Virginia receives a $2.2M grant to tackle the overuse of unnecessary health care

Ann Arbor, Michigan March 13, 2019 – Today, at the University of Michigan’s Value-Based Insurance Design Summit, Virginia’s Secretary of Health and Human Resources, Dr. Daniel Carey, announced that the non-profit Virginia Center for Health Innovation (VCHI) had secured support from Arnold Ventures through a $2.2 M grant to launch a statewide pilot to reduce the provision of low value health care in Virginia. Low value health care includes medical tests and procedures that research has proven add no value in particular clinical circumstances and can lead to potential patient harm and a higher total cost of care.

A national dialogue around low value care has been growing since 2012 when the American Board for Internal Medicine’s Choosing Wisely® initiative identified more than 550 tests and procedures that should be questioned by providers and patients. “VCHI looked at just 42 of these measures, using 2017 claims data for 5 M Virginians from Virginia’s All-Payer Claims Database and the Milliman MedInsight Health Waste Calculator, and identified 2.07 M unnecessary services costing $747 M,” stated Secretary Carey. “The data made it clear we needed to do much, much better.”

Through its ongoing partnership with Michigan’s VBID Center, the American Board of Internal Medicine, Virginia Health Information, and Milliman, VCHI will now work with the leadership of six Virginia health systems and three clinically integrated networks (Ballad Health; Carilion Clinic; HCA and Virginia Care Partners; Inova and Signature Partners; Sentara and Sentara Quality Care Network; and VCU Health System). Together, these groups represent 900+ practice sites that will join to form a large-scale health system learning community targeting the reduction of seven low value care measures. “We are absolutely delighted that Virginia’s medical community has responded so positively to our early data reports and shown a commitment to advancing better value and better care, “ said Beth Bortz, President and CEO of the Virginia Center for Health Innovation. “As partners in this initiative, each health system and clinically integrated network will review baseline and practice-level performance data from the Milliman MedInsight Health Waste Calculator, develop system improvements based on that data, and share best practices with other providers in the learning community.”

To reinforce this work, VCHI will also launch an employer task force with the aims of increasing employer knowledge of low-value health care, exposing Virginia employers to employers that are mobilizing for improvement, and engaging employers in action they can take in employee communications, benefit design, and contracting to drive sustainable improvement. Both the Virginia Chamber of Commerce and the Virginia Business Coalition are project partners.  “Employers are concerned with the continuously rising cost of health care and are looking for ways to ensure maximum value for their investment.  This effort, which is both data-driven and highly collaborative, is exactly the kind of partnership our members are ready to engage in.  We look forward to working with VCHI and the task force on items that align with our business plan for the Commonwealth, Blueprint Virginia 2025” stated Barry DuVal, President and CEO of the Virginia Chamber.

Bortz readily acknowledges that this pilot would not be possible without the strong data infrastructure provided by Virginia Health Information and Milliman. Marcos Dachary, Director of Product Management at Milliman MedInsight adds, “Beth and VCHI’s efforts began in 2013, and the MedInsight team has been honored to help the Commonwealth lead the nation in evaluating their data for potentially wasteful services and also creating a plan for action. Reducing financial, emotional, and physical harm from low value services is a difficult task and we’re proud to create a data driven path forward for providers, payers, and purchasers, so they can take actions that ultimately benefit consumers.”

With the financial support of Arnold Ventures, VCHI will leverage its considerable aligned assets to:

  • increase clinician competence in reviewing performance reports and implementing targeted interventions to improve outcomes;
  • improve understanding of which interventions are effective in reducing seven provider-driven low value care tests and procedures and provide health systems and practice leaders throughout the country with tested best practices they can implement;
  • reduce the physical, emotional, and financial harm patients experience from unnecessary tests and procedures; and
  • educate Virginia employers (including state government) on the actions they can take to drive complementary payment reform that better incentivizes value in health care.

In the longer term, VCHI aims to create the financial headroom the health care system needs to dedicate resources to the provision of underutilized high value health care services such as immunizations and cancer screenings. “I am grateful that Arnold Ventures shares my enthusiasm for VCHI’s work and has made this investment in the Commonwealth. Making sensible reforms to our health system that reduce costs and improve patient care has been a long-time priority for me. All eyes are now on Virginia because, if successful, we could serve as a national model for improved value in health care spending,” stated U.S. Senator Mark R. Warner (VA).

Mark Fendrick, MD, Director of the University of Michigan VBID Center (, shares Warner’s enthusiasm. “We have been watching Virginia grab the reins of low value care reduction for the last couple of years and can’t wait to see what they accomplish with this grant. They have put together a very rigorous evaluation strategy, led by Dr. John Mafi at UCLA, which should provide new and valuable insights into what works and what doesn’t in the reduction of unnecessary care. The work they are proposing is necessary, ambitious, and achievable. It could do a great deal to advance health value.”

About the Virginia Center for Health Innovation

Incorporated in January 2012 following a recommendation from Gov. Robert McDonnell’s Virginia Health Reform Initiative, the Virginia Center for Health Innovation (VCHI) seeks to facilitate innovation by convening key stakeholders and securing the resources to accelerate value-driven models of wellness and healthcare throughout Virginia. VCHI’s work is focused on achieving three aims: reducing low value health care, increasing high value health care, and ensuring Virginia has the infrastructure in place to measure and reward value in health care. Among its many innovative projects, the most notable for their alignment with this initiative is the Virginia Health Value Dashboard and the Virginia Scorecards on Payment Reform. For more information visit: and follow on Twitter, Facebook and LinkedIn.

About Arnold Ventures

Arnold Ventures is a philanthropy dedicated to improving lives through evidence-based solutions that maximize opportunity and minimize injustice. Arnold Ventures invests in sustainable change, building it from the ground up based on research, deep thinking, and a strong foundation of evidence. With more than 80 employees in Houston, Washington, D.C., and New York City, Arnold Ventures focuses on criminal justice, health, education, and public finance. It is the 8th largest philanthropy in the United States based on annual giving, committing more than $250 million to grantees in 2018.