Despite efforts to increase efficiency in healthcare, a substantial number of Medicare beneficiaries receive low-value services, concludes a new JAMA study.
Researchers analyzed 2009 claims for more than 1.3 million Medicare beneficiaries and found between 25 percent and 42 percent of beneficiaries received low-value services that provide little or no benefit to patients.
Medicare spent $8.5 billion, or $310 per beneficiary, on services detected by the study's more sensitive measures of low-value care, while spending on low-value services with more specific definitions totaled $1.9 billion, or $71 per beneficiary.
That accounted for 0.6 percent to 2.7 percent of overall spending, depending on the measures' level of sensitivity. While representing "modest proportions" of total Medicare spending, the researchers note the findings suggest widespread overuse of unnecessary treatments.
The study looked at 26 measures of low-value services, which included cervical cancer screening for women 65 years and older, CT scanning of the sinuses for uncomplicated acute rhinosinusitis, preoperative stress testing and back imaging for patients with low back pain.
"There are hundreds of other low-value services," study researcher and Harvard professor J. Michael McWilliams, M.D., told Kaiser Health News.
The researchers note that claims-based measures of low-value services could help develop and evaluate programs to reduce unnecessary, wasteful care. Moreover, direct claims-based measures could help identify specific instances of overuse as well as their frequency among the most efficient providers, according to the study. The researchers also point to boarder bundled payment models as ways to enhance incentives to identify and eliminate low-value services.
In 2012, three years after the study period, the Choosing Wisely campaign launched and 54 specialty societies flagged overused procedures that benefit neither patients nor the healthcare system. However, when joint surgeons listed unnecessary procedures for their specialty, none of their choices included high-dollar surgeries commonly performed despite lack of evidence for their use.