The Scale of the Problem
Low-value services
817,597
delivered from 2020 to 2022.
People affected
196,727
a year received at least one.
Spending on waste is falling
Low-value care spending, by year
Based on 48 services medical societies consider wasteful, only the tip of the iceberg.
Where the Money Goes
Five services drive 57% of wasteful spending. Hover or tap a bar for details.
Wasteful spending by service, 2020 to 2022
View data
| Service | Wasteful spending | Share of these services that were wasteful | People affected |
|---|---|---|---|
| PICC lines in stage III to V kidney disease | $20,802,178 | 88% | 513 |
| Prostate-specific antigen (PSA) tests | $15,417,944 | 86% | 101,897 |
| Vitamin D deficiency testing | $14,306,161 | 32% | 52,866 |
| Coronary angiography | $12,140,423 | 7% | 810 |
| Annual resting EKGs | $10,171,856 | 31% | 180,264 |
| All other measured services | $53,702,149 |
Where You Live Shapes the Waste
The Alliance is the first in the nation to report waste by neighborhood deprivation.
- Wasteful screening is more common in advantaged neighborhoods.
- Harmful treatments rise with deprivation.
- Pre-op testing waste is the same everywhere, so protocols can fix it.
4.5x
more likely to get opioids for acute low-back pain in the most deprived neighborhoods than the least.
What We Can Do Together
Purchasers
Demand accountability.
Require waste guarantees in value-based contracts and steer members to team-based primary care.
Health plans
Stop paying for waste.
Build waste guarantees into provider contracts and use claim edits for wasteful services.
Providers
Make room for needed care.
Commit to avoiding wasteful services and reach patients with gaps in care.
Method: Milliman MedInsight Health Waste Calculator applied to commercially insured members in the Alliance's All-Payer Claims Database, Jan. 2020 to Dec. 2022. Read the full report.