Year in Research Nominee for 2010
This article examines the benefits and challenges of developing programs that impose disincentives for low-value medical services.
While a number of programs encourage consumption of high-benefit services through low out-of-pocket costs, little effort has been made to create programs that drive down consumption of low-value health services. In this article, the authors define low-value health services, identify the benefits of programs that deter use of low-value services, and discuss the challenges of implementing such programs.
To identify potential low-value medical treatments, the authors searched the Tufts Medical Center Cost-Effectiveness Analysis Registry, which is a database of 1,700 cost-effective analyses. They identified two types of medical services as low-value: those that caused more harm than benefit, and those that provided only marginal health benefits (defined as costing more than $100,000 per quality-adjusted life year.)
Low-value medical services contribute to sky-rocketing health care costs in the United States. While many programs currently encourage increased consumption of high-value medical services, few if any attempt to curb consumption of low-value medical services. Without such programs in place, it may be difficult to control the steady rise in national medical costs.