Identifying potential overuse of non-evidence-based health care.

  1. Law
  2. Utah Code
  3. Utah Health Code
  4. Utah Health Data Authority Act
  5. Identifying potential overuse of non-evidence-based health care.

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Affected by 63I-1-226 on 12/31/2023

Effective 5/12/2020
26-33a-117. Identifying potential overuse of non-evidence-based health care.
  • (1) The department shall, in accordance with Title 63G, Chapter 6a, Utah Procurement Code, contract with an entity to provide a nationally-recognized health waste calculator that:
    • (a) uses principles such as the principles of the Choosing Wisely initiative of the American Board of Internal Medicine Foundation; and
    • (b) is approved by the committee.
  • (2) The department shall use the calculator described in Subsection (1) to:
    • (a) analyze the data in the state's All Payer Claims Database; and
    • (b) flag data entries that the calculator identifies as potential overuse of non-evidence-based health care.
  • (3) The department, or a third party organization that the department contracts with in accordance with Title 63G, Chapter 6a, Utah Procurement Code, shall:
    • (a) analyze the data described in Subsection (2)(b);
    • (b) review current scientific literature about medical services that are best practice;
    • (c) review current scientific literature about eliminating duplication in health care;
    • (d) solicit input from Utah health care providers, health systems, insurers, and other stakeholders regarding duplicative health care quality initiatives and instances of non-alignment in metrics used to measure health care quality that are required by different health systems;
    • (e) solicit input from Utah health care providers, health systems, insurers, and other stakeholders on methods to avoid overuse of non-evidence-based health care; and
    • (f) present the results of the analysis, research, and input described in Subsections (3)(a) through (e) to the committee.
  • (4) The committee shall:
    • (a) make recommendations for action and opportunities for improvement based on the results described in Subsection (3)(f);
    • (b) make recommendations on methods to bring into alignment the various health care quality metrics different entities in the state use; and
    • (c) identify priority issues and recommendations to include in an annual report.
  • (5) The department, or the third party organization described in Subsection (3) shall:
    • (a) compile the report described in Subsection (4)(c); and
    • (b) submit the report to the committee for approval.
  • (6) Beginning in 2021, on or before November 1 each year, the department shall submit the report approved in Subsection (5)(b) to the Health and Human Services Interim Committee.




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