In 1998, the Institute of Medicine defined 3 problems in health care quality: underuse, misuse, and overuse.1 The Institute of Medicine Committee on Better Care at Lower Costs estimated that in 2009, about 30% (or roughly $750 billion) was wasted on excessive administrative expenses, fraud, unnecessary services, and other causes.2 This fueled efforts to identify duplicative and unnecessary costs and separate low-value care from high-value care. In 2012, Berwick and Hackbarth3 pointed out that the best strategy to reduce costs and still meet the needs of the public for high-quality care was to reduce waste, estimating that the lower end of potential savings was more than 20% of total health care spending. An analysis4 of 2014 medical claims in Virginia found that a high volume of low-value services (costing $538 or less) accounted for the bulk of unnecessary costs.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Lum F, Lee P. Waste in the US Health Care System—Insights For Vision Health. JAMA Ophthalmol. Published online October 07, 2019. doi:10.1001/jamaophthalmol.2019.4647
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: