Encouraging high-value preventive medical care may unintentionally increase use of health services that provide little or no health benefit, according to a new study by researchers at the University of Michigan School of Public Health.
Published in Health Affairs, the study examined an intervention that lowered cost-sharing for evidence-based, high-value preventive services for specific populations. “If we want to increase the efficiency of the health care system, we need to do more than encourage use of high-value services,” said Ms. Betsy Cliff, PhD candidate at Michigan Public Health and lead author of the study.
“We need to explicitly discourage low-value services. They’re not delivered separately in the health care system, so we shouldn’t treat them separately.”
Quality improvement programs have focused on increasing the use of high-value services. This study focused on a state employee health benefit program with reduced or eliminated consumer cost sharing for targeted services.
Researchers used administrative data of about 64,000 enrollees to look at service claims and used guidelines from national organizations to categorize high- and low-value services. They found an increased percentage of people received a high-value preventive service, an intended effect.
But it also increased the percentage receiving low-value services, which was not intended by the program. Some of these services are recommended for specific populations but are often offered as part of preventive care services package to patients for whom they offer little or no benefit. “Low-value care represents wasted money and likely ineffective medical care,” Ms. Cliff said.Friday Letter Submission