Evaluating an Intervention to Reduce Unnecessary Medical Services

Dates of Project: November 2010 through March 2012

Field of Work: Reducing unnecessary medical care

Problem Synopsis: Studies have documented regional and local variations in medical care. By one estimate, some 30 to 40 percent of health care spending in the U.S. goes towards unnecessary, inappropriate, or even harmful services.

Synopsis of the Work: The evaluation studied the work of five medical groups in California, four focused on reducing avoidable emergency room visits and one seeking to increase prescribing of generic, as opposed to brand name, prescription drugs.

The RAND Corporation worked under contract on the evaluation. A large insurance company in California provided comparison data on emergency room utilization and generic prescribing rates.

Key Findings

  • Medical groups participating in the improvement effort were very positive about the approaches learned. All groups reported that they continued many implemented activities and were applying the tools they learned to other issues.

  • The effectiveness of the groups' efforts was mixed. Among the four groups focused on emergency room overuse, two saw a reduction while the other two had no improvement and even experienced an overall increase. The group that worked on increasing generic prescription rates saw improvement for each of the three classes of medications on which it focused.

  • The improvement program generated from $2 to $14 in savings for every $1 spent on the cost of participating and implementing changes.