RT Journal
A1 Berwick DM, Hackbarth AD
T1 ELiminating waste in us health care
JF JAMA
JO JAMA
YR 2012
FD April 11
VO 307
IS 14
SP 1513
OP 1516
DO 10.1001/jama.2012.362
UL http://dx.doi.org/10.1001/jama.2012.362
AB The need is urgent to bring US health care costs into a sustainable range for both public and private payers. Commonly, programs to contain costs use cuts, such as reductions in payment levels, benefit structures, and eligibility. A less harmful strategy would reduce waste, not value-added care. The opportunity is immense. In just 6 categories of waste—overtreatment, failures of care coordination, failures in execution of care processes, administrative complexity, pricing failures, and fraud and abuse—the sum of the lowest available estimates exceeds 20% of total health care expenditures. The actual total may be far greater. The savings potentially achievable from systematic, comprehensive, and cooperative pursuit of even a fractional reduction in waste are far higher than from more direct and blunter cuts in care and coverage. The potential economic dislocations, however, are severe and require mitigation through careful transition strategies.