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Use ‘supply side’ to cut low-value care

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An opinion piece in The New England Journal of Medicine about best to reduce low-value care says, among other things:

“Population-based, supply-side incentives with outcome monitoring may prove to be our best alternative. They reduce reliance on blunt payment instruments or service-level coverage decisions and performance-based payment. Such incentives, like those in accountable care contracts, may reduce use of low-value care through partial capitation or shared savings paired with meaningful outcome monitoring and broad quality measurement. Accountable care contracts encourage physicians to consider value, since incentives are explicitly aligned with quality and cost. …{P}hysicians may be ready for a stewardship role in an environment where quality and payments are aligned. Although we have little evidence on whether accountable care contracts will affect low-value care, such population-based incentive structures may have the best potential to promote within-clinic experimentation to find approaches that increase effective care and reduce low-value care. Accountable care contracts should encourage investment in practice policy setting and other approaches — patient decision aids, clinical decision support, and clinician education and feedback.”

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