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Study Finds Low-Value Care for Medicare Patients Only Marginally Decreasing

Analysis  |  By Melanie Blackman  
   February 16, 2021

The study by RAND Corporation found that study participants who received low-value services decreased less than 3% between 2014 and 2018.

The number of Medicare patients who received low-value care only dropped 2.6% between 2014 and 2018, according to a RAND Corporation study published by JAMA Network Open Tuesday morning.

In 2014, 36.3% of study participants received low-value care, while 33.6% received low-value care in 2018. This slight decrease comes even after payment revisions and the launch of Choosing Wisely, a national campaign to educate clinicians which discourages low-value care.

Low-value care, which RAND defines as "patient services that offer no net clinical benefit in specific scenarios," makes up an estimated 10% to 20% of overall healthcare spending. This can include prescribing treatment options that patients don't necessarily need, such as inappropriately prescribing antibiotics.

According to the study, two-thirds of low-value care consists of opioids being prescribed for acute pain, preoperative laboratory testing, and prescribing antibiotics for infections.

"Our study highlights several promising opportunities for targeted interventions that may reduce wasteful health care spending while improving the quality of care," John N. Mafi, the study’s lead author and an adjunct physician policy researcher at RAND, said in the press release.

Low-value care is not only expensive for payers and patients as it consists of wasteful spending, according to the study authors, it can also create harmful outcomes for patients.

Additionally, the study found that annual spending per 1,000 Medicare patients receiving low-value care decreased from $52,766 in 2014 to $46,922 in 2018.

"Given mushrooming deficits and the fact that the Medicare trust fund is running out of cash, there will be enormous pressure to find ways to trim spending in the Medicare program and making significant progress in reducing low value care needs to be a top priority," Mafi said in the press release.

The study authors suggest that policy makers should focus on low-value care education for both physicians and patients, as well as payment reforms. Increased use of technology can also help physicians to decrease low-value medical care.

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Melanie Blackman is the strategy editor at HealthLeaders, an HCPro brand.


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