Reducing the provision and use of low-value care can increase health care quality and lower costs. Recent national estimates of spending on clinical waste or low-value care top $100 billion, including substantial out-of-pocket spending. The Smarter Health Care Coalition focuses on addressing harmful, low-value care that wastes precious health care dollars that could be spent elsewhere, and presents financial, physical, and mental harm to patients. As a first step, the Coalition sent a letter to Secretary Azar in 2019, highlighting the need to re-examine Medicare’s payment for harmful preventive services highlighted by MedPAC and the US Preventive Services Task Force (USPSTF).

Recent Updates

Low-Value Care Briefing

On September 28th, 2022, the Smarter Health Care Coalition held a virtual briefing focused on proposals policymakers could implement to decrease the prevalence of low-value care and redirect critical resources to high-value care.

The discussion included a review of the recent publication, “Utilization and Spending on Low-Value Medical Care Across Four States, Volume 2”. This briefing featured Dr. Mark Fendrick, Director, University of Michigan Center for Value-Based Insurance Design and Dana Richardson, Chief Executive Officer, Wisconsin Health Information Organization with Katy Spangler, SHCC Co-Director moderating.

“We are robbing low-value care Peter to pay high-value care Paul”

“As equity becomes paramount in national discussions, it’s important to note that VBID programs that reduce or eliminate copayments have positive impacts in reducing disparities in care and improving equity.”

-Dr. Mark Fendrick

Briefing made in part by a generous sponsorship of SHCC member, Pfizer.

Letter to HHS Secretary Xavier Becerra
On April 19, 2021, the Coalition sent a letter to Secretary Becerra recommending that HHS exercise existing authority to:

1. Eliminate Medicare payment for services rated “D” by the US Preventive Services Task Force, per Section 4105 the Affordable Care Act

2. Add flexibility to the Center for Medicare and Medicaid Innovation (CMMI) V-BID Demonstration to allow Medicare Advantage organizations to reduce payments or increase cost-sharing for “D” rated, harmful preventive services, per Section 3021 of the Affordable Care Act

3. Further exercise CMMI authority to build a new, multi-state demonstration project to reduce low-value care in commercial, Medicare, and Medicaid populations.

Increasing Access to Necessary Care During the COVID-19 Pandemic & Beyond- August 2020
On August 13, in collaboration with the University of Michigan Center for Value-Based Insurance Design, we held a interactive webinar that addressed how the pandemic has created a rare opportunity to enhance the efficiency of medical expenditures through payment reform, benefit design, and policy initiatives.

Op-Ed: Re-Examining the Delivery of High-Value Care through COVID-19- June 2020
On June 15, SHCC Co-Director Katy Spangler collaborated with Dr. A. Mark Fendrick, the Director of the University of Michigan Center for Value-Based Insurance Design, and John Rother, the President of the National Coalition on Health Care to publish an article in The Hill about high-value care amidst COVID-19.

COVID-19 has created unprecedented opportunities for change, including the opportunity to fix the under-delivery of evidence-based care and the over-delivery of unnecessary care. The article discusses policy solutions for revolutionizing health care in the coming months and years.

Low-Value Care Letter to Secretary Azar – August 2019
The Coalition submitted a letter to Secretary Azar advocating for the use of existing legislative authority to reduce the provision of low-value care in the Medicare program.