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Assessing low-value health care services in the military health system
Health affairs
  • Tracey Pérez Pérez Koehlmoos, University of the Health Sciences, in Bethesda, Maryland
  • Cathaleen King Madsen, Henry M. Jackson Foundation for the Advancement of Military Medicine, in Bethesda, Maryland
  • Amanda Banaag, Henry M. Jackson Foundation for the Advancement of Military Medicine
  • Adil H Haider, Aga Khan University
  • Joel . S Weissman, Harvard Medical School
  • Andrew J Schoenfeld, Harvard Medical School
Publication Date
8-1-2019
Document Type
Article
Abstract

Low-value care is the provision of procedures and treatments that provide little or no benefit to patients while increasing the cost of health care. This study examined the provision of low-value care in the Military Heath System (MHS), comparing care delivered in civilian health care facilities (purchased care) to care delivered in Department of Defense-controlled health care facilities (direct care). We used 2014 TRICARE claims data to evaluate the provision of nineteen previously developed measures of low-value care, including diagnostic, screening, and monitoring tests and therapeutic procedures. Of these, six measures appeared more frequently in direct care, while eleven measures appeared more frequently in purchased care-which may reflect the outsourcing of specialist services from the former to the latter. Magnetic resonance imaging for low back pain emerged as the most common low-value service in both care environments and could represent a target for future interventions. As the MHS and the United States increasingly focus on value-based care, the identification of low-value services accompanied by efforts to reduce such inefficient practices could provide greater quality of care at a lower cost.

Citation Information
Tracey Pérez Pérez Koehlmoos, Cathaleen King Madsen, Amanda Banaag, Adil H Haider, et al.. "Assessing low-value health care services in the military health system" Health affairs Vol. 38 Iss. 8 (2019) p. 1351 - 1357
Available at: http://works.bepress.com/adil_haider/101/