Colorado struggles to cut unnecessary medical care, despite focus on costs

• The study found the estimated cost of the services is a fraction of the total services provided with little value, some of which can disrupt appropriate care.
• The most charged services were prescriptions for opiates and multiple antipsychotics, and screenings for vitamin D deficiency, KFF Health News reports.

Why it matters: Extraneous medical procedures are a key driver of higher health care costs, and the analysis shows that Colorado's decade-long efforts to curb them aren't working.

The big picture: The U.S. health system pays doctors based on how much care they provide, regardless of whether it's needed. And patients question when they don't receive extensive treatment.

• About 10-30% of the $3 trillion spent on health care nationwide each year is low-value, multiple estimates show.

What they're saying: "One of the hardest things to do in this work is to align financial incentives," Lalit Bajaj, an emergency physician at Children's Hospital Colorado, told KFF, "because in our health care system, we get paid for what we do."

Zoom in: Children's Hospital Colorado now requires surgeons to evaluate a patient before a CT scan is needed after it found about 45% of kids arriving at the emergency room with abdominal pain were receiving the imaging, despite research showing it's not helpful in most cases. Now the rate is roughly 10%.

• Likewise, new protocols promoting rest and other interventions for the treatment of bronchiolitis cut down on X-rays and reduced prescriptions like albuterol after rates for both reached unnecessary levels.

Between the lines: To not lose too much revenue, Children's Hospital worked with insurers to develop incentives to earn a bonus if they save the health plan money.