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4 steps to reduce unnecessary care


Robert Pearl, M.D., writes in Forbes on how to cut back on unneeded healthcare.

He offers four steps:

1. “Empower patient decision-making. New tools, including interactive videos, can help patients objectively evaluate the pros and cons of procedures and treatments. ”

2. “Shift to value-based pay practices. Paying for the value of care, rather than for the volume of services, would eliminate the perverse incentives in the current fee-for- service reimbursement system. A major step in that direction was the announcement from the U.S. Department of Health and Human Services to shift 50 percent of Medicare reimbursements to reward higher quality and pay based on clinical outcomes by 2018. ”

3. “Determine when new approaches are really better. To help accomplish this, every medical journal should require authors to compare new procedures, devices and drugs to current, often lower-cost alternatives. In a similar vein, the FDA should revise its charter to enable it to require that existing therapies be compared to new drugs and devices prior to approval.”

4. “Reform medical malpractice. Changes to litigation for medical malpractice would lessen the burden of unnecessary care associated with defensive medicine. What motivates many doctors to do too much for patients, including much they would never choose to do for themselves, is fear of missing an extremely unlikely problem and being sued.”


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