Researchers from Brigham and Women’s Hospital Detail Findings in Insurance (Who’s Accountable? Low-value Care Received By Medicare Beneficiaries Outside of Their Attributed Health Systems): Insurance

2024 JAN 03 (NewsRx) -- By a News Reporter-Staff News Editor at Health Policy and Law Daily -- Current study results on Insurance have been published. According to news reporting originating in Boston, Massachusetts, by NewsRx journalists, research stated, “Policy makers and payers increasingly hold health systems accountable for spending and quality for their attributed beneficiaries. Low-value care-medical services that offer little or no benefit and have the potential for harm in specific clinical scenarios-received outside of these systems could threaten success on both fronts.”

Funders for this research include Arnold Ventures, NIH National Institute on Aging (NIA), Agency for Healthcare Research and Quality’s Comparative Health System Performance Initiative.

The news reporters obtained a quote from the research from Brigham and Women’s Hospital, “Using national Medicare data for fee-for-service beneficiaries ages sixty-five and older and attributed to 595 US health systems, we describe where and from whom they received forty low-value services during 2017-18 and identify factors associated with out-of-system receipt. Forty-three percent of low-value services received by attributed beneficiaries originated from out-of-system clinicians: 38 percent from specialists, 4 percent from primary care physicians, and 1 percent from advanced practice clinicians. Recipients of low-value care were more likely to obtain that care out of system if age 75 or older (versus ages 65-74), male (versus female), non-Hispanic White (versus other races or ethnicities), rural dwelling (versus metropolitan dwelling), more medically complex, or experiencing lower continuity of care. However, out-of-system service receipt was not associated with recipients’ health systems’ accountable care organization status.”

According to the news reporters, the research concluded: “Health systems might improve quality and reduce spending for their attributed beneficiaries by addressing out-of-system receipt of low-value care-for example, by improving continuity.”

This research has been peer-reviewed.

For more information on this research see: Who’s Accountable? Low-value Care Received By Medicare Beneficiaries Outside of Their Attributed Health Systems. Health Affairs, 2023;42(8):1128-1139. Health Affairs can be contacted at: Project Hope, 7500 Old Georgetown Rd, Ste 600, Bethesda, MD 20814-6133, USA.

Our news correspondents report that additional information may be obtained by contacting Ishani Ganguli, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115, United States. Additional authors for this research include Kathleen L. Mulligan, Maia L. Crawford, Benjamin Usadi, A. James O’Malley, Ching-Wen Wendy Yang, Elliott S. Fisher and Nancy E. Morden.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1377/hlthaff.2022.01319. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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