Reducing low-value testing before cataract surgery was associated with cost savings for financially capitated healthcare systems, but it was also associated with losses for fee-for-service healthcare systems, which could be a barrier to eliminating low-value care, this study finds.
Of 1,054 patients (469 intervention, 585 controls) included in the study:
During 12-months follow-up, preoperative visits increased in the intervention group to 67%, but chest x-rays, laboratory tests, and electrocardiograms remained low.
Three-year projections estimated a modest amount of cost savings ($67,241) for the academic medical centers, but losses ($88,151) for fee-for-service health systems.
The findings suggest that interventions in complex health systems will have trade-offs and unintended consequences, which should be monitored and reported, the authors say.
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