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 being addressed in health care reform bills proposed by the Obama administration and Congress this year.  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

Thinking Outside the Pillbox: A System-wide Approach to Improving Patient Medication Adherence for Chronic Disease
In its new research brief, "Thinking Outside the Pillbox," NEHI addresses the root causes of poor patient medication adherence - a significant contributor to overall health care waste - and offers promising solutions to improve adherence, particularly among chronic disease patients.

Remaking Primary Care: From Crisis to Opportunity
A growing body of evidence suggests that a strong, high-quality primary care system is directly related to superior health outcomes in other nations. Yet the current primary care system in the United States is seen by practitioners and patients alike as ineffecient, fragmented and expensive. In this background paper, NEHI highlights the driving factors behind the primary care system crisis in the United States and offers comprehensive, innovative solutions.

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. For more information on the project click here .