Voices in Health Care Value - April 2020

April 2020

Welcome to the seventh issue of Voices in Health Care Value, the newsletter of the Research Consortium for Health Care Value Assessment (RC-HCVA). This issue features work from our colleagues at the Healthcare Value Hub. We appreciate your comments and inputs to subsequent issues. If you are interested in becoming a Colleague in Value (individuals and groups who work in this area or who are simply interested in its findings) please register here


Low-Value Care at the State Level

By George Miller

This quarter’s featured Colleague in Value is Altarum’s own Healthcare Value Hub. (A summary of the work of the Hub appears later in this newsletter.) Some of the Hub’s activities complement those of the Research Consortium for Health Care Value Assessment (RC-HCVA) that are aimed at identifying and addressing low-value care.

Both the Hub and the RC-HCVA have recently conducted analyses to identify differences among states in controlling low-value care. One of the features of the Hub’s Healthcare Affordability State Policy Scorecard is an assessment of states’ progress in reducing the provision of low- and no-value care with respect to both policies and outcomes. Similarly, a recent study conducted by the RC-HCVA estimated the frequency of each state’s provision of low-value care to commercially-insured beneficiaries for 20 specific clinical services. Each of these analyses revealed significant differences in the degree to which different states are addressing wasteful clinical spending. A discussion of the results of the two studies is included in our most recent RC-HCVA concept paper, written by the Hub’s Lynn Quincy and Amanda Hunt. An earlier RC-HCVA concept paper discusses the value of such state-level assessments. While assessments at the state level mask differences in local practice patterns that help explain state-to-state differences, they do provide state policy makers with evidence that can provide incentives to address low-value care at the state level.1

The need for such state-level action has never been more evident. The COVID-19 pandemic has highlighted our nation’s current underfunding of public health and bio-threat preparedness, as well as the important role states play in such preparations. Furthermore, as more of our limited health care resources are diverted to addressing the pandemic, fewer resources are available for other clinical needs. In the long run, reducing low-value care will help free up funds to more efficiently address ongoing clinical, public health, and bio-threat needs, helping us to prepare for the next health care crisis.

1. Other researchers have addressed aspects of low-value care at a more granular geographic level. See, for example, the work of Colla and colleagues (2014) and Oakes and colleagues (2020).

RESEARCH CORNER – In Case You Missed It


  • The second Quick Strike project from the Research Consortium for Health Care Value Assessment was published, looking at state level estimates of selected low-value care services. Read here.

  • This article by Maria Castelluci from Modern Healthcare highlights findings from the Consortium’s Quick Strike 2 project. Read article here.

  • Other articles highlighting findings from the Consortium’s Quick Strike 2 project.

    • Benefits Pro: read here

    • Healthcare Business News: read here

    • Radiology Business: read here

    • Crain’s Detroit Business: read here

    • Xtelligent Healthcare: read here

    • Academy Health What We’re Reading: read here

  • A demonstration brief was published by the Research Consortium on using the Low Value Care Visualizer to find meaning within dense claims data. Read here.

  • Academy Health discusses the Low Value Care Visualizer, a new resource provided by the Research Consortium for Health Care Value Assessment. Read here.

  • In an article by Henderson and colleagues published in JAMA Internal Medicine, research findings suggest that Vitamin D tests reduced significantly in Canada when tied to non-payment policies, compared to a slight reduction from information initiatives such as Choosing Wisely. Read article here.

  • Read commentary on Henderson’s work by Dr. Eve Kerr from IHI here.

  • In an article by Allison Oakes and colleagues published in Medical Care, research findings suggest that systematic overuse associated with observable, structural characteristics of the regional health care system. Read here.

THE COMMUNITY – A Spotlight Feature on a Colleague in Value


Each issue will spotlight work by a Colleague in Value. This issue’s spotlight is on Altarum's Healthcare Value Hub.

The Healthcare Value Hub

With support from the Robert Wood Johnson Foundation, the Healthcare Value Hub provides free, timely information about the policies and practices needed to achieve an equitable and affordable health system that focuses on the goals and needs of the people it serves.

The Hub works at the intersection of advocacy, research and policy, with a staff dedicated to monitoring, translating and disseminating evidence, and a focus on connecting advocates, researchers and policymakers to build communities and create momentum toward a patient-centered, high-value healthcare system.

Our evidence reviews focus on:

  • Reasons for our Cost and Quality Problems
  • Strategies to Improve Healthcare Value, including:
    • Transparency measures
    • Altering financial and non-financial incentives facing providers and consumers to improve care coordination and quality outliers
    • Addressing monopoly pricing
    • Addressing unmet needs and the social determinants of health
    • And much more….


The Hub’s FREE, publicly available resources include:

  • Publications, such as:
    • Single Payer: Can it Bend the Cost Curve?
    • Housing Interventions to Improve Health Outcomes
    • Reducing Low-Value Care: Saving Money and Improving Care
    • Revealing the Truth about Healthcare Price Transparency
    • Prescription Drug Competition Hampered by Policies, Barriers and Delay Tactics
    • Improving Healthcare Value in Rural America
  • Consumer Healthcare Experience State Surveys
  • Glossaries
  • Infographics, such as:
    • Guide to High-Value Healthcare
    • Social Determinants of Health
    • Six Categories of Healthcare Waste
    • Consumer Harm: The Impact of High Prices and Uneven Quality
    • The Road to Drug Competition Hampered by Policies, Barriers and Delay Tactics
  • Tracking State News

Connect with the Hub:

The Hub connects advocates, researchers and policymakers together to further conversations and action to improve quality, increase equity and lower the cost of healthcare. Go to www.HealthcareValueHub.org/Stay-Connected to sign up for:

  • Research Roundup, a monthly e-newsletter with state news, new research and commentaries.
  • Content alerts to be notified when new resources about particular states or topics are released.
  • Event notifications - Monthly webinars focus on timely topics and new research.


  • Registration for AcademyHealth ARM, June 13-16 in Boston, MA can be found here.


  • The 2019 Sustainable Health Care Spending Symposium took place this past July 2019 with incredible information and speakers. The full monograph can be found here. 


Sign up for Voices in Health Care Value