TGIF

Here are a few interesting studies and tools for weekend reflection:

Fierce Healthcare reports that a study published in the Mayo Clinic Proceedings identified 146 contemporary medical interventions that either are ineffective or do patients more harm than good.  Health plans get ready to expand your list of medically unnecessary procedures.

The list of medical "reversals" includes:
 • Screening and treating for asymptomatic bacteriuria in women with diabetes--While recommended in the United States, this study found the practice did not reduce complications.
 • Anticonvulsant drugs during pregnancy--Despite doubts in medical textbooks, the study found anticonvulsants taken during pregnancy increase the risk of fetal malformation.
 • Prone positioning in ventilated patients with acute lung injury--As utilization increases, this study found no proof of prone position's survival benefit compared to the supine position.
 • Anti-arrhythmic drugs for rate and rhythm control in patients with atrial fibrillation--The study failed to prove treating patients with atrial fibrillation with costly anti-arrhythmic drugs to maintain sinus rhythm improves survival.
 • Percutaneous coronary intervention for treatment of multivessel disease--PCI has been increasingly used to treat multivessel disease but, according to the study, coronary-artery bypass grafting is still superior.

The Leapfrog Group has created an online tool that allows health plans, employers, and other purchasers to calculate the surcharge they pay as a result of hospital errors.

According to InsuranceNewsNet.comhttp://insurancenewsnet.com/oarticle/2013/07/26/20-episodes-drive-employer-health-costs-a-388447.html?lifehealth#.UfKN7W39x8E, Truven Health Analytics, an actuarial consulting firm, has determined that twenty specific "medical episodes" account for 41% of overall growth in employer healthcare spending.

According to the company, the study examined medical claims data for over 8 million commercially insured individuals under the age of 65 from 2006 to 2011, including those covered by large employers who are self-insured. It found that during the five year period, employer healthcare costs increased by an average of 4.3 percent per year, driven by spending on preventive health services; osteoarthritis (except spine); multiple sclerosis; childbirth (Cesarean section); and complications of surgical and medical care. The majority of spending growth was driven by an increase in the cost per case, primarily attributable to medical and surgical procedures. Other cost drivers that show up in the data are the steadily increasing cost of specialty drugs and the ongoing obesity epidemic, which is an underlying driver of many of the diseases noted in the report. 

Finally, the Society for Human Resource Management has posted a report with suggested best practices for wellness program design. Have a good weekend.