The figures are both sobering and staggering. Nearly 20% of American households reported medical debt in 2019, and it remains the leading cause of bankruptcy, while also contributing to food insecurity, utility debt, eviction and foreclosure. Meanwhile, experts estimate that $700 to $900 billion in annual health care expenditures is wasted — through unnecessary tests and treatments, and failures in delivering and coordinating care.
Into this breach stepped Johns Hopkins radiologist Pamela Johnson, Stanley Levenson CIM Scholar. “I knew a problem of this magnitude could not be solved by a single medical institution,” she says. “As a nation, we needed to move from ‘high volume’ to ‘high value.’”
So in 2017, she and her Hopkins colleagues convened 100 academic medical centers partners from across the country to form the High Value Practice Academic Alliance. The cornerstone of this national alliance is an annual conference, held each year in Baltimore, where clinicians disseminate their initiatives to improve health care quality while driving down unnecessary costs. The alliance also zeroed in on training tomorrow’s physicians in the principles of high-value health care. The impact has been far-reaching, with more than 1,000 abstracts presented to date.
“Over time, we realized we needed to shift from single-resource issues to more broadly improving the effectiveness of clinical care and coordination to protect patients from potentially avoidable emergency department visits and hospital stays.” – Pamela Johnson
In the first years of the alliance, says Johnson, physicians focused on reducing “low-value” tests as part of the national Choosing Wisely campaign, which has successfully eliminated unnecessary lab and radiology tests at Johns Hopkins and across the country.
“Over time, we realized we needed to shift from single-resource issues to more broadly improving the effectiveness of clinical care and coordination to protect patients from potentially avoidable emergency department visits and hospital stays,” says Johnson. Toward that end, alliance faculty are publishing a “roadmap” — a series of manuscripts — to guide hospitals across the country in delivery patient-centered, high-value care.
“Our mission is to dramatically improve the reach and quality of health care for patients throughout the United States,” Johnson says, “which will drive measurable reductions in health care spending.”
In addition to her national leadership, Johnson has been a key driver of change at Johns Hopkins. In 2020, she was appointed vice president of care transformation for the entire Johns Hopkins Health System (see p. 20). “The funding I received as CIM’s Stanley Levenson Scholar has been absolutely critical to this work,” Johnson says. “It has been used to support the national alliance, the creation of continuing medical education programs and the awarding of seed grants to Hopkins faculty.”
