Nav: Home

Cost savings possible from reducing use of low-value health services, study says

August 29, 2016

The first national study to examine spending on a wide array of low-value health services among adults with commercial health insurance finds that while use of such services is modest, there is considerable potential for cost savings.

Studying insurance claims from more than 1.46 million adults from across the nation, researchers found that spending on 28 low-value medical services totaled $32.8 million during 2013 among the group. That accounted for 0.5 percent of total spending or more than $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.

The study, done by researchers from the RAND Corporation and the University of Southern California, examined medical services that experts have agreed provide little value to patients given the cost and available alternatives. The findings are published as a research letter in the journal JAMA Internal Medicine.

"Our findings add evidence to the notion that reducing overuse of medical procedures could improve quality while reducing spending," said Rachel Reid, lead author of the study and a physician scientist at RAND, a nonprofit research organization.

Experts estimate that $200 billion in health care spending in the United States is for overtreatment. In order to reduce that amount, the American Board of Internal Medicine Foundation and consumer groups launched an initiative called Choosing Wisely in 2012 to encourage physicians and patients to engage in conversations about evidence-based medical practice.

"The services 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," Reid said. "The potential savings from reducing these low-value services and others are substantial."

While previous studies of low-value medical care have focused on Medicare recipients or narrower regions, the RAND/USC study evaluated the care received by a large group of nonelderly adults insured through one of the nation's largest commercial health insurance companies. Regionally, the Southern, Middle Atlantic and Mountain regions had proportionately more low-value spending.

"Areas with high Medicare spending also seem to have greater use of low-value services among those with commercial insurance" said Neeraj Sood, senior author of the study, professor at the Price School at USC and director of research at the Leonard D. Schaeffer Center for Health Policy at USC. "This confirms that there are opportunities for cost savings, and that both private insurers and Medicare can benefit from efforts to reduce use of low-value care"

The analysis of 28 low-value procedures found that 7.8 percent of the patients studied received low-value services in 2013.

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.

"Disparities in health care cut two ways - it can cause poor access to high-value care among vulnerable patients and overuse of low-value care among more-advantaged groups. Both need attention," Sood said.

Researchers say that 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 people in consumer-directed health plans also had lower levels of high-value health care.
-end-
Support for the study was provided by the Leonard D. Schaeffer RAND-USC Initiative in Health Policy and Economics, and the National Institutes of Health.

RAND Health is the nation's largest independent health policy research program, with a broad research portfolio that focuses on population health, health care costs, quality and public health systems, among other topics.

RAND Corporation

Related Health Care Articles:

Care management program reduced health care costs in Partners Pioneer ACO
Pesearchers at Partners HealthCare published a study showing that Partners Pioneer ACO not only reduces spending growth, but does this by reducing avoidable hospitalizations for patients with elevated but modifiable risks.
Health care leaders predict patients will lose under President Trump's health care plans
According to a newly released NEJM Catalyst Insights Report, health care executives and industry insiders expect patients -- more than any other stakeholder -- to be the big losers of any comprehensive health care plan from the Trump administration.
The Lancet: The weaponisation of health care: Using people's need for health care as a weapon of war over six years of Syrian conflict
Marking six years since the start of the Syrian conflict (15 March), a study in The Lancet provides new estimates for the number of medical personnel killed: 814 from March 2011 to February 2017.
In the January Health Affairs: Brazil's primary health care expansion
The January issue of Health Affairs includes a study that explores a much-discussed issue in global health: the role of governance in improving health, which is widely recognized as necessary but is difficult to tie to actual outcomes.
Advocacy and community health care models complement research and clinical care
Global lung cancer researchers and patient advocates today emphasized that new models of delivering care and communicating about cancer care play an important role in the fight against lung cancer.
About 1 million Texans gained health care coverage due to Affordable Care Act
Texas has experienced a roughly 6 percentage-point increase in health insurance coverage from the Affordable Care Act, according to new research by experts at Rice University and the Episcopal Health Foundation.
In India, training informal health-care providers improved quality of care
Training informal health-care providers in India improved the quality of health care they offered to patients in rural regions, a new study reports.
Affordable Care Act has improved access to health care, but disparities persist
The Affordable Care Act has substantially decreased the number of uninsured Americans and improved access to health care, though insurance affordability and disparities by geography, race/ethnicity, and income persist.
Integrated team-based care shows potential for improving health care quality, use and costs
Among adults enrolled in an integrated health care system, receipt of primary care at integrated team-based care practices compared with traditional practice management practices was associated with higher rates of some measures of quality of care, lower rates for some measures of acute care utilization, and lower actual payments received by the delivery system, according to a study appearing in the Aug.
Study finds quality of care in VA health care system compares well to other settings
The quality of health care provided to US military veterans in Veterans Affairs (VA) facilities compares favorably with the treatment and services delivered outside the VA.

Related Health Care Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Climate Crisis
There's no greater threat to humanity than climate change. What can we do to stop the worst consequences? This hour, TED speakers explore how we can save our planet and whether we can do it in time. Guests include climate activist Greta Thunberg, chemical engineer Jennifer Wilcox, research scientist Sean Davis, food innovator Bruce Friedrich, and psychologist Per Espen Stoknes.
Now Playing: Science for the People

#527 Honey I CRISPR'd the Kids
This week we're coming to you from Awesome Con in Washington, D.C. There, host Bethany Brookshire led a panel of three amazing guests to talk about the promise and perils of CRISPR, and what happens now that CRISPR babies have (maybe?) been born. Featuring science writer Tina Saey, molecular biologist Anne Simon, and bioethicist Alan Regenberg. A Nobel Prize winner argues banning CRISPR babies won’t work Geneticists push for a 5-year global ban on gene-edited babies A CRISPR spin-off causes unintended typos in DNA News of the first gene-edited babies ignited a firestorm The researcher who created CRISPR twins defends...