Problem of Overspending and Underperforming in the United States
The US spends more on health care per capita than any other country but does not achieve outcomes commensurate with that spending.
A substantial share of this spending is devoted to services that buy no additional health, and in some instances, expose patients to serious harm. Experts estimate that between $158 and $226 billion is spent on low-value care every year (2011 dollars). Private payers bear the cost of between $90 and $140 billion of this amount. And there is reason to believe even the upper estimates of low-value care are too conservative.
Beyond the heavy price that public and private purchasers pay, low-value services harm patients. Low-value care services:
- Expose patients to iatrogenic harm. Harm may be directly related to the overused procedure itself, or follow from downstream services as incidental findings are worked-up.
- Impose high out-of-pocket costs. In an era of high-deductible plans, analyses have found that between 17 percent and 33 percent of spending
on low-value care is paid by patients.
- Lead to lost time, lost productivity, and "botheredness."
The Choosing Wisely campaign alone has identified about 500 commonly overused services across the
spectrum of medical care.
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Who We Are
- Low-Cost, High-Volume Health Services Contribute the Most to Unnecessary Health Spending (Health Affairs)
- Reducing Low-Value Care (Health Affairs Blog Post)
- Low-Value Care Infographic (V-BID Center)
- Taking Action on Overuse (MacColl Center for Health Care Innovation)
- Swimming against the Current - What Might Work to Reduce Low-Value Care? (NEJM Viewpoint)
- Treating, Fast and Slow: Americans' Understanding of and Responses to Low-Value Care (Milbank Quarterly Article)