More than $750 billion of US health care spending annually represents waste, including approximately $200 billion in overtreatment. Reducing overuse could improve quality and access while reducing spending and has been championed by clinicians through the Choosing Wisely initiative, as well as payers and policymakers. Indirect assessments of waste based on geographic spending variation reveal the scale of the problem, but cannot concretely inform methods of improvement. Direct assessments of low-value care have thus far focused on Medicare only, a limited set of measures, or a specific geographic area. We assessed low-value health care and spending in a large, national, commercially insured population.
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