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Editor's Note |

Developing Methods for Less Is More

Mitchell H. Katz, MD; Deborah Grady, MD, MPH; Rita F. Redberg, MD, MSc
JAMA Intern Med. 2014;174(7):1076. doi:10.1001/jamainternmed.2014.1101.
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We have been very gratified by the response of our readers to our Less Is More series. Physicians and patients have endorsed the need to eliminate medical practices that confer no benefit but have true risks. For the field to move forward, however, we need better ways to measure unnecessary care. In that spirit, we thought that this article by Schwartz et al1 was an important contribution. The authors developed a list of 26 measures of low-value care that could be assessed using claims data and then applied them to a large sample of Medicare recipients. Depending on the level of sensitivity used, their measures identified 25% to 42% of beneficiaries as having received low-value care. This article highlights the opportunity for eliminating unnecessary care, and we hope that others will use and improve the methods developed by the authors. Most important, we hope that development of better measures of low-value care will ultimately spur development of interventions to reduce unnecessary care.

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