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. The Task Force has since identified its own "Top Five" low-value care services, as a call to action for purchasers and
payers to reduce harm and overspending related to care that is not clinically indicated.
Read More About Low-Value Care >>
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Who We Are
- Evaluation of an Intervention to Reduce Low-Value Preoperative Care for Patients Undergoing Cataract Surgery at a Safety-Net Health System (JAMA)
- Measuring 21 low-value hospital procedures: claims analysis of Australian private health insurance data (2010-2014)
- Interventions Aimed at Reducing Low-Value Health Services: A Systematic Review
- Watch the NIHCM webinar: 'Too Much Medicine'
- Levers to Reduce Use of Unnecessary Services: Creating Needed Headroom to Enhance Spending on Evidence-Based Care (American Journal of Managed Care)
- First, Do No Harm: Calculating Health Care Waste in Washington State - Washington Health Alliance and JAMA Article
- Low-Cost, High-Volume Health Services Contribute the Most to Unnecessary Health Spending
- Reducing Low-Value Care (Health Affairs Blog Post)
- V-BID Center Infographic on Low-Value Care
- Taking Action on Overuse (MacColl Center for Health Care Innovation)
- Swimming against the Current - What Might Work to Reduce Low-Value Care? (NEJM Viewpoint)
- The Importance of Addressing Low Value Care and Wasteful Spending in our Healthcare System Today (Roll Call Opinion)
- Tackling Low-Value Care: A New "Top Five" for Purchaser Action
- Treating, Fast and Slow: Americans' Understanding of and Responses to Low-Value Care (Milbank Quarterly)
- Watch the Academy Health Webinar: Innovations in Low-Value Care Measurement