Hospitals challenge Lown ranking on unnecessary services

The American Hospital Association is disputing the Lown Institute's report on unnecessary services, which ranks healthcare organizations based on overuse of low-value tests and procedures.

The report from the nonpartisan healthcare think tank was released May 17. For the ranking, Lown examined service use measures at more than 3,100 hospitals. Data in the ranking came from the Medicare claims database and spanned 2018 to 2020. Eight common procedures — including hysterectomy for benign disease, coronary stents for stable heart disease and spinal fusion for low back pain — were measured. Four tests were also considered.  

In a statement shared with Becker's on May 17, Aaron Wesolowski, the American Hospital Association's vice president of policy research, analytics and strategy, took issue with the ranking and methodology.He said healthcare organizations and their workers have been on the front lines of the pandemic amid unprecedented financial and operational challenges. 

"Throughout the pandemic, but especially in the early months, many nonessential services and procedures were put off due to government restrictions or voluntary actions from hospitals to make room for massive surges of COVID-19 patients," Mr. Wesolowski said. "Studies have shown that these delays or sometimes even cancellations in nonemergent care have had some negative outcomes on the health and well-being of patients, who continue to show up at the hospital sicker and with more advanced illnesses. Many of these services may alleviate patients’ pain or provide other help to patients. Lown may define these services as 'low value,' but they can be of tremendous value to the patients who receive them."

He also called the latest Lown report "misleading" and said it has limitations and flaws, including the narrow focus on Medicare patients, use of only claims data and methodology gaps.

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