The QIC is responsible for the integrity of all of the Alliance’s reporting and plays a significant role. For example, in the First, Do No Harm report released in October of 2019, using the Milliman MedInsight Health Waste Calculator™ (Calculator) the Alliance analyzed waste for the 47 tests, procedures, and treatments commonly recognized as overused by the Choosing Wisely® campaign and the medical community. The Alliance found that of the 9,526,365 services examined for both the commercially and Medicaid-insured in Washington state, 51% were determined to be low-value, meaning they were either wasteful or likely wasteful. This resulted in an average of 846,973 people receiving at least one low-value service each year (that’s equivalent to approximately 11% of the total state population), at a total estimated cost of $703 million.
But the results are not the story here, it’s the backstory. When the Alliance previewed the results to the QIC, the members asked, “Can you give medical groups something to really work with, like how they are each doing on these waste categories?” The Alliance then presented the QIC with blinded statewide results, from the least to most wasteful medical groups. When asked whether the Alliance should publish the blinded results or identify medical groups in its public release, the QIC responded, “Not only should you release them, you are obliged to.” What is striking is that none of the physician members knew how their medical groups had performed, just that they, and everyone else, should know.