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Research Letter
Less Is More
October 2016

Low-Value Health Care Services in a Commercially Insured Population

Author Affiliations
  • 1RAND Corporation, Boston, Massachusetts
  • 2Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, Boston, Massachusetts
  • 3Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles
  • 4Department of Health Policy and Management, Sol Price School of Public Policy, University of Southern California, Los Angeles
JAMA Intern Med. 2016;176(10):1567-1571. doi:10.1001/jamainternmed.2016.5031

More than $750 billion of US health care spending annually represents waste, including approximately $200 billion in overtreatment.1 Reducing overuse could improve quality and access while reducing spending and has been championed by clinicians through the Choosing Wisely initiative, as well as payers and policymakers. Indirect assessments of waste based on geographic spending variation reveal the scale of the problem, but cannot concretely inform methods of improvement. Direct assessments of low-value care have thus far focused on Medicare only, a limited set of measures, or a specific geographic area.25 We assessed low-value health care and spending in a large, national, commercially insured population.

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