Medicare Pays Billions for Wasteful Care
One approach to stem overuse, he says, is for federal and commercial insurance plan coverage policies to either require patients to pay high co-payments or deductibles for certain services. Or, he says, "maybe you set up pay-for-performance approaches where you're rewarding physicians on how they perform on certain metrics."
Accountable care organizations and bundled payment models set up by the Centers for Medicare & Medicaid Services and other payers "incentivize lower use of overused services, but maintain provider discretion and are less likely to have unintended consequences," Schwartz says.
By quantifying the extent to which patients receive some low-value procedures, the report takes the Choosing Wisely campaign one step further.
Choosing Wisely is an initiative of the American Board of Internal Medicine, which offers guidance to doctors, hospitals, and patients, on procedures of questionable value.
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