Advantaged Patients Receive More Low-Value Medical Services Interview with:
Dr. Rachel O. Reid MD MS
Associate Physician Policy Researcher
RAND Corporation What is the background for this study? What are the main findings?

Response:  Waste in the US health care system is both common and expensive, estimated to be in the range of $750 billion annually. Contributing to this waste is over-treatment and use of low value services that offer little or no clinical benefit to patients.

We studied 1.46 million adults from across the US with commercial insurance and found that spending on 28 low value services totaled $32.8 million in 2013, accounting for 0.5% of their medical spending or $22 per person annually.

The most commonly received low-value services included hormone tests for thyroid problems, imaging for low-back pain and imaging for uncomplicated headache. The greatest proportion of spending was for spinal injection for lower-back pain at $12.1 million, imaging for uncomplicated headache at $3.6 million and imaging for nonspecific low-back pain at $3.1 million.

Low-value spending was lower among patients who were older, male, black or Asian, lower-income or enrolled on consumer-directed health plans, which have high member cost-sharing. What should readers take away from your report?

The 28 clinical services included in this study reflect many clinical areas and types of care, but still are a small portion of all the low-value care patients receive. The potential savings from reducing these low-value services and others are substantial.

Our study shows differences in low-value care between key subgroups of patients. Our findings highlight that disparities in health care cut two ways, poor access to high-value care among vulnerable patients and overuse of low-value care among those more-advantaged groups. Both aspects of the problem need attention. What recommendations do you have for future research as a result of this study?

Response: Among the issues that should be better understood before interventions are created to reduce use of low value-care are why more-advantaged groups receive more of the care and whether patients in consumer-directed health plans also had lower levels of high-value health care. Thank you for your contribution to the community.


Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on August 31, 2016 by Marie Benz MD FAAD