Resource Stewardship Initiative
The Resource Stewardship Council was formed by Blue Cross Blue Shield of Michigan to encourage physicians to improve health care decision making when using medical services, procedures and tests that have been identified as areas of over-utilization. The Physician Alliance is a member of this council. The Resource Stewardship (RSI) promotes the use of evidence-based medicine when making health care stewardship decisions. The RSI also encourages conversations between physicians and patients about appropriate and necessary care.
The council identified medical services, procedures and test that may be overused or of questionable value and that have significant variation in use among physician organizations in Michigan. Many of these “over utilized” services are very similar to Health Effectiveness Data Information Data Information Set (HEDIS) measures, a common metric system that payers use to evaluate a practice’s quality performance. From the list of potential over utilized services, The Physician Alliance identified four key targets for reduction.
TPA’s focus areas are:
- Decrease the use of imaging for low back pain (HEDIS METRIC) – Click for more information
- Decrease women younger than 30 years of age receiving human papillomavirus (HPV) testing, alone or in combination with cytology for cervical cancer – Click for more information
- Decrease routine annual cervical cytology (pap tests) in women 30-65 years of age – Click for more information
- Decrease annual testing – Vitamin D – Click for more information
These selections are supported by documented healthcare standards, such as HEDIS. (Poor performance on HEDIS metrics results in reduced pay for performance revenue in many programs.) Decreased use of these services can lead to higher quality of patient care, increased patient safety, improvement in the practices pay for performance revenue, and decrease in overall healthcare costs.