Interventions Aimed at Reducing Use of Low-Value Health Services: A Systematic Review. (October 2017)

• Record Type: Journal Article
• Authors: Colla, Carrie H.; Mainor, Alexander J.; Hargreaves, Courtney; Sequist, Thomas; Morden, Nancy
• Is Part Of: Medical care research and review. Volume 74:Number 5(2017:Oct.)
• Page Start: 507
• Page End: 550
• Publication Date: 2017-10
• Subjects: low-value care -- overuse -- interventions -- systematic review -- waste; Medical care -- United States -- Periodicals; Medical care -- Periodicals; Medical care -- Research -- United States -- Periodicals; Medical care -- Research -- Periodicals; Medical economics -- United States -- Periodicals; Medical economics -- Periodicals; 362.10973
• DOI: 10.1177/1077558716656970
• Languages: English
• ISSNs: 1077-5587

Abstract

The effectiveness of different types of interventions to reduce low-value care has been insufficiently summarized to allow for translation to practice. This article systematically reviews the literature on the effectiveness of interventions to reduce low-value care and the quality of those studies. We found that multicomponent interventions addressing both patient and clinician roles in overuse have the greatest potential to reduce low-value care. Clinical decision support and performance feedback are promising strategies with a solid evidence base, and provider education yields changes by itself and when paired with other strategies. Further research is needed on the effectiveness of pay-for-performance, insurer restrictions, and risk-sharing contracts to reduce use of low-value care. While the literature reveals important evidence on strategies used to reduce low-value care, meaningful gaps persist. More experimentation, paired with rigorous evaluation and publication, is needed.