Reducing Overuse and Misuse

Overuse and misuse of health care services are two of the biggest problems affecting the quality and cost of care.

Health care purchasers in several states have implemented well-established and successful initiatives to reduce misuse and overuse of care. In Washington state, such efforts have resulted in a 94 percent reduction in bariatric surgery spending and a $10 million reduction in enteral nutrition spending.

This brief by Bailit Health Purchasing focuses on actions state purchasers can take with contracted plans, providers, and other engaged purchasers to reduce misuse and overuse of health care services.

Such strategies include:

  • Developing a communications strategy to ensure problems of overuse and misuse are being discussed by state leaders.
  • Coordinating efforts with other large health care purchasers.
  • Supporting the efforts of external experts to identify overused and misused services.
  • Introducing evidence-based concepts into policies, regulations, and statutes.
  • Introducing value-based insurance designs that encourage members to utilized high-value services.

With overuse estimated to affect 30 percent of health care services, there is opportunity for purchasers, plans, and providers to work together to reduce the amount of overused and misused health care services being delivered to patients.


With experts estimating that nearly one-third of all U.S. health care spending results in no benefit to the patient, state health care purchasers are increasingly interested in working with health plans, providers, and others to reduce overuse and misuse, improve quality, and manage costs. On a webinar hosted by State Health and Value Strategies, a program of the Robert Wood Johnson Foundation, speakers discussed the actions purchasers can take to reduce unnecessary health care services.


  • Tara Oakman, program officer, Robert Wood Johnson Foundation
  • Megan Burns, MPP, senior consultant, Bailit Health Purchasing
  • Mary Beth Dyer, MPP, senior consultant, Bailit Health Purchasing
  • Neal Kohatsu, MD, MPH, medical director, California Department of Health Care Services

Watch the archived webinar