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Invited Commentary
May 13, 2019

Improving the Delivery of Common Medical Procedures to Achieve Value-Based Care

Author Affiliations
  • 1Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
  • 2Department of Surgery, University of Michigan, Ann Arbor
  • 3HOK Architects, New York, New York
  • 4Department of Gastroenterology, University of Michigan, Ann Arbor
  • 5Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan
JAMA Intern Med. 2019;179(7):963-964. doi:10.1001/jamainternmed.2019.0001

Health care systems are increasingly under pressure to realign their service lines to achieve value-based care. Because value is influenced by both the frequency and price of a service, payers and systems have adopted 2 general approaches to improving care delivery: reducing the frequency of procedures and reducing the price of each procedure.

One strategy to achieve higher-value care is to reduce the frequency of low-effect tests or procedures. The rationale behind this approach is that some of the tests or procedures we perform are simply not necessary or have little effect on the patient’s ultimate outcome.1 By reducing or eliminating how often these tests or procedures are performed, the value of care increases. The most prominent example of this approach is the Choosing Wisely campaign, which has resulted in more than 550 recommendations to reduce unnecessary or duplicative care.2

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