(HealthDay News) — Medicare spent at least $1.9 billion in 2009 on 26 types of tests and procedures that offer patients few or no health benefits, according to a new study published online May 12 in JAMA Internal Medicine.
At least one in four Medicare patients received at least one of these services in 2009, according to the analysis of claims made by more than 1.3 million Medicare patients that year, according to Harvard Medical School researchers. The 26 procedures examined in the study are among hundreds of health care services known to provide little or no medical gain to patients in many cases, the researchers noted.
Some of the 26 services included in the study — such as arthroscopic debridement for knee osteoarthritis — almost never provide any health benefit to patients, the researchers said. However, some of the services can be wasteful in some cases but provide important benefits in others. For example, lower back imaging is of little benefit to patients with muscle soreness but can save the lives of patients with cancer or a spinal abscess.
“Because the value of a service depends on the patient, it is challenging to devise payment and coverage policies that limit wasteful care but not valuable care. Some tests and treatments that are wasteful across the board are easy targets — we can stop paying for them. But for most services, incentives that allow providers greater discretion at the point of care may be needed to cut significant amounts of waste while minimizing unintended consequences,” study author J. Michael McWilliams, MD, PhD, associate professor of health care policy, said in a Harvard news release. McWilliams is also a practicing general internist at Brigham and Women’s Hospital in Boston.