Health care in the United States is very expensive, and many experts believe one thing contributing to that expense is the abundance of unnecessary or “low-value” health care services provided to patients. Policymakers typically believe that patients receive this unnecessary care because they expect or demand it. However, this month, the University of Michigan revealed new polling data that turns that assumption upside down.
The University of Michigan National Poll on Healthy Aging polled a national sample of approximately 2,000 adults between 50 and 80 years old. Over 50% of those polled agreed that health care providers in general “often recommend medications, tests, or procedures that patients do not really need.” Around 25% said the same about their own providers, and 17% reported that they had a service recommended to them in the past year that they felt they did not need. Tellingly, a large number of patients who received such recommendations went ahead with the test or prescription fill despite feeling it was unnecessary or wasteful, indicating that patients listen to their providers’ recommendations even when it conflicts with the patient’s own beliefs.
By contrast, only 9% of those polled reported that they thought they needed a service their provider said was unneeded. Nearly 80% of those who requested such a service received an explanation from their provider about why the service was not necessary, and most patients understood and accepted these explanations.
These findings suggest that patients may not be the primary drivers of unnecessary services. If true, this means that efforts to reduce overuse by changing patient behavior may be misdirected. It also means that providers may have much more control over these costs than previously thought, including the ability to influence patients by explaining why the requested service is of low value in general, or to that patient in particular.
Medicare Rights continues to advocate for policy solutions that do not penalize or burden patients who lack the expertise to choose the most appropriate care. Instead, we must look for ways to improve provider and patient education—including an understanding of what services are inappropriate—and spur better communications between patients and the health care experts they rely on.
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