Reducing Low-Value Care and Improving Health Care Value

Transitioning to a state of health care delivery that prioritizes value over volume will require balancing “top-down” policy prescriptions with a “bottom-up” approach geared toward affecting local cultural change. Such an approach involves implementing de-adoption strategies tailored to address the behavioral and organizational factors that drive the provision of low-value care within a local health care ecosystem. The article introduces four components that are crucial to achieve the de-adoption target.

Key to these efforts will be the reliable measurement of low-value care; incorporation of low-value care as a component of performance measurement; and the implementation of interventions that align with the motivations of patients, clinicians, and health care organizations. When top-down initiatives are met with an equally robust bottom-up response, the US healthcare system will be well-positioned to reduce low-value care and make considerable strides in improving health care value.