Reducing overuse of c-sections and cervical cancer screening
Overuse is ubiquitous across medical specialties, and obstetrics and gynecology are no exceptions. Two recent studies shine a light on the problem of overuse in women's health. More
Hospitals overuse medical tests and procedures that don’t help patients, analysis finds
“Overuse is ubiquitous,” said Dr. Vikas Saini, president of the Lown Institute. “Nearly every hospital is doing at least some things that patients don’t really need.”
“There is improvement,” he added, “but it is very slow and it is very uneven.”
Saini, of the Lown Institute, said he hopes more attention on overuse will push hospitals to do better. “We’re trying to create new norms for what it means to be a good hospital,” he said.
Overdiagnosis and overtreatment – the experts aren’t immune either
The US health system pushes treatment over prevention. This approach has many flaws, one of the most unfortunate and costly being overdiagnosis and overtreatment. More
Enough to Wreck Their Rest: $10,322 for a Sleep Study
According to Dr. Vikas Saini, president of the Lown Institute, a think tank that analyzes low-value health care, sleep studies fall into a gray zone.
“They are incredibly useful and necessary in certain clinical circumstances,” he said. “But it’s known to be one that can be overused.”
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“Do I need to be knocked out for this procedure?” And other questions about anesthesia overuse
General anesthesia is necessary for some medical procedures, but can put children and older adults at risk of harm. In this guest blog, a medical student shares what they're learning about avoiding anesthesia overuse. More
The Vaccine Rollout Is Changing How We Think about Prescription Meds
A new survey reveals that, for the first time, many Americans see pharmaceutical companies as brand names, just like Nike or Amazon More
Pandemic Leads Doctors to Rethink Unnecessary Treatment
Covid-caused delays in medical treatments and surgeries are producing data for health care providers to take another look at what’s needed and what isn’t. More
Colorado Will Pay Hospitals to Close Expensive Free-Standing ERs
Colorado health officials so abhor the high costs associated with free-standing emergency rooms they’re offering to pay hospitals to shut the facilities down. The state wants hospitals to convert them to other purposes, such as providing primary care or mental health services. More
Time To Set Aside The Term ‘Low-Value Care’—Focus On Achieving High-Value Care For All
Let us begin anew with language that reinforces equitable access to care and treatment of African American and Latinx patients, their families, communities, clinicians, and care teams. More
Patterns and Determinants of Low-Value Preoperative Testing in Michigan
This cohort study examines use of preoperative testing before 3 low-risk ambulatory surgical procedures across diverse practice settings in Michigan. More
Less routine care during Covid-19 is not a crisis
How can the avoidance of routine care during the pandemic benefit patients? New research on the physical and financial harms from low-value preventive care show that the pandemic might have a "silver lining." More
Op-Ed: How doctor culture sinks U.S. healthcare
Physicians' values and norms save our lives and cost us dearly. More
Designing a Successful Primary Care Physician Capitation Model
This Viewpoint proposes 7 elements necessary for a successful transition from a fee-for-service (FFS) to a capitated payment model for primary care physicians, all intended to sustain their ability to improve the quality and value of the care they provide while reducing costs. More
Measuring what matters: How hospital rankings are evolving
Last year, the Lown Institute, a Brookline, Mass.-based nonpartisan healthcare think tank, broke new ground with the release of the Lown Hospitals Index that includes metrics such as racial inclusivity, pay equity and community benefit spending. The institute is now releasing updated 2021 results for the full index starting with the May 4 announcement of the top hospitals in the U.S. for avoiding overuse of low-value tests and procedures. "What we're trying to show is the hospitals at the top of our list are showing that it can be done. It is quite possible. So, for us the rationale for doing this is to show by example what can be done and then participate in what needs to be a broader movement to have American healthcare to move in that direction. It's only when we're able to do that will we be able to solve the deeper problems in healthcare, including affordability," said Dr. Vikas Saini, president of the Lown Institute. More
Viewpoint: A Path Forward for Alternative Payment
This Viewpoint explores existing payment models and waste elimination incentives and proposes a new approach to addressing waste in health care. More
Variability and Costs of Low-Value Preoperative Testing for Cataract Surgery Within the Veterans Health Administration
This cohort study of Veterans Health Administration records examines the prevalence of low-value preoperative tests for eye cataract operations and associations with patient demographic characteristics, procedure type, and facility size. More
Southern and for-profit hospitals more frequently deliver unnecessary tests and procedures: analysis
Overuse of unnecessary healthcare services was most common among for-profit hospitals, nonteaching hospitals and those located in the southern U.S., according to a new review of Medicare claims conducted by the Lown Institute. The study found more than 1.3 million low-value tests and procedures delivered by 3,351 U.S. hospitals between Jan. 1, 2015, and Dec. 31, 2017—a rate of one such unnecessary service delivered to an older adult every 80 seconds. More
VIDEO: 2021’s Top Hospitals for Avoiding Overuse
In case you missed the avoiding overuse launch event, you can watch the full recording here! Featuring Vikas Saini and Shannon Brownlee along with guest experts Mike Chernew, Rita Redberg, and Mark Smith, as well as hospital leaders Pete Healy and Gary Kaplan. More
Hospitals in South Fare Worst in Avoiding Low-Value Tests, Analysis Finds
More than 1 million tests and procedures that Medicare patients received in hospitals over a three-year period were likely not needed, according to an analysis released today. Most of the top performing hospitals in the Lown Institute Hospital Index are not from large, well-known health systems that appear on the annual rankings of U.S. News and World Report—in fact, only Cleveland Clinic, which ranked 58th on the Lown list, is on the U.S. News honor roll, according to the a statement on findings. More
Report: Worst Hospitals for Unnecessary Procedures
In what was called a first-of-its-kind list, the Lown Institute on Tuesday released the names of the worst 50 and best 50 hospitals ranked by how frequently their patients had any of 12 procedures largely regarded as unnecessary. Lown president Vikas Saini, MD, said for the hospitals with the most overuse, "it appears there is a culture. The evidence that these procedures are not useful hasn't penetrated or is being ignored." Saini warned that overuse isn't just a matter of the hospitals performing more revenue-generating procedures; patients could be harmed. "When you're getting stuff done that's not necessary, you are subjecting yourself to a risk of harm, and even if the harm is very small, even if the risk is small, it's still real," he said, especially if you're the unfortunate person that develops that complication. More