Waste and Inefficiency in Health Care

What We're Thinking

Experts estimate that 30% of the $2.3 trillion spent on health care is wasted, meaning it could be eliminated without reducing the quality of patient care. But before this waste in our health care system can be eliminated, it must first be identified -- where it is, why and how much.

By identifying waste and the steps necessary to eliminate it, NEHI believes we can make our health care system more streamlined, value-driven and focused on quality patient care. 

What We're Doing

Comparative Effectiveness Research

Policymakers in and beyond Washington are calling for the expanded use of comparative effectiveness research (CER) in the U.S. health care system, and proposals to expand government-funded CER are likely to be part of the health care agenda put forth by the new president and Congress in 2009.  What impact will CER have on patient care and decision-making throughout the health care system -- and, in turn, on innovation in health care products and processes?

NEHI is launching an initiative aimed at addressing that critical question.  In the coming months, NEHI will conduct focus groups to gather cross-industry views on the impact of CER on health care innovation; produce an issue brief; convene an expert roundtable to further explore key questions; hold a larger policy forum; and publish a more comprehensive white paper providing a roadmap on CER and its impact on innovation.

Click here for further background on CER and the critical questions NEHI aims to answer.

Waste and Inefficiency

How Many More Studies Will It Take? A Compendium of Evidence from 1998-2006
This compendium, published  with a grant from Blue Cross Blue Shield of Massachusetts, presents compelling evidence of waste and the need -- and opportunities -- to address it.  It includes two important resources: An annotated bibliography, published by RAND in 2001, of the literature on quality of care in the United States between 1993 and 1998, and a NEHI compendium of the 460 most reliable sources on waste and inefficiency in health care from 1998 to 2006.

Waste and Inefficiency in the U.S. Health Care System
To address the variance between agreed-upon standards of care and actual care provided by strengthening physician guidelines, we must overcome key barriers to adherence.

Improving Physician Adherence to Clinical Practice Guidelines
To address the variance between agreed-upon standards of care and actual care provided by strengthening physician guidelines, we must overcome key barriers to adherence.

Emergency Department Overuse Study

NEHI is currently working on a joint initiative with the Institute for Healthcare Improvement (IHI) to identify and test strategies for reducing non-urgent emergency department (ED) visits. Non-urgent ED use, on the rise due to an "open-door" ED policy, a weakened primary care system and a provider shortage, is problematic from both a health care cost and quality standpoint. The NEHI/IHI partnership will test innovative strategies for reducing non-urgent ED use and will provide a roadmap for organizations to address the problem. View our announcement of the partnership here.