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Imagining a World Without Low-Value Services: Progress, Barriers, and the Path Forward

The COVID-19 pandemic has exposed shortcomings of the U.S. healthcare system and provided an opportunity to rethink low-value services. Dr. Dhruv Khullar, assistant professor of population health sciences, and colleagues examined how financial and non-financial incentives, uncertainty in clinical decision-making and insufficient partnering with patients and families contribute to the delivery of low-value care in a new article published in the American Journal of Managed Care. Both high- and low-value services have decreased during the pandemic, but without attention and solutions, low-value services will likely return to pre-pandemic levels or higher to make up for lost revenue. The researchers note barriers, like gaps in measuring the value of services, incentives within healthcare organizations to deliver more care, and ineffective patient communications. Reducing low-value services in the future will require a clearer assessment of their economic and health harms, explicitly stating the trade-offs inherent in expending resources on care that does not provide benefits commensurate with its cost, and other interventions.

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