The findings, according to Mafi, highlight worrisome trends and underscore an urgent need to improve the quality and safety of care delivered to Medicare patients. "While Medicare measures hospitals and physicians on quality of care such as flu shots and mammogram rates for breast cancer screening, very little measurement is done on low-value care. I also believe there are many other forces that lead to the status quo prevailing, such as non-evidence-based protocols, force of habit, medical training, and how your colleagues around you practice."

In addition to policymakers continuing to help educate physicians and patients about these risks and continuing with payment reforms that discourage low-value practices, the researchers recommend incorporating more computer-based decision-support tools that can dissuade physicians from exercising low-value care.

"I think it does need to start with physician payment reform and trying to design payment policies that are not overly complex but also do not incentivize the delivery of expensive procedures that may not benefit patients," said Mafi, adding that "ultimately, given the multifactorial nature of this problem, it will require multifaceted solutions as I and others have argued previously, including a combination of physician payment reform, physician education and engagement, and seamless electronic health record decision support tools."

The study takes into account only a small portion of unnecessary care that is amenable to measurement.

The findings were published in JAMA Network Open.

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