The U.S. spends more money on healthcare than other countries without commensurate improvement in health outcomes. Part of this wasteful spending is attributed to low-value care, services for clinical scenarios that lack evidence and therefore do not benefit health, raise costs, and sometimes cause patient harm. Examples are cardiovascular screening tests for asymptomatic low-risk patients and routine laboratory testing (e.g., bloodwork) prior to low-risk surgery.
It is unclear how low-value care changed during the COVID-19 pandemic. Some experts were optimistic that healthcare providers would adapt to selectively reduce low-value care while prioritizing appropriate care during the challenging pandemic period. Our team studied insurance claims from 2 million Virginians to improve understanding of the value of care provided during the pandemic.
We identified $2 billion in spending for 11 low-value services in Virginia in 2019-2021. Unfortunately, low-value care rebounded to 7% higher than pre-pandemic utilization rates during 2021. While it is encouraging that Virginians with the greatest socioeconomic deprivation experienced 15% less low-value care than pre-pandemic, they also received 16% less appropriate care, suggesting potential widening of healthcare disparities. These results underscore the need for policy-level efforts to address the complex drivers of low-value care and redistribute expenditures to services that enhance health.
