Are You Paying for Useless Medical Tests?

coins on a black backgroundA new study suggests that you may be spending money on medical tests and procedures that you really don’t need. Researchers examined the insurance claims of approximately 1.5 million American adults with commercial health insurance. The analysis revealed that nearly 8% of patients paid for “low-value services,” and would potentially have been better off keeping their money in the bank and foregoing tests.

What Are Low-Value Services?

Low-value services are considered medical services, such as procedures and tests, that don’t really provide value to the patient once you take into account the expense and the alternative treatments or protocols that could have been followed.

For this most recent study, researchers investigated the cost and benefit of 28 low-value services, including hormone tests for thyroid problems, x-rays and MRI scans for lower-back pain, and brain scans for run-of-the-mill headaches. These tests are only a small sample of low-value services, but can help shed light on the broader picture.

The researchers discovered that these services represented 0.5% of total health care spending in the United States. That’s $32.8 million in low-value services.

  • Scans for ordinary headaches cost $3.6 million
  • MRIs and x-rays for low-back pain accounted for $3.1 million
  • Spinal injections for low-back pain made up $12.1 million

The Demographic Breakdown

Researchers noted that older, male, black or Asian, lower-income, or individuals with high deductible insurance plans were the least likely to spend money on low-value services. Low-value service spending was highest in the south, mid-Atlantic, and mountain regions of the U.S.

A previous report announced that $750 billion of the $2.5 trillion spent each year on health care is lavish and misspent, as many people with good coverage are receiving plenty of care, but unfortunately the low-quality kind. On the flipside, many people with barebones insurance coverage aren’t getting the health care, tests, and procedures they need.

Factors and Solutions

Several factors that may be contributing to the discrepancy between money spent and quality of service received. For instance, doctors may not be trained to discuss the potential risks and benefits of certain services with patients. Patients should always be their best health advocates, but often a patient will request a test from a doctor, and although the test may, in the doctor’s opinion, be unnecessary, the pressure to