged that the status quo isn’t cutting it anymore.”  Adam Elshaug, Ph.D., "Combating Overuse and Underuse in Health Care", The Commonwealth Fund

What were once on the fringes of conversation in the healthcare industry are now gaining momentum as important topics: overuse and underuse. Why? Because they represent significant opportunities for a positive paradigm shift in healthcare.

In a Q&A on the subject for The Commonwealth Fund, Dr. Adam Elshaug discusses how patient engagement can help curb the problems of underuse and overuse. To learn more about overuse and medical waste spending, check out our blog post: Applying Do No Harm Principles To Healthcare Costs.

Inefficient care costs money. Lots of it.

When patients don’t receive the treatment they need, their health issues typically compound. Further down the road, those compounded problems become harder to ignore, requiring medical treatment that is far more expensive than it would have been had their issue been addressed initially.

Add those costs of underuse to the costs of overuse, when patients get unnecessary treatments, and the financial consequences become dramatic. According to Dr. Elshaug, “this kind of inefficient care represents up to 30 percent of all medical spending in the United States, amounting to $780 billion annually.”

Vera addresses the root causes of overuse and underuse

Campaigns aimed at limiting overuse and underuse have illustrated just how complex the problems are. Education alone isn’t enough. “You need to address all the contributing root causes — guidelines, financial incentives, culture, patient education, technology, and so on,” says Dr. Elshaug.

At Vera Whole Health, our approach to healthcare treats each of these root cause to help curb overuse and underuse. Let’s take a look at a few examples.

  • Guidelines  Vera providers focus on evidence-based care, so patients are presented with treatments that reflect current, established care guidelines.
  • Financial Incentives  Vera clinics offer free preventive care services and highly coordinated referral management that eliminate the financial incentives to perform unnecessary procedures.
  • Patient Education  Vera dedicated care teams educate and partner with patients to make every treatment option a shared decision.

“Research into shared decision-making shows that when patients are clearly informed of the potential risks and benefits of a given procedure, fewer will opt to have it. With certain exceptions, roughly 30 percent fewer patients will opt for a procedure after carefully weighing the pros and cons.”  Dr. Elshaug

Patient education, evidence-based care, and free preventive care are just some of the ways that Vera eliminates issues of underuse and overuse. The result is a healthcare environment where patients get the care they need, when they need it. Efficient care not only improves health outcomes, it also reduces costs associated with unnecessary treatments.

Reduced costs and improved health outcomes, it’s how Vera is making good on the original intent of managed care. Want to learn more? Check out our white paper Delivering Managed Care The Way It Was Intended.

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