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December 2015

Producing Evidence to Reduce Low-Value Care

Author Affiliations
  • 1Department of Health Policy and Management, Rollins School of Public Health and Winship Cancer Center, Emory University, Atlanta, Georgia
  • 2Cancer Outcomes, Public Policy, and Effectiveness Research Center, Section of General Internal Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
JAMA Intern Med. 2015;175(12):1893-1894. doi:10.1001/jamainternmed.2015.5453

Efforts to reduce low-value care can decrease spending while helping patients avoid potentially harmful treatments. However, these efforts face enormous challenges. The current approach focuses on 2 strategies to reduce low-value care. First, professional societies are exhorting physicians to consider costs and value when deciding among alternative treatments. For example, the Choosing Wisely campaign has brought together more than 50 medical specialty societies to develop lists of low-value services.1 These initiatives appeal to a sense of professionalism by promoting the idea that physicians are stewards of societal resources. Second, payers are promoting health care system innovation and implementing payment reforms to reduce the incentives to provide ineffective treatments. Unfortunately, discussions about how to reduce low-value care often gloss over a crucial third strategy: a sustained effort to generate evidence that will distinguish between high- and low-value care.

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