Study: Nearly Half of Patients Received Low-Value Care

Alexandra Wilson Pecci, February 8, 2018

That overuse of care amounted to an estimated $282 million in unnecessary healthcare spending in one year. 

Nearly half of patients received care that is considered low value or wasteful, according to an analysis of 1.3 million patients across Washington state who received a healthcare service known to be commonly overused.

That overuse of care amounted to an estimated $282 million in unnecessary healthcare spending in one year, found the report from the Washington Health Alliance.

"Overuse in the healthcare system has become so common that we frequently don't even think to question it," Nancy A. Giunto, executive director of the Washington Health Alliance, said in a statement.

"However, preventing harm to patients is critical, in addition to the fact that everyone pays the price because overuse contributes to higher insurance premiums across the board,” she said.

The services measured include 47 common tests, procedures, and treatments that clinician-led national initiatives such as Choosing Wisely and the U.S. Preventive Services Task Force have determined are overused.

The report used the MedInsight Health Waste Calculator from the actuarial consulting firm Milliman to produce an analysis of low-value healthcare services across the state.

It found that more than 45% of the healthcare services examined were determined to be of low value. Approximately 1.3 million individuals received one of these 47 services. Among 1.3 million individuals, 47.9% received a low-value service.

Also, 36% of spending on the healthcare services examined went to low-value treatments and procedures. This amounts to an estimated $282 million in unnecessary spending.

Of the 47 treatments and services analyzed, 93% of overuse was attributed to just 11 common tests, procedures, and treatments, such as:

  • Preoperative tests and lab studies prior to low-risk surgery
  • Too-frequent cancer screenings
  • Eye imaging tests for people without significant eye disease
  • Annual EKG tests or cardiac screenings for people with low risk of heart disease
  • Imaging for uncomplicated conditions such as low back pain

A study last year in JAMA Internal Medicine found that hospital-based primary care practices are more likely to make referrals to specialists and order expensive imaging and other unneeded tests for patients with common conditions than do their colleagues in community-based practices.

Practice location, rather than practice ownership, is the driving factor behind the disparity.

The use of low-value care was even more common among patients who saw someone other than their primary care physician at a hospital-based primary care practice, that study showed.

Alexandra Wilson Pecci

Alexandra Wilson Pecci is an editor for HealthLeaders Media.

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