- Approaches to Reducing Low-Value Care in Traditional Medicare
- Three Ways CMMI Is Applying Evidence To Protect Patients, Providers And Taxpayers
- VA Clinicians Identify Key Drivers and Approaches to Low-Value Care
- Fee-for-Service Models Linked to Higher Odds of Low-Value Surgeries
- Right-Sizing Testing Before Elective Surgery for Patients With Low Risk
- Fee cuts for radiology and low-value imaging
Approaches to Reducing Low-Value Care in Traditional Medicare
A Health Affairs Forefront analysis outlines how traditional Medicare could reduce low- and no-value care through targeted utilization management and alternative payment models. The authors note that clinical uncertainty limits algorithmic decision-making, requiring careful focus on clearly inappropriate services. They argue that combining utilization management with payment reforms is critical to slowing spending growth while preserving high-value care.
Three Ways CMMI Is Applying Evidence To Protect Patients, Providers And Taxpayers
In a recent Health Affairs article, leaders from the Center for Medicare & Medicaid Innovation outline how CMMI is strengthening the use of rigorous evidence to design payment and delivery models that better protect patients, support provider participation, and safeguard federal spending. The article highlights key strategies such as requiring downside financial risk in models, prioritizing high‑value care, and refining outcome measurement to ensure that innovations demonstrably improve quality and reduce unnecessary costs. These efforts reflect a broader health policy shift toward smarter, evidence‑based innovation that aims to improve care while reducing waste for taxpayers.
VA Clinicians Identify Key Drivers and Approaches to Low-Value Care
A qualitative study of 65 clinicians across 46 VA medical centers found that environmental constraints, social pressures, and beliefs about consequences contribute to the persistence of low-value care. Clinicians recommended improving access and quality, enhancing electronic health records, spreading best practices, and strengthening a systemwide culture of value. These insights highlight practical strategies from frontline providers to reduce unnecessary services.
Fee-for-Service Models Linked to Higher Odds of Low-Value Surgeries
A new study found that patients attributed to fee-for-service (FFS) Medicare models had higher odds of receiving low-value surgical procedures compared with those in value-based payment models. The analysis showed that FFS alignment was associated with increased use of surgeries considered low clinical value, even after adjusting for patient and clinical factors. These findings suggest that payment model design may influence the delivery of services that offer limited benefit to patients.
Right-Sizing Testing Before Elective Surgery for Patients With Low Risk
In a recent JAMA Network Open article, researchers examined the feasibility of a structured de-implementation strategy to reduce routine preoperative testing before common, low‑risk elective surgeries in healthy patients. The quality improvement study found that the intervention was implementable across diverse hospital settings, was well‑received by clinical stakeholders, and was associated with a significant drop in unnecessary testing, highlighting a promising approach to cutting low‑value care and associated costs in surgical practice.
Fee cuts for radiology and low-value imaging
In a recent International Journal of Health Economics and Management article, researchers examined whether cutting fees for a commonly used imaging service would reduce use of low‑value radiology, especially among patients for whom it’s not clinically recommended. Using Medicare data, they found that even large payment cuts did not significantly change imaging rates, suggesting that clinician referral patterns—not reimbursement levels—may drive overuse. This has important implications for health policy efforts aimed at reducing unnecessary care and controlling costs, indicating that payment reforms alone may be insufficient to curb low‑value services.
