Building A Better Health Care System Post-COVID-19: Steps for Reducing Low-Value and Wasteful Care

According to authors, the upheaval in the provision of routine health care caused by the COVID-19 pandemic offers an unprecedented opportunity to significantly reduce low-value care with concurrent efforts from providers, health systems, payers, policymakers, employers, and patients. Read more here.

The Effect of Increased Cost-Sharing on Low-Value Service Use
A V-BID program implemented at a large public employer in Oregon was found to have significantly reduced the use of targeted low-value services without increasing overall health care costs. The program increased cost-sharing on several low-value services, such as spinal surgery for pain and advanced imaging services.
Waste in the Medicare Program: a National Cross-Sectional Analysis of 2017 Low-Value Service Use and Spending
New research has revealed that low-value care remains common among Medicare beneficiaries. 35.5% of fee-for-service enrollees received a low-value service in 2017, contributing to excess spending and potentially exposing patients to harm. The authors argue that reducing the utilization of even a small subset of low-value services could substantially reduce wasteful spending in Medicare.
Roadmap for Addressing Low-Value Care
Developed by the National Pharmaceutical Council in conjunction with Going Below the Surface, the Roadmap is a step-by-step guide to improve how we use our resources in a way that maximizes high-value services and minimizes low-value ones. It’s designed to serve as a reference tool to help organizations consider key goals, questions and tactics to effectively implement a plan to focus on services that enable optimal outcomes. Read more here.
Many Older Adults 'Overscreened' for Cancer
According to a recent report published in JAMA Network, many patients reported undergoing screening for cancer, even though they were older than the upper age limit for recommended screening. This overscreening could potentially harm patients, outweighing potential benefits. Changing benefit designs to prevent low-value care, such as overscreening, may be one method to halt this trend.
Medicare Part D Plans Rarely Cover Brand-Name Drugs when Generics are Available

Authors of a new Health Affairs article found that 84% of Medicare Part D plan-product combinations only covered generic versions of medications. Consistent and generous coverage for generic drugs is a key way to reduce prescription drug spending for consumers.

Cutting 'Wasteful Drugs' Could Save Employers $6 Billion

A new guidebook developed by Pacific Business Group on Health and Johns Hopkins University researchers identifies 49 drugs with less expensive alternatives that could be cut from the lists of drugs covered by employers. Learn more here.

Trends in Low-Value Carotid Imaging in the Veterans Health Administration From 2007 to 2016

The Choosing Wisely campaign has led medical societies to identify some uses of carotid imaging as low-value care. The authors believe interventions targeting the ordering clinicians are needed to meaningfully reduce low-value testing and utilization cascades. This recommendation is further supported by the most recently issued draft recommendation statement released by the U.S. Preventive Services Task Force. Read more here.

Doctors Get Plenty of Advice on Starting Treatment. This Could Help Them Know When to Stop.

After working for decades to address deficits in an evidence-based healthcare system, medical experts have realized that identifying when to scale back on screenings and treatment is just as important as knowing when to start. In a recent article, University of Michigan researchers propose a new framework for ‘right-sizing’ care. Read more here.

Some Physicians are Ordering Thyroid Tests for Unsupported Reasons
Up to one-third of physicians in a recent study reported sending patients for thyroid ultrasounds for reasons that aren’t clinically supported, such as abnormal thyroid function test results or because patients requested the procedure. Ordering unnecessary tests could cause unintended harm. Read more about the need to reduce low-value care from our one pager.
Reducing Imaging Utilization in Primary Care Through Implementation of a Peer Comparison Dashboard
Research shows that high clinical variation has been linked to decreased quality of care, increased costs, and decreased patient satisfaction. This study discusses how implementing a peer comparison dashboard in one large primary care network can impact this issue. Read more here.
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