Based on evidence-based lists of services that provide minimal clinical benefits, researchers identified 26 low-value services. These services fell into the following categories: low-value cancer screening, low-value diagnostic and preventive testing, low-value preoperative testing, low-value imaging, low-value cardiovascular testing and procedures, and other low-value surgical procedures.
After analyzing 2009 Medicare claims, the researchers found between 25 percent and 42 percent of beneficiaries received low-value services, accounting for 0.6 percent to 2.7 percent of total program spending, depending on the sensitivity and specificity of the measures used in the study.
“Despite their imperfections, claims-based measures of low-value care could be useful for tracking overuse and evaluating programs to reduce it,” the study’s authors wrote. “However, many direct claims-based measures of overuse may be insufficiently accurate to support targeted coverage or payment policies that have a meaningful effect on use without resulting in unintended consequences. Broarder payment reforms, such as global or bundled payment models, could allow greater provider discretion in defining and identifying low-value services while incentivizing their elimination.”
More Articles on Healthcare Spending:
4 Talking Points on America’s Healthcare Spending
Aligning Physicians Around Lowering the Cost of Care: UPMC’s Approach
9 Drivers of High Healthcare Costs in the U.S.
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.
