Study among fee-for-service Medicare recipients shows need for more efforts to curb practice

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Spending on low-value health care among fee-for-service Medicare recipients dropped only marginally from 2014 to 2018, despite both a national campaign to better educate clinicians and increasing use of payment revisions that discourage wasteful care, according to a new RAND Corporation study.

Three items accounted for two-thirds of the low-value care. Among these, prescribing opioids for acute back pain increased despite a growing national awareness of the harms caused by the drugs and the role of such prescribing in fueling the nation’s opioid crisis.

The study found that the proportion of study participants receiving any of 32 low-value services decreased from 36.3% in 2014 to 33.6% in 2018. Annual spending per 1,000 individuals on low-value care also decreased, from $52,766 to $46,922 from 2014 to 2018. The findings are published online by the journal JAMA Network Open.

“Our study highlights several promising opportunities for targeted interventions that may reduce wasteful health care spending while improving the quality of care,” said John N. Mafi, the study’s lead author and an adjunct physician policy researcher at RAND, a nonprofit research organization.

Given mushrooming deficits and the fact that the Medicare trust fund is running out of cash, there will be enormous pressure to find ways to trim spending in the Medicare program and making significant progress in re

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