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4 Ways to Cut Spending on Inappropriate Healthcare

Unnecessary healthcare services cost the industry $750 billion annually. For employers looking to bring their healthcare spending into check, this is a good place to start.

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Unnecessary health care services represent 27.5 percent of the exorbitant costs of healthcare—$750 billion is spent annually on unnecessary or inefficient care. For employers looking to bring their health care spending into check, bringing these numbers down is a good place to start.

A recent webinar presented by Catalyst for Payment Reform tackled the issue of inappropriate care and strategies major employers are successfully using to combat the issue—and save money.

“This is a problem that’s not going to go away on its own,” noted Catalyst’s Suzanne Delbanco. “There’s a lot we need to put into place in terms of structure, process and even the right incentives.”

Related: 20 conditions top U.S. health care spending

Inappropriate care covers a variety of services, from unnecessary tests and surgeries to over-prescribing antibiotics to painkillers. One of the main problems, however, is that there’s no definite line that separates “appropriate” from “inappropriate” care—there’s a grey area that might be deemed appropriate in one case but not another. “Studying appropriateness is challenging: it refers to any individual patient, not the population,” Bob Berenson of the Urban Institute told the webinar audience. “One needs a lot of clinical detail that isn’t available from administrative data such as claims.”

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