Waste in the Medicare Program: a National Cross-Sectional Analysis of 2017 Low-Value Service Use and Spending - PubMed

Waste in the Medicare Program: a National Cross-Sectional Analysis of 2017 Low-Value Service Use and Spending - PubMed

Analysis of Medicare Claims Data Reveals Significant Spending on Low-Value Services

More than one in three Medicare beneficiaries received at least one low-value service in 2017, according to an AHRQ-funded study published in the Journal of General Internal Medicine (JGIM). The authors examined claims reflecting Choosing Wisely® recommendations and other guidelines for all 15,168,134 Medicare fee-for-service beneficiaries, 65 years of age or older, who were continuously enrolled in parts A, B or D for at least two years. They found that these beneficiaries received about 10 million distinct low-value services—those offering patients little to no clinical benefit—resulting in about $2.1 billion in wasteful claim-level spending. Opioids prescribed for acute low back pain, preoperative baseline laboratory studies and oral antibiotics for acute upper respiratory or external ear infections were identified as the three most frequent services. The authors suggested that targeted interventions to reduce low-value services could greatly reduce wasteful spending in Medicare. Access the abstract.

Waste in the Medicare Program: a National Cross-Sectional Analysis of 2017 Low-Value Service Use and Spending

Rachel O Reid 1 2 3, John N Mafi 4 5, Lesley H Baseman 6, A Mark Fendrick 7 8, Cheryl L Damberg 5

Affiliations 

• PMID: 32728953
 
• DOI: 10.1007/s11606-020-06061-0

No abstract available

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